NCD PATIENT EXPERIENCES ON CHRONIC DISEASE CARE DURING COVID-19 PANDEMIC. A QUALITATIVE CROSS-SECTIONAL STUDY DESIGN STUDY IN TWO SELECTED HEALTH FACILITIES IN MBARARA REGION.

Background: Living with chronic conditions during the COVID-19 pandemic has forced a rapid and dramatic change in where, when and how care is sought to reduce the risk of virus transmission. Several reports have confirmed that COVID-19 patients with pre-existing chronic conditions experience severe disease, worsened health outcomes, and higher mortality than those without Lack of access to healthcare, poor treatment adherence and lack of self-care due to physical/social distancing, lockdowns, and disruption in outpatient services were among the hindrances in the healthcare system despite patients living with chronic diseases requiring maximum attention and easy access to health care for proper monitoring. Therefore, important to explore the patient experiences of chronic disease care during the COVID 19 pandemic in Mbarara region. Methods: This was an exploratory descriptive study with a qualitative approach conducted in randomly selected health centers in Mbarara Region, Southwestern Uganda. People living with chronic diseases receiving care in health facilities around Mbarara Region were purposively sampled for an in-depth interview using an interview guide. Interviews were recorded and transcribed using verbatim in MSWord. The descriptive data analysis was done using Creswell’s six-step model and transcribed by the researcher manually and keywords were identified to represent the codes. Results:  Participant experiences during the COVID-19 pandemic were categorized into four themes: lifestyle changes, challenges faced during the lockdown, experiences of the participants diagnosed with COVID-19, preventive measures taken and lessons learnt during the COVID-19 pandemic. Conclusions:  People with chronic conditions experienced a confluence of the COVID-19 pandemic and chronic diseases in the context of difficulty in accessing healthcare and in recommendation more research should be done to quantify the factors associated with these patient experience

Anatomical variation and distribution of the vagus nerve in the esophageal hiatus: a cross-sectional study of post-mortem cases in Uganda

Purpose Vagus nerve injuries during gastroesophageal surgery may cause significant symptoms due to loss of vagal anti-inflammatory and neuromodulator function. Many previous studies have shown high anatomical variability of the vagus nerve at the esophageal hiatus, but information on its variability in Uganda specifically and Africa in general is scanty. This study provides a reliable and detailed description of the anatomical variation and distribution of the vagus nerve in the esophageal hiatus region of post-mortem cases in Uganda. Methods This was an analytical cross-sectional survey of 67 unclaimed post-mortem cases. Data collection used a pretested data collection form. Data were entered into Epi-Info version 6.0 data base then exported into STATA software 13.0 for analysis. Results The pattern of the anterior vagal trunk structures at the esophageal hiatus was: single trunk [65.7%]; biplexus [20.9%]; triplexus [8.9%] and double-but-not-connected trunks [4.5%]. The pattern of the posterior trunk structures were: single trunk [85.1%]; biplexus 10.4% and triplexus [4.5%]. There was no statistically significant gender difference in the pattern of vagal fibres. There was no major differences in the pattern from comparable British studies. Conclusion The study confirmed high variability in the distribution of the vagus nerve at the esophageal hiatus, unrelated to gender differences. Surgeons must consider and identify variants of vagal innervation when carrying out surgery at the gastroesophageal junction to avoid accidental vagal injuries. Published surgical techniques for preserving vagal function are valid in Ugand

Knowledge and Practices of Self-Care among People with Diabetes in South Western Uganda: A Cross-Sectional Study at a Regional Referral Hospital in Mbarara City.: Diabetes self-care knowledge and practice in Mbarara city.

Background:  Diabetes is a chronic metabolic disease with increasing prevalence globally. Glycemic control is the ultimate management goal possible through self-care activities predominantly patient-driven and enhanced by one’s knowledge. These consequently minimize associated adverse complications hence maintaining the quality of life among people with diabetes. Self-care knowledge and practice are globally found unsatisfying to control glycemia among many diabetic populations. There is a critical need to assess current knowledge and practice regarding self-care among diabetic people to control their diabetes. Methods:  We conducted a hospital-based cross-sectional study on 228 participants who were living with diabetes for at least six months since diagnosis. A standard tool, adopted and modified to suit the setting was used; the self-report Diabetic Knowledge Test Questionnaire for self-care knowledge and a revised version of the Summary Diabetes Self-Care Activities Questionnaire for practice. Both descriptive and logistic analysis was done using Stata software, version 13. Results:  Adequate diabetes self-care knowledge was average (56%) and adequate self-care practice was below average (35%). Major gaps in foot care, blood glucose testing, hypoglycemia recognition, and management. Multiple logistic regression revealed longer duration with diabetes and more frequency of receiving health education highly associated with adequate self-care knowledge and practice (duration ≥ 11 years, AOR: 2.9; P=0.014) and health education on every clinic visit (AOR: 4.0; P=0.005) for self-care knowledge while duration ≥ 6 years (AOR=3.3, P-value = 0.011) and health education twice from the time they started clinic visits (AOR= 0.2, P= 0.048) for self-care practice.     Conclusion:  Interventions should be developed focusing on precise and user-friendly health education packages translated to local languages, and eye-catching to the audience, priority to newly diagnosed and less educated. A further study assessing appropriate health education delivery avenues to clients of various characteristics, especially rural communities