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

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.

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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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Assessment of risk factors associated with vitamin D status among children of an urban and a rural areas of Bangladesh

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v46i2.49024 ◽

2020 ◽

Vol 46 (2) ◽

pp. 134-141

Author(s):

Anamika Saha ◽

Md Salim Shakur ◽

Runa Laila ◽

Salomee Shakur ◽

Md Sohel Shomik ◽

...

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Hypovitaminosis D ◽

Urban Children ◽

Outpatient Department ◽

P Value ◽

Rural Children ◽

Vitamin D Status ◽

Factors Associated

Background: Vitamin D deficiency is one of the most common micronutrient deficiency in children worldwide, even in Bangladesh. However, to date, the prevalence of vitamin D deficiency among children of different region of Bangladesh is less reported. Objective: This study was conducted to assess vitamin D status of urban and rural Bangladeshi children including the risk factors associated with vitamin D deficiency are also evaluated. Methods: A multi-centre (urban and rural based), cross sectional study was done from July 2016 to June 2017, using serum 25(OH) vitamin D3 as a marker of nutritional vitamin D status. Urban and rural children were taken from Paediatric Outpatient Department, United Hospital Limited. Dhaka and Medical Outpatient Department, Upazila Health Complex, Ghatail, Tangail respectively. Children of 1-10 years age attending OPD with mild undernutrition (<–1 SD z score) and/or clinical features suggestive of vitamin D deficiency were included in the study. Results: A total 150 children were studied with 102 (68.0%) urban and 48 (32.0%) rural children. Hypovitaminosis D (25-OHD <30ng/ml) was found in 75.0% of children. Hypovitaminosis D was found significantly more in urban children (81.0%) compared to rural (62.0%) children (OR=0.382, 95% CI: 0.177-0.822, p value <0.05). Inadequate exposure to sunlight was significantly associated with hypovitaminosis D compared to adequate sun exposure and it was about 2.5 times higher (OR=2.475, 95% CI: 1.139-5.380, p value <0.05). No significant associations of vitamin D deficiency were detected with skin color of children, covering clothes of mother, exclusive breast feeding, limb pain and anthropometric status. Children of higher educated mother (above Secondary School Certificate) (OR=0.412, 95% CI: 0.189-0.900) were more associated with vitamin D deficiency. Conclusion: Vitamin D deficiency (VDD) is prevalent among Bangladeshi children, urban children being more vulnerable to VDD. Adoption of a screening programme for children of all age group and implementation of preventive strategies for VDD through public health policies are strongly recommended. Bangladesh Med Res Counc Bull 2020; 46(2): 134-141

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Nutritional Knowledge and Practice among Patients with Non-communicable Diseases Attending Mbale Regional Referral Hospital in Eastern Uganda: A Cross Sectional Study

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2019/v37i130154 ◽

2019 ◽

pp. 1-11

Author(s):

Esther Nambala ◽

Jayne Byakika-Tusiime ◽

Yahaya Gavamukulya

Keyword(s):

Cross Sectional Study ◽

Nutrition Knowledge ◽

Referral Hospital ◽

P Value ◽

Nutritional Knowledge ◽

Sectional Study ◽

Cross Sectional ◽

Regional Referral Hospital ◽

Adequate Knowledge ◽

Eastern Uganda

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.

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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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Practice, Perceived Barriers and Motivating factors to medical-incident reporting: A cross-section survey of health care providers at Mbarara Regional Referral Hospital, Southwestern Uganda.

10.21203/rs.2.13919/v4 ◽

2020 ◽

Author(s):

Naome Turyahabwe ◽

James Mwesigwa ◽

Christine Atuhairwe ◽

Ivan Mugisha Taremwa

Keyword(s):

Health Care ◽

Patient Safety ◽

Health Care Providers ◽

Incident Reporting ◽

Referral Hospital ◽

Perceived Barriers ◽

P Value ◽

Motivating Factors ◽

Care Providers ◽

Regional Referral Hospital

Abstract Background : Medical-incident reporting (MIR) ensures patient safety and delivery of quality of care by minimizing unintentional harm among health care providers. We explored medical-incident reporting practices, perceived barriers and motivating factors among health care providers at Mbarara Regional Referral Hospital (MRRH). Methods : We conducted a cross-sectional descriptive study on 158 health provider at Mbarara Regional Referral Hospital (MRRH), Western Uganda. Data was gathered using a structured questionnaire and analyzed with SPSS. The chi-square was used to determine factors associated with MIR at MRRH. Results : The results showed that there was no formal incident reporting structure. However the medical-incidences identified were: medication errors (89.9%), diagnostic errors (71.5%), surgical errors (52.5%) and preventive error (47.7%). The motivating factors of MIR were: establishment of a good communication system, instituting corrective action on the reported incidents and reinforcing health workers knowledge on MIR (p-value 0.004); presence of effective organizational systems like: written guidelines, practices of open door policy, no blame approach, and team work were significantly associated with MIR (p-value 0.000). On the other hand, perceived barriers to MIR were: lack of knowledge on incidents and their reporting, non-existence of an incident reporting team and fear of being punished (p value 0.669). Conclusion : Medical Incident Reporting at MRRH was sub-optimal. Therefore setting up an incident management team and conducting routine training MIR among health care workers will increase patient safety.

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Anemia and risk factors among children 6 months to 59 months old: a hospital-based prospective study

Bhutan Health Journal ◽

10.47811/bhj.45 ◽

2017 ◽

Vol 3 (2) ◽

pp. 1-5

Author(s):

Kalpana Chhetri ◽

Mimi L. Mynak ◽

Kuenley Pedon

Keyword(s):

Risk Factors ◽

Family Income ◽

Referral Hospital ◽

P Value ◽

Major Public Health Problem ◽

Severe Anemia ◽

Pediatric Ward ◽

Factors Associated ◽

National Referral Hospital ◽

Prevalence Of Anemia

Background: Anemia is a major public health problem and the most common nutritional issue in many parts of the world, especially in developing countries. The objective of the study was to determine the prevalence of anemia and factors associated with anemia among children 6 to 59 months old admitted in Pediatric ward of National Referral Hospital, Thimphu. Methods: A hospital-based descriptive cross-sectional study. All children 6 months to 59 months old admitted in Pediatric ward of National Referral Hospital, Thimphu were included in the study. A total of 353 children were included in the study. Data was analyzed using STATA 12. Results: The prevalence of anemia was 58.4%. Mild, moderate and severe anemia was 65%, 22.8% and 12.2% respectively. Anemia was more common in children less than 2 years old. The majority of the children had microcytic hypochromic anemia with low serum iron. The risk factors associated with moderate to severe anemia were malnutrition [p-value 0.001, OR 32.1, 95% CI (9.10-118.8)], low education level of caregiver [p value 0.0019, OR 5.10, 95% CI (1.66-15.68), monthly family income less than 5000/month [p-value 0.0004, OR 4.6 , 95% CI (1.89-11.54)] and chronic illness [p value 0.030, OR 2.43, 95% CI (1.08-5.47)]. Conclusion: This study found a high prevalence of anemia in under-5 children, with iron deficiency accounting for the majority of the cases. Children under 2 years were affected more.

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