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PREVALENCE OF PNEUMONIA AND ITS ASSOCIATED FACTORS IN CHILDREN UNDER FIVE YEARS AT SOROTI REGIONAL REFERRAL HOSPITAL
(2024-06-02) OKUSA, JOHN MICHAEL
Background: Pneumonia continues to be the foremost cause of morbidity and mortality among
children under the age of five, resulting in the demise of 740,180 children globally and contributing
to 14% of all deaths in this age group, with 22% of deaths occurring among children aged 1 to 5
years. Most researches have been conducted to establish factors that contribute to pneumonia but
have reported inconsistent findings.
Objectives: This study assessed the prevalence of pneumonia and its associated factors in children
under-five years.
Methodology: This was a cross sectional study at the Pediatric Department of Soroti Regional
Referral Hospital, from the month of March to April 2024. The study included 385 children aged
2 to 59 months admitted to the pediatric ward. Pneumonia diagnosis was made according to the
2014 standard clinical WHO and integrated management of new born and childhood illness
classification of cases. Semi-structured questionnaires were used to collect data on socio demographic, socioeconomic, child related and facility related factors and bivariate analysis using
Chi-square in SPSS version 27 was done to assess for the factors independently associated with
pneumonia.
Results: Of the 385 children admitted in the pediatric ward, 97 (25.2%) had pneumonia. Factors
significantly associated with pneumonia included: age of the child (p= <0.001), level of maternal
education (p= <0.001), housing conditions (p= <0.001), use of wood as fuel (p= <0.001),
immunization status (p= <0.001), nutrition status (p= <0.001), exclusive breastfeeding (p=0.006),
history of ARTI (p= <0.001), Vitamin A deficiency (p= <0.001), hospital stay (p= <0.001) and
accessibility to health care services (p= <0.001).
Conclusion: The prevalence of pneumonia in children under-five years was high. Most of the
factors associated with pneumonia are modifiable; addressing these factors could reduce this
prevalence. The study recommends implementation of a comprehensive health care program at the
community level in the study area to address the factors associated with pneumonia above.
Motion Prediction with Gaussian processes for Safe Human-Robot Interaction in Virtual Environments
(IEEE, 2023) STANLEY, MUGISHA; VAMSI, KRISHNA GUDA; CHRISTINE, CHEVALLEREAU; DAMIEN, CHABLAT; MATTEO, ZOPPI
ABSTRACT
Humans use collaborative robots as tools for accomplishing various tasks. The interaction
between humans and robots happens in tight shared workspaces. However, these machines must be safe
to operate alongside humans to minimize the risk of accidental collisions. Ensuring safety imposes many
constraints, such as reduced torque and velocity limits during operation, increasing the time to accomplish
manytasks.However,forapplicationssuchasusingcollaborativerobotsashapticinterfaceswithintermittent
contacts, speed limitations result in poor user experiences. This research aims to improve the efficiency of
a collaborative robot while improving the safety of the human user. We used Gaussian process models to
predict human hand motion and developed strategies for human intention detection to improve the time for
the robot while improving human security in a virtual environment. We then studied the effect of prediction.
Results from comparisons show that the strategies with prediction model improved robot time by 3% and
safety by 17%. When used alongside gaze for prediction, the strategy based on the Gaussian process model
resulted into an improvement of the robot time by 2% and the safety by 13%.
Treatment success rate and associated factors among drug susceptible tuberculosis individuals in St. Kizito Hospital, Matany, Napakdistrict, Karamoja region.
(PLOS One Publishers, 2024-05-14) Ronald, Opito; Keneth, Kwenya; Saadick Mugerwa, Ssentongo; Mark, Kizito; Susan, Alwedo; Baker, Bakashaba; Yunus, Miya; Lameck, Bukenya; Eddy, Okwir; Lilian, Angwech Onega; Andrew, Kazibwe; Emmanuel, Othieno; Fred, Kirya; Peter, Olupot‑Olupot
Background Tuberculosis (TB) is the leading cause of death among infectious agents globally. An estimated 10million people are newly diagnosed and 1.5 million die of the disease annually. Uganda is among the 30highTB-burdened countries, with Karamoja having a significant contribution of the disease incidence in the country. Control of the disease in Karamoja is complex because a majority of the at-risk population remains mobile; partly because of the nomadic lifestyle. This study, therefore, aimed at describing the factors associated with drug-susceptible TB treatment success rate (TSR) in the Karamoja region.
