Mulago Hospital

About: Mulago Hospital is a healthcare organization based out in Kampala, Uganda. It is known for research contribution in the topics: Population & Health care. The organization has 542 authors who have published 545 publications receiving 34804 citations.

Antibiotic use knowledge and behaviour at a Ugandan University

Abstract: the study evaluated knowledge, attitude and behaviour of antibiotic usage in two student groups at Makerere University in Uganda. Out of 30,000 students enrolled at the university, 1000 were asked to participate by filling a self administered questionnaire. The sampling group was divided into Group A which included students from the College of health sciences and group B made of students of other faculties. the response rate was 72.1% and 58.8% were male. the sample size distribution didn’t differ from the university gender distribution Z=1.57, p< 0.05. the use of antibiotics to avoid illness was reported by 24.0% in group A and 31.8% in group B (P<0.05). When asked the course of action if they felt the antibiotic being used was not helpful, 35.1% in group A and 50.6% in B said they would go back to the same health care worker for advice while 1.4% and 9.9% respectively would switch health care provider. Up to 69.3% of the respondents reported antibiotics use in the last twelve month. the most common symptoms reported as the primary reason for antibiotic use was cough at 16%, followed by sore throat at 7.1% and common cold at 6.1%. the high reliance on health care personnel for prescription was rather encouraging and it gives health workers a window of opportunity to promote rational antibiotic use when prescribing to patients. However, for this to materialize the health workers must be aware of antibiotic resistance and ways to combat it. therefore constant training and encouragement must be given to the health care workers and the public.

Injection-induced sciatic nerve injury in Ugandan children.

Abstract: In developing countries, sciatic nerve injury following gluteal intramuscular injection is a persistent problem. A study over 6 months involving 133 children seen in Mulago hospital with acute flaccid paralysis revealed 124 (93%) children with injection-induced sciatic nerve injury. The identity of the drug in 79 cases (59.4%) was quinine. It is recommended that the gluteal region should not be used as an intramuscular injection site in children.

The new female condom (FC2) in Uganda: perceptions and experiences of users and their sexual partners.

Abstract: The new version of the female condom (FC2) was introduced in Uganda in October 2009, following an unsuccessful female condom programme begun in 1998. The failure of the earlier programme was partly attributed to low acceptance of the first type of female condom (FC1). We evaluated the acceptability of FC2 and the experiences of users and their sexual partners. This was a qualitative cross-sectional evaluation. We conducted 16 in-depth interviews with FC2 users (8 women and 8 male partners). We also conducted eight focus group discussions with women who used FC2, and 22 key informant interviews with service providers. All the female users appreciated FC2 as a tool to empower them to avoid sexually transmitted infections (STIs) and unwanted pregnancies. They liked FC2 because it has no smell, is not noisy, and does not rupture easily. The men also liked FC2 because of its soft texture and lubrication. Some women found FC2 insertion cumbersome, while others feared that it would slip in on itself during sex. Concurrent use of male condoms with FC2 and the reuse of FC2 were also mentioned. Providers reported a high demand for FC2; their main challenges were inadequate supplies and distribution mechanisms. This evaluation shows generally high acceptance of FC2. The experiences of users and their partners were largely positive, although some fears and incorrect practices arose. FC2 should be added to the existing HIV/STI-prevention and family-planning options in Uganda and other countries, with sufficient training and support to ensure correct use.

Prevalence, types and factors associated with echocardiographic abnormalities among newly diagnosed diabetic patients at Mulago Hospital

Abstract: Background: The prevalence of Diabetes mellitus (DM) is on a rise in sub Saharan Africa and will more than double by 2025. Cardiovascular disease (CVD) accounts for up to 2/3 of all deaths in the diabetic population. Of all the CVD deaths in DM, 3/4 occur in sub Saharan Africa (SSA). Non invasive identification of cardiac abnormalities, such as Left Ventricular Hypertrophy (LVH), diastolic and systolic dysfunction, is not part of diabetes complications surveillance programs in Uganda and there is limited data on this problem. This study sought to determine the prevalence, types and factors associated with echocardiographic abnormalities among newly diagnosed diabetic patients at Mulago National referral hospital in Uganda. Methods: In this cross sectional study conducted between June 2014 and December 2014, we recruited 202 newly diagnosed adult diabetic patients. Information on patients' socio-demographics, bio-physical profile, biochemical testing and echocardiographic findings was obtained for all the participants using a pre-tested questionnaire. An abnormal echocardiogram in this study was defined as the presence of LVH, diastolic and/or systolic dysfunction and wall motion abnormality. Bivariate and multivariate logistic regression analyses were used to investigate the association of several parameters with echocardiographic abnormalities. Results: Of the 202 patients recruited, males were 102(50.5%) and the mean age was 46±15 years. Majority of patients had type 2 DM, 156(77.2%) and type 1 DM, 41(20.3%) with mean HbA1C of 13.9±5.3%. Mean duration of diabetes was 2 months. The prevalence of an abnormal echocardiogram was 67.8 % (95% CI 60%-74%). Diastolic dysfunction, systolic dysfunction, LVH and wall motion abnormalities were present in 55.0%, 21.8%, 19.3% and 4.0% of all the participants respectively. In bivariate logistic regression analysis, the factors associated with an abnormal echocardiogram were age (OR 1.09 [95% CI 1.06 1.12], P <0.0001), type 2 DM (OR 5.8[95% CI 2.77-12.07], P<0.0001), hypertension (OR 2.64[95% CI 1.44-4.85], P=0.002), obesity (OR 3.51[955 CI 1.25-9.84], P=0.017 and increased waist circumference (OR 1.02[95% CI 1.00-1.04], P=0.024. On Multiple logistic regression analysis, age was the only factor associated with an abnormal echocardiogram (OR 1.09[95%CI 1.05-1.15], P<0.0001). Conclusion: Echocardiographic abnormalities were common among newly diagnosed adults with DM. Traditional CVD risk factors were associated with an abnormal echocardiogram in this patient population. Due to a high prevalence of echocardiographic abnormalities among newly diagnosed diabetics, we recommend screening for cardiac disease especially in patients who present with traditional CVD risk factors. This will facilitate early diagnosis, management and hence better patient outcomes. Keywords: Diabetes mellitus, echocardiography, cardiac abnormalities