Community pharmaceutical care: an 8-month critical review of two pharmacies in Kampala

Background: The concept of pharmaceutical care is neither well developed nor adequately documented in Uganda. Objectives: This study is therefore an attempt to identify and quantify the various service components of community pharmacy practice in Kampala, Uganda's capital city. Setting: Two pharmacies operating retail outlets were chosen out of about 110 in Kampala. The city itself is fairly small with a rather congested population. It is Uganda's economic hub with the greatest number of private sector health facilities and pharmacy outlets. Methods: This study involved an 8-month observation period at the two pharmacies, combined with a data collection form to record demographic characteristics of respondents and parameters such as self-medication, pharmacy initiated therapy, prescription filling, patient/non-patient clients and treatment received. Results: 567 observations were made. Missing data for parameters studied were omitted during analysis, thus yielding different totals for the various sets of variables. Just less than half of 564 respondents (44.3%), were females compared to males (55.7%). The study found that clients over the age of 12 years seeking pharmaceutical services were 8-fold (93.1%) more likely to be the very patients compared to children (OR = 8.3; 95% CI, 3.7-18.7). Slightly ove r thirty percent of respondents (32.3%) were third party patients. About fifteen percent (14.7%) of respondents came to fill prescriptions, 28.8% to receive pharmacy-initiated therapy and 56.5% came for self-medication with all drugs including antibiotics at 22.4%. Most clients (75.2%) received treatment.The availability of a drug at the pharmacy was found to be a significant predictor of whether treatment was received, with the client age acting as a confounding variable (OR = 59.7; 95% CI 25.9-137.6). African Health Sciences 2003 3(2); 87-9

Access to Antiretroviral Therapy in Uganda: Kampala, June 2002

This research is an attempt to understand the current situation in Uganda int erms of access to ARVs. It describes what role generic alternatives to branded ARVs have played in reducing prices and increasing access to antiretroviral therapies (ART). In addition, it reviews the laws governing pharmaceutical patients in Uganda, as well as the newly proposed Industrial Property Bill 2002 (IP Bill). Finally, the thoughts and comments of some HIV-infected patients regarding affordability of medications are also included.|Introduction, Methods, UNAIDS HIV/AIDS Drugs Initiatives, Prices and Access to Antiretrovirals, Additional Barriers to Access, Legislation Relating to Pharmaceuticals, Interviews with Patients Accessing Antiretrovirals, Limatations to the Study, Conclusions, References, Attachment

The Challenge of Re-treatment Pulmonary Tuberculosis at Two Teaching and Referral Hospitals in Uganda

Background With an annual tuberculosis (TB) incidence of about 350 cases per 100,000 of the population, Uganda is a high burden country. Moreover, it is evident that some TB patients have been treated for a previous episode of the disease. Objective To highlight the burden of re-treatment pulmonary TB and examine patient factors associated with re-treatment among adults at two teaching and referral hospitals, Mbarara and Mulago Methods A descriptive cross sectional study with data collection between September 2004 and March 2005; we calculated the prevalence and used logistic regression to explore factors associated with re-treatment. Results The prevalence of re-treatment pulmonaryTB at Mbarara based on medical records was 30.0% (95%CI: 21.2 to 40.0), and 21.3% (95%CI: 12.9 to 31.8) from exit interviews.The corresponding estimates at Mulago hospital were 12.0% (95% CI: 6.4 to 20.0) and 43.9% (33.0 to 55.3). Compared to the 18-26 year age category, the prevalence odds ratio (POR) for a seven-year increase in age was 1.54 (95%CI: 1.04-2.28; p = 0.027), while female patients were 0.39 (95%CI: 0.17-0.90; p = 0.025) times less likely to report re-treatment disease than males, in this facility-based study. Conclusions Re-treatment pulmonary TB is frequent at the two teaching and referral hospitals.A contribution to re-treatment prevention should entail more rigorous management of new TB cases, particularly at lower levels of care. Keywords: Tuberculosis, pulmonary, re-treatment, prevalence African Health Sciences Vol. 7 (3) 2007: pp. 136-14