Methods
This was a retrospective study on case notes of all individuals diagnosed with and treated for drug-susceptible TB at St. Kizito Hospital Matany, Napak district, Karamoja from 1 2020 to 31 st st Jan December 2021. Data were abstracted using a customized data abstraction tool. Data analyses were done using Stata statistical software, version 15.0. A chi-square test was conducted to compare treatment success rates between the years 2020 and 2021, while Modified Poisson regression analysis was performed at a multivariable level to determine the factors associated with treatment success.
Results
We studied records of 1234 participants whose median age was 31(IQR: 13–49) years. Children below 15 years of age accounted for 26.2% (n = 323). The overall treatment success rate for the study period was 79.3%(95%CI; 77.0%-81.5%), with a statistically significant variation in 2020 and 2021, 75.4% (422/560) vs 82.4% (557/674) respectively, (P = 0.002). The commonest reported treatment outcome was treatment completion at 52 %(n = 647) and death at wasat10.4%(n=129). Older age, undernutrition (Red MUAC), and HIV-positive status were significantly associated with lower treatment success: aPR = 0.87(95% CI; 0.80–0.94), aPR = 0.91 (95%CI; 0.85–0.98) and aPR = 0.88 (95%CI; 0.78–0.98); respectively. Patients who were enrolled in 2021 had a high prevalence of treatment success compared to those enrolled in 2020, aPR = 1.09 (95%CI; 1.03–1.16).
Conclusion
TBTSR in Matany Hospital was suboptimal. Older age, poor nutrition, and being HIV-positive were negative predictors of treatment success. We propose integrating nutrition and HIV care into TB programming to improve treatment success
Isoniazid preventive therapy completion between July-September 2019: A comparison across HIV differentiated service delivery models in Uganda
(PLOS One Publishers, 2024-01-02) Levicatus, Mugenyi; Proscovia, Mukonzo Namuwenge; Simple, Ouma; Baker, Bakashaba; Mastula, Nanfuka; Jennifer, Zech; Collins, Agaba; Andrew, Mijumbi Ojok; Fedress, Kaliba; John, Bossa Kato; Ronald, Opito; Yunus, Miya; Cordelia, Katureebe; Yael, Hirsch-Moverman
Background
Tuberculosis (TB) remains the leading cause of death among people living with HIV
(PLHIV). To prevent TB among PLHIV, the Ugandan national guidelines recommend Isoniazid
Preventive Therapy (IPT) across differentiated service delivery (DSD) models, an effective
way of delivering ART. DSD models include Community Drug Distribution Point
(CDDP), Community Client-led ART Delivery (CCLAD), Facility-Based Individual Management
(FBIM), Facility-Based Group (FBG), and Fast Track Drug Refill (FTDR). Little is
known about the impact of delivering IPT through DSD.
Methods
We reviewed medical records of PLHIV who initiated IPT between June-September 2019 at
TASO Soroti (TS), Katakwi Hospital (KH) and Soroti Regional Referral Hospital (SRRH).
We defined IPT completion as completing a course of isoniazid within 6–9 months. We utilized
a modified Poisson regression to compare IPT completion across DSD models and
determine factors associated with IPT completion in each DSD model.
