Browsing by Author "Okello, Nelson"

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    Antibiotic prescription practices among prescribers for children under five at public health centers III and IV in Mbarara district
    (PLOS ONE, 2020) Okello, Nelson; Oloro, Joseph; Kyakwera, Catherine; Kumbakumba, Elias; Obua, Celestino
    Introduction Rational use of medicines requires that patients receive medications appropriate to their clinical needs. Irrational prescription of antibiotics has been reported in many health systems across the world. In Uganda, mainly nurses and assistant medical officers (Clinical officers) prescribe for children at level III and IV primary care facilities (health center II and IV). Nurses are not primarily trained prescribers; their antibiotic prescription maybe associated with errors. There is a need to understand the practices of antibiotic prescription among prescribers in the public primary care facilities. We therefore determined antibiotic prescription practices of prescribers for children under five years at health center III and IV in Mbarara district, South Western Uganda. Methods This was a retrospective descriptive cross-sectional study. We reviewed outpatient records of children <5 years of age retrospectively. Information obtained from the outpatient registers were captured in predesigned data abstraction form. Health care providers working at health centers III and IV were interviewed using a structured questionnaire. They provided information on socio-demographic, health facility, antibiotic prescription practices and availability of reference tools. Data was analyzed using STATA software version 13�0. Results There were 1218 outpatients records of children under five years reviewed and 35 health care providers interviewed. The most common childhood illness diagnosed was upper respiratory tract infection. It received the most antibiotic prescription (53%). The most commonly prescribed oral antibiotics were cotrimoxazole and amoxicillin, and ceftriaxone and benzyl penicillin were the commonest prescribed injectable antibiotics. Up to 68.4% of the antibiotic prescription was irrational. No prescriber or facility factors were associated with irrational antibiotic prescription practices.
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    Prevalence and Risk Factors for Multi-Drug Resistant Tuberculosis at LRRH in Lango Sub-Region Northern Uganda: A Cross-Sectional study.
    (Lira University, 2023) Ssewanyana, Jimmy; Omech, Bernard; Okello, Nelson
    Background: The emergence of drug-resistant TB over recent years is a growing global public health threat in developing countries. Uganda is among the countries with the highest MDR TB burden globally, with an estimated prevalence of multi-drug-resistant tuberculosis at 1.4% among all new cases and 12.1% among previously treated TB cases. Methods: A cross-sectional design was employed to collect data from 565 individuals using a data extraction tool and an interview guide for key informants to determine the prevalence of and factors associated with MDR-TB clients in LRRH. Quantitative data was analyzed with State Version 14 at univariate, bivariate, and multivariate levels. Applied thematic content analysis method was used for qualitative data analysis. Results: The prevalence of MDR-TB at LRRH in Lango sub-region was found to be 14.8% (84/565). The logistic regression revealed that treatment literacy (AOR =1.11, p<0.001) and a history of TB treatment (AOR = 6.22, P = 0.001) associates with development of MDR-TB. Conclusion: The study found out that 14.8% prevalence of MDR-TB at LRRH in Lango sub-region, surpass rates from previous research, including the 12.1% national prevalence among retreatment cases. Treatment literacy and history of treatment were the associated factors. Recommendations: Enhancing treatment literacy, strengthening monitoring, improving diagnostic access, supporting previously treated patients, training healthcare professionals, engaging communities, and conducting continuous research for combating MDR-TB in Lango sub-region. Keywords: prevalence, Multi-drug resistance, Tuberculosis.
