Barriers and factors affecting personal protective equipment usage in St. Mary’s Hospital Lacor in Northern Uganda

Background: To protect health workers (HCWs) from risky occupation exposure, CDC developed the universal precautions (Ups) including Personal Protective Equipment (PPEs). However compliance to it by HCWs has remained poor even in high-risk clinical situation. The objective of this study was to identify and describe the factors that influence a HCWs’ decision to wear PPEs and the barriers that exist in preventing their use Methods: A cross-sectional survey was carried out in the St. Mary’s Hospital Lacor in all the wards to collected quantitative information as well as qualitative and observational data on PPE use Results: Out of the total 59 respondents, 2% do not know the purpose of PPE, 23.7% do not know how to don and doff PPEs, 13.6% do not use PPE even when indicated and 10% are not using an appropriate PPE. The main barriers relates to poor fitting and weak domestic gloves, few of aprons, frequent stock out and inadequate PPE as well as lack of training in PPE Conclusion: This study provides a baseline for measuring the effectiveness of interventions to improve compliance

Invasive procedures and Hospital Acquired Infection (HAI) in A large hospital in Northern Uganda

No Abstract

Consumer perceptions and demand for biofortified sweet potato-based biscuit: The case of Akarabo golden power biscuit in Rwanda

Certain varieties of sweet potato, especially orange-fleshed, are being promoted as part of the strategy to combat vitamin A deficiency in children and pregnant mothers. However, the consumption of sweet potato is more widespread in rural households where it is mainly boiled or eaten raw. The lack of value addition excludes majority of urban and higher income consumers who consider sweet potato an inferior product. At the same time low income urban households that would be interested in consuming sweet potatoes are not able to receive regular supplies from the rural producing areas due to perishability and bulkiness of the produce. This study examines consumer perceptions and demand for value-added biofortified biscuit derived from the vitamin A-rich orange fleshed sweet potato in Rwanda. Specifically, it assesses consumer perceptions and preference for biofortified biscuit, consumer willingness to pay for biofortified biscuit and consumers’ rating of the biofortified biscuit. It uses data from 1085 consumers stratified by income levels drawn from consumers in several urban markets of Rwanda. The study finds very favorable rating of the taste, color, packaging, looks, and sweetness for the biofortified biscuit. It also finds higher willingness to pay (WTP) for the biofortified biscuit among consumers from low and low/middle income groups. However, the study finds mixed results of WTP for the biofortifed sweet potato among consumers in the high income neigborhoods. Also, contrary to expectations, the study finds no evidence that knowledge of vitamin A increases consumer rating for the biofortified biscuit, suggesting that the promotion campaigns did not change the way consumers perceive the biofortified sweet potato, perhaps due to the way the campaign was designed. The study concludes that the biofortified biscuit is currently more acceptable among the low and low/middle end income categories probably because of greater promotion at these levels. However, it has a high potential for the high amd medium income groups as evident from the high rating it received among these groups. The paper discusses the implications of these findings and suggests a need for more detailed studies and indepth quantitative analysis of consumer perceptions and WTP for orange-fleshed sweet potato.Key words: Consumers, demand, biofortified biscuits, Rwand

Trichinella spiralis infestation complicating open reduction and internal fixation for closed fracture femur

Trichinella Spiralis infestation complicating internally fixed fracture has not been reported. We report a case of trichinella spiralis infestation complicating a closed fracture of femur that was managed by open reduction and internal fixation using Kuntcher nail resulting into non-union

Including refugees in disease elimination: challenges observed from a sleeping sickness programme in Uganda.

BACKGROUND: Ensuring equity between forcibly-displaced and host area populations is a key challenge for global elimination programmes. We studied Uganda's response to the recent refugee influx from South Sudan to identify key governance and operational lessons for national sleeping sickness programmes working with displaced populations today. A refugee policy which favours integration of primary healthcare services for refugee and host populations and the availability of rapid diagnostic tests (RDTs) to detect sleeping sickness at this health system level makes Uganda well-placed to include refugees in sleeping sickness surveillance. METHODS: Using ethnographic observations of coordination meetings, review of programme data, interviews with sleeping sickness and refugee authorities and group discussions with health staff and refugees (2013-2016), we nevertheless identified some key challenges to equitably integrating refugees into government sleeping sickness surveillance. RESULTS: Despite fears that refugees were at risk of disease and posed a threat to elimination, six months into the response, programme coordinators progressed to a sentinel surveillance strategy in districts hosting the highest concentrations of refugees. This meant that RDTs, the programme's primary surveillance tool, were removed from most refugee-serving facilities, exacerbating existing inequitable access to surveillance and leading refugees to claim that their access to sleeping sickness tests had been better in South Sudan. This was not intentionally done to exclude refugees from care, rather, four key governance challenges made it difficult for the programme to recognise and correct inequities affecting refugees: (a) perceived donor pressure to reduce the sleeping sickness programme's scope without clear international elimination guidance on surveillance quality; (b) a problematic history of programme relations with refugee-hosting districts which strained supervision of surveillance quality; (c) difficulties that government health workers faced to produce good quality surveillance in a crisis; and (d) reluctant engagement between the sleeping sickness programme and humanitarian structures. CONCLUSIONS: Despite progressive policy intentions, several entrenched governance norms and practices worked against integration of refugees into the national sleeping sickness surveillance system. Elimination programmes which marginalise forced migrants risk unwittingly contributing to disease spread and reinforce social inequities, so new norms urgently need to be established at local, national and international levels