Results
Data from 2968 PLHIV were reviewed (SRRH: 50.2%, TS: 25.8%, KH: 24.0%); females:
60.7%; first-line ART: 91.7%; and Integrase Strand Transfer Inhibitor (INSTI)-based regimen:
61.9%. At IPT initiation, the median age and duration on ART were 41.5 (interquartile
range [IQR]; 32.3–50.2) and 6.0 (IQR: 3.7–8.6) years, respectively. IPT completion overall was 92.8% (95%CI: 91.8–93.7%); highest in CDDP (98.1%, 95%CI: 95.0–99.3%) and lowest
in FBG (85.8%, 95%CI: 79.0–90.7%). Compared to FBIM, IPT completion was significantly
higher in CDDP (adjusted rate ratio [aRR] = 1.15, 95%CI: 1.09–1.22) and CCLAD
(aRR = 1.09, 95% CI 1.02–1.16). In facility-based models, IPT completion differed between
sites (p<0.001). IPT completion increased with age for FBIM and CCLAD and was lower
among female participants in the CCLAD (aRR = 0.82, 95%CI 0.67–0.97).
Conclusion
IPT completion was high overall but highest in community-based models. Our findings provide
evidence that supports integration of IPT within DSD models for ART delivery in
Uganda and similar settings.
Diagnostic and pre-treatment intervals among patients with cervical cancer attending care at the Uganda Cancer Institute: a cross-sectional study
(BMC Women's Health, 2023-11-27) Jackie, Lalam Lacika; Henry, Wabinga; Joseph, Kagaayi; Ronald, Opito; Christopher, Garimoi Orach; Amos Deogratius, Mwaka
Abstract
Background Majority of patients with cervical cancer in the low- and middle-income countries experience long
diagnostic and pre-treatment intervals. This study sought to determine the factors associated with the diagnostic and
pre-treatment intervals among patients with cervical cancer.
Methods This was a cross-sectional study conducted at the Uganda Cancer Institute (UCI) during October 2019 to
January 2020. Patients aged ≥ 18 years with histological diagnosis of cervical cancer were consecutively sampled. Data
were collected using a pre-tested semi-structured questionnaire and a data abstraction form. Diagnostic intervals,
defined as the time between first visit of a patient to a primary healthcare provider to time of getting confirmed
diagnosis, of ≤ 3 months was defined as early & >3 months as late. Pre-treatment intervals, which is the time from
histological diagnosis to starting cancer chemo-radiotherapy of ≤ 1 month was defined as early and > 1 month as late.
Data were analysed using STATA version 14.0. We used modified Poisson regression models with robust variance to
determine socio-demographic and clinical factors associated with the intervals.
Results The mean age of the participants was 50.0 ± 11.7 years. The median diagnostic and pre-treatment intervals
were 3.1 (IQR: 1.4–8.2) months and 2.4 (IQR: 1.2–4.1) months respectively. Half of the participants, 49.6% (200/403)
were diagnosed early; one in 5 patients, 20.1% (81/403) promptly (within one month) initiated cancer chemoradiotherapy.
Participants more likely to be diagnosed early included those referred from district hospitals (level 5)
(aPR = 2.29; 95%CI: 1.60–3.26) and with squamous cell carcinomas (aPR = 1.55; 95%CI: 1.07–2.23). Participants more
likely to be diagnosed late included those who first discussed their symptoms with relatives, (aPR = 0.77; 95%CI:
(0.60–0.98), had > 2 pre-referral visits (aPR = 0.75; 95%CI (0.61–0.92), and had advanced stage (stages 3 or 4) (aPR = 0.68;
95%CI: 0.55–0.85). Participants more likely to initiate cancer chemo-radiotherapy early included older patients (≥ 60
years) (aPR = 2.44; 95%CI: 1.18–5.03). Patients likely to start treatment late were those who had ≥2 pre-referral visits (aPR = 0.63; 95%CI: 0.41–0.98) and those that took 3 - 6 months with symptoms before seeking healthcare (aPR =
0.52;95%CI: 0.29 - 0.95).
Conclusion
Interventions to promote prompt health-seeking and early diagnosis of cervical cancer need to target
primary healthcare facilities and aim to enhance capacity of primary healthcare professionals to promptly initiate
diagnostic investigations. Patients aged < 60 years require targeted interventions to promote prompt initiation of
chemo-radiation therapy.