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    Prevalence of neonatal sepsis and associated factors among neonates admitted in the neonatal intensive care unit at Lira regional referral hospital, northern Uganda
    (Research Square, 2023) Katugume, Brendah; Muzungu, JohnBaptist; Okello, Nelson; Kigongo, Eustes; Namutebi, Deborah Andrinar
    BACKGROUND: Sepsis is one of the leading causes of mortality and morbidity among neonates. Neonatal sepsis (NS) contributes to 44% of 5.4 million under-5 mortalities globally, and 12% of neonatal deaths in Uganda in 2020 were attributed to NS. Early risk factor identification and improved obstetric care are proven to reduce deaths due to NS, yet there is scanty literature for the Lango sub-region. We, therefore, determined the prevalence of NS, and identified the factors associated with NS in the Lango sub-region of northern Uganda. METHODS: A hospital-based, quantitative, cross-sectional study with a retrospective chart review was conducted in the neonatal intensive care unit (NICU) at Lira regional referral hospital (LRRH), in northern Uganda, among 194 records of neonates admitted to the NICU from September 2022 to February 2023. The participant records were selected by systematic sampling technique and a structured data extraction tool was used to collect data. Using SPSS version 25 data entry and analysis were done. The univariate analysis gave a general description of the data. Using logistic regression analysis associations were measured and the statistical significance was declared at a P value of 0.05 after multivariate analysis. RESULTS: Among a total of 194 neonates whose charts were reviewed, 80% of these had neonatal sepsis, giving a prevalence of 41.2%. Age in days of the neonate (AOR=4.212[1.627-10.903]) for neonates of 1-3days of age, sex where males (AOR=2.09[1.123-3.887]), an APGAR score of 1-4 at birth (AOR= 0.309, 95% CI: [0.115- 0.831]) and weight at birth <2500g (AOR=2.543[1.381-4.683]) were significantly related to NS. CONCLUSIONS AND RECOMMENDATIONS: The prevalence of NS among neonates admitted to the NICU of LRRH was high at 41.2% and the neonates of 1-3 days of age, male sex, a birth weight of <2500g, and an Apgar score of 1-4 at birth were significantly related to NS. Therefore, Caregivers ensure safe newborn care, early infection detection, and prophylactic antibiotics during procedures, especially for neonates with low birth weight, and low Apgar score males during the first 3 days of life are recommended to reduce the risk of developing NS. Further research is to be conducted on the major causative agents and outcomes of NS.
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    Reproductive Concerns and Associated Factors Among Adolescent and Young Adult Cancer Survivors in Uganda: A Hospital-Based Cross-Sectional Study
    (Journal of Adolescent and Young Adult Oncology., 2024) Nyeko, Richard; Okello, Nelson; Abeja, Christine Joy; Adyanga, Proscovia; Apio, Betty; Nabasirye, Caroline Kambugu; Mwa, Pamella Aol; Angom, Racheal; Geriga, Fadhil; Buser, Julie
    Purpose: Reproductive health (RH) is a critical issue among cancer survivors worldwide. However, in developing countries where RH services for patients with cancer are often lacking, reproductive concerns among adolescent and young adult (AYA) survivors remain uncertain. In this study, we assessed the reproductive concerns of AYA cancer survivors in a resource-limited context of Uganda. Methods: We collected data from AYA cancer survivors at two facilities in Uganda using an intervieweradministered questionnaire. Descriptive statistics were calculated, one-way analysis of variance was used for intergroup comparisons, and multiple regressions were used to test for predictors of reproductive concerns. Results: A total of 110 AYA cancer survivors, with a median age of 20 years (interquartile range [IQR], 18–22), were interviewed. More than half (53.6%) of the respondents were males. The median time since cancer diagnosis was 19 months (IQR, 13.0–35.0). Almost all (91.8%) respondents had a future desire to have children, but only 15.5% received reproductive counseling. The mean total score for the reproductive concern subscales was highest for the fertility concern, followed by the information-seeking and health-related concerns. Reproductive counseling, desire to have children, and respondents’ age were the factors influencing reproductive concern. Conclusions: The study shows a strong desire for biological parenthood with very low reproductive counseling among AYA cancer survivors, who remain concerned about their fertility, information needs, and health. This outcome underscores the need to integrate RH services into resource-limited cancer care settings. Keywords: reproductive health, concerns, adolescents and young adults, cancer survivors