Department of Paediatrics and Child Health
http://ir.lirauni.ac.ug/xmlui/handle/123456789/375
2024-03-28T21:46:32ZPrevalence of neonatal sepsis and associated factors among neonates admitted in the neonatal intensive care unit at Lira regional referral hospital, northern Uganda
http://ir.lirauni.ac.ug/xmlui/handle/123456789/763
Prevalence of neonatal sepsis and associated factors among neonates admitted in the neonatal intensive care unit at Lira regional referral hospital, northern Uganda
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.
2023-01-01T00:00:00ZEtiological Factors of Neonatal Mortality in a Large Rural Hospital- St. Mary’s Hospital Lacor
http://ir.lirauni.ac.ug/xmlui/handle/123456789/613
Etiological Factors of Neonatal Mortality in a Large Rural Hospital- St. Mary’s Hospital Lacor
Lanyero, Beatrice; OKello, Nelson; Okello, Tom Richard
Purpose: The aim of the study was to identify the gaps for further improvement of neonatal survival at St. Mary’s Hospital
Lacor, Gulu city Uganda. Objective: To determine the etiological factors associated with neonatal deaths in St. Mary’s Hospital Lacor
and examine neonatal mortality attributable to maternal conditions. Method: With the aid of a pre-coded and pretested data collection
tool, a consecutive sampling technique was applied to the neonates admitted searching for all records of dead neonates from October
2020 to September 2021 and used it to retrieve all medical records of neonates including: the total admissions, number of deaths or
recurrences of neonatal deaths, age at death, sex and diagnoses and analyzed using SPSS version 23 Result: The majority of all
neonatal deaths occur within the first 7days of life (82.7%) followed by those who are 8-28days old (17.3%). Amongst the dead
neonates, the male tended to predominate (60.6%) compared to their female counterparts (39.4%). Prematurity was the significantly
leading cause of neonatal mortality in St Mary’s Hospital (60.6%), followed by birth asphyxia (23.6%), neonatal sepsis (7.9%) and
congenital abnormalities (5.5%); P value = 0.0001. Maternal age and conditions like premature rupture of membrane, pre-eclampsia,
obstructed labor formed important contributors to neonatal outcomes Conclusion: Neonatal mortality could be significantly reduced
by focusing efforts on premature neonatal management and its prevention
2023-01-01T00:00:00ZAnti-malarial drug use, appropriateness and associated factors among children under-fve with febrile illnesses presenting to a tertiary health facility: a cross sectional study
http://ir.lirauni.ac.ug/xmlui/handle/123456789/519
Anti-malarial drug use, appropriateness and associated factors among children under-fve with febrile illnesses presenting to a tertiary health facility: a cross sectional study
Nyeko, Richard; Otim, Felix; Obiya, Evelyn Miriam; Abala, Catherine
Background Malaria is endemic in 95% of Uganda and constitutes the country’s most signifcant public health prob lem—being the leading cause of morbidity and mortality, especially among children under fve years of age. The cur rent national malaria treatment policy is to use artemisinin-based combination therapy (ACT) as frst-line treatment,
and recommends parasitological confrmation of malaria before therapy. Adherence to this policy, however, remains
suboptimal, with the self-initiated home-based therapy being common—posing undue exposures to, and pressure
on the current artemisinin-based combinations, with the danger of emergence of drug resistance. The study evalu ated the anti-malarial use and its appropriateness among febrile children under fve presenting to a tertiary health
facility in northern Uganda in light of the current malaria treatment policy.
Methods This was a cross-sectional study in a tertiary health facility in northern Uganda between March and Sep tember 2021. Children aged 6–59 months with fever were selected using systematic random sampling. A pretested
interviewer-administered questionnaire was used to collect clinical data from the caregivers. Data were analysed
using SPSS version 23. Descriptive statistics and multiple logistic regression models were applied. P-value<0.05 was
considered for statistical signifcance.
Results Seventy-two (34.3%) of the 210 children with fever in this study used anti-malarials prior to the hospital
visit, 29.2% (21/72) of which were on a self-medication basis, 22.2% (16/72) were empiric prescriptions—all of which
inappropriate, and only 48.6% (35/72) were prescribed based on a parasitological diagnosis of malaria. The most
commonly used anti-malarials were artemether-lumefantrine 60/72 (88.3%), while a lesser proportion of quinine 7/72
(9.7%), artesunate 3/72 (4.2%) and dihydroartemisinin-piperaquine 2/72 (2.8%) were used. The factors independently
associated with anti-malarial use among the children with febrile illnesses were duration of fever (p=0.001); level of
the nearest facility (p=0.027), distance from the nearest health facility (p=0.025), and caregivers’ age (p=0.038).
Conclusions Inappropriate use of anti-malarials for childhood febrile illnesses is prevalent in the study setting,
facilitated by the ease of over-the-counter access, empiric prescription and use of leftover anti-malarials. This calls for a
need to address communities’ health-seeking behaviour and the health providers’ practice alike.
2023-01-01T00:00:00ZOral–visceral iatrogenic Kaposi sarcoma following treatment for acute lymphoblastic leukemia: a case report and review of the literature
http://ir.lirauni.ac.ug/xmlui/handle/123456789/442
Oral–visceral iatrogenic Kaposi sarcoma following treatment for acute lymphoblastic leukemia: a case report and review of the literature
Nyeko, Richard; Geriga, Fadhil; Angom, Racheal; Kambugu, Joyce Balagadde
Background: There have hardly been any reported cases of children presenting with Kaposi sarcoma as a second
malignancy following treatment for acute lymphoblastic leukemia outside a transplant setting.
Case presentation: We report a case of a 5-year-old boy of Bantu origin, which, to our knowledge, could be only the
second reported case of oral–visceral Kaposi sarcoma after acute lymphoblastic leukemia treatment. The patient presented
with a 1-month history of progressive, non-painful, soft tissue oral mass, 1 month after completing treatment
for high-risk acute lymphoblastic leukemia. He was successfully treated for Kaposi sarcoma on a two-drug regimen
(bleomycin and vincristine) with good clinical response.
Conclusion: Visceral Kaposi sarcoma as a second malignancy may occur after pediatric acute lymphoblastic leukemia
treatment, but its rarity makes it unlikely to raise suspicion among clinicians, thus precluding early diagnosis and
treatment. We recommend routine evaluation for Kaposi sarcoma lesions in children undergoing long-term surveillance
following treatment for childhood acute leukemia
2022-01-01T00:00:00Z