Psychiatric disorders among war-abducted and non-abducted adolescents in Gulu district, Uganda: a comparative study

Objective:We aimed to assess the nature and patterns of psychiatric disorders among adolescents who had been war-abducted in the war in northern Uganda, compared to non-abducted adolescents living in Gulu district, Uganda.Method: A cros sectional study that used an unmatched case-control design compared 82 abducted and 71 non-abducted adolescents for scores on measures of psychological distress and for selected psychiatric diagnoses using the Strength and Difficulties Questionnaire (SDQ) and the Mini International Neural-Psychiatric Interview for Children and Adolescents English version 2.0 (M.I.N.I-KID). Results: More than 90% of adolescents reported exposure to severe trauma, either through direct or indirect experiences. Significantly more war abducted adolescents reported PTSD (26.8%v.12.7%) (p=0.03) major depression (19.5%v.4.2%) (p=0.004), and generalised anxiety disorder (13.4v.4.2%) (p=0.049) than non abducted adolescents. By contrast, non-abducted adolescents reported more past suicidality (p=0.004, χ2=8.2) than adolescents who were abducted. However, despite high rates of psychiatric disorder, these adolescents had good psychosocial adjustment. Conclusion: Adolescents in war affected areas whether warabducted or not have varied and clinically significant emotional responses to different kinds of traumatic exposure. In a war-affected area, the development of a sustainable service for adolescents that tries to address the full range of mental health problems may be more appropriate than a psychological trauma service that focuses on one diagnosis.African Journal of Psychiatry Vol. 10 (4) 2007: pp. 225-23

Orthopaedic Outreach Program in Uganda: A Strategy to Improve Inequality in Service Delivery between Rural and Urban Communities

Background: Musculoskeletal diseases are on the increase worldwide. Greater than 80% of Ugandans live in rural areas, facing formidable barriers to specialized care. In 1991 the Orthopedics Outreach Program (OOP) was initiated as a plausible solution to the inequity of orthopedic care between the urban and rural disadvantaged populations. This investigation was conducted to evaluate the output, effectiveness, and barriers to access, of the OOP over 13 years.Methods: This was a retrospective analysis to quantify surgical output and effectiveness of the OOP using the outreach record and a cross sectional analysis to assess access and efficacy of the program. Semi-structured and key informant interviews targeted to key actors involved in the OOP were conducted to provide a qualitative assessment of the program.Results: Sixty seven outreach visits were completed, 6,653 patients seen, and 1,071 surgeries performed, at a total cost of US$12,701.00. The cost per patient seen was US$1.91 and US$11.86 per surgery performed. Poverty was uniformly cited as barrier to access, others were, transportation, and lack of awareness. There was unanimous opinion on the worthiness and effectiveness of the OOP, but many operational issues and constraints were cited.Conclusion: The OOP may provide a short and medium term solution to equity and access for orthopedic care in Uganda. There is need to quantify the burden of specific orthopedics conditions. A follow-up analysis assessing operational efficacy and output from 2004 to date, under the African Medical and Research Foundation (AMREF) and Ministry of Health funding is recommended

Farmers’ perceptions of orange-fleshed sweetpotato: Do common beliefs about sweetpotato production and consumption really matter?

Efforts to combat vitamin A deficiency in developing countries have focused on the promotion of growing and consuming orange-fleshed sweetpotato (OFSP), among other crops. Past studies have found increased intake and even incomes among households that have been reached with information about nutritional benefits of OFSP. Consequently, efforts to scale up the production and consumption of OFSP are on-going in several African countries where vitamin A deficiency is a major problem. However, to date, few studies have systematically examined farmers’ perceptions and attitudes towards some of the attributes of OFSP. This paper interrogates some of the beliefs about the production and consumption of sweetpotato in general, and OFSP, in particular. It uses data generated using multi-stage sampling technique and involving 732 households in the Lake zone of Tanzania. The households were stratified into project participants (the intervention group) and non-participants (the control group). Within each household, data were collected from a male or female adult member (usually spouses) through personal interviews. Overall, 455 project participants and 277 non-participants were interviewed. This study uses both descriptive and exploratory factor analysis to assess some common beliefs about sweetpotato production and consumption. Contrary to the common beliefs, the study finds that sweetpotato is an important food crop to producing households, and that the common negative beliefs about sweetpotato production and consumption are not widely held. This study, therefore, recommends the need to upscale and out-scale efforts to sensitize farmers about the nutritional benefits of growing and consuming OFSP to counter the common negative beliefs about sweetpotato. In particular, educating farmers on the health effects of inadequate intake of Vitamin A and the importance of OFSP as its source can greatly influence their perceptions about OFSP. Further, there is need to increase efforts at breeding aimed at supplying the multiple desirable table and postharvest attributes of orange-fleshed sweetpotato, in addition to focusing on agronomic traits. For sub-Saharan Africa, such attributes include taste, storability of the tubers, dry matter content, and sugar content.Keywords: Sweetpotato, attributes, nutritional benefits, common beliefs, farmer perceptions, Tanzani