Browsing by Author "Kakuru, Abel"

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    Incidence and risk factors for clinical omphalitis among neonates in Eastern Uganda using chlorhexidine gel for cord care : a community-cohort study.
    (BMC, 2025) Wogabaga, John; Burgoine, Kathy; Kakuru, Abel; Nambozo, Brendah; Chebet, Martin; Tumuhamye, Josephine; Wanume, Benon; Oguttu, Faith; Musaba, W. Milton; Napyo, Agnes; Wani, Solomon; Olupot-Olupot, Peter; Weeks, D. Andrew; Tylleskär, Thorkild; Mukunya, David
    Background: Omphalitis is a bacterial infection of the umbilicus and/or surrounding tissues, occurring primarily in the neonatal period. Whereas it is known to be a major route of localized and often systemic infection, studies describing incidence and risk factors remain scanty, especially in resource limited settings where the condition is thought to be common. We assessed the incidence and risk factors for omphalitis among neonates born to women who received a birth kit containing chlorhexidine for umbilical cord care after birth in Eastern Uganda. Trial registration for the parent study: The BabyGel trial was registered in the Pan African Clinical Trial Registry-(PACTR202004705649428 Registered 1 April 2020, https://pactr.samrc.ac.za/). Methods: We conducted a community-based cohort study between January 2021 and June 2023. This study was nested within the BabyGel trial. Our outcome of interest was clinical omphalitis, defined as purulent discharge from the umbilical cord stump within the first twenty-eight days of life as witnessed by a study midwife. Data were analyzed using Stata version 17.0. Bivariable and multivariable analyses were conducted using Cox proportional hazard regression models to estimate hazard ratios (HR) of selected exposures and time to omphalitis. Results: A total of 2052 neonates were enrolled; half of which were female (51.1%). The incidence of omphalitis was 3.0% (62/2052; 95% confidence interval (CI): 1.9%, 4.4%). The incidence rate of omphalitis was 1.6 cases per 1000 person days (95% CI: 1.1, 2.3). Neonates born at home were twice as likely to develop omphalitis as those born in a health facility (adjusted hazards ratio (AHR) 1.99; 95% CI: 1.01, 3.9). Conclusion: The incidence of omphalitis among neonates in Eastern Uganda was low. Home births carried twice the risk for omphalitis. Use of chlorhexidine coupled with close follow-up of neonates in the community by health workers and community health workers might have reduced the risk of omphalitis. Keywords: Omphalitis, Neonate, Chlorhexidine, BabyGel, Neonatal sepsis, Newborn, Low-resource setting
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    Severe malaria readmissions in Northern Uganda : a cross‑sectional study.
    (Malaria Journal, 2025) Olum, James; Mukunya, David; Nambozo, Brendah; Nantale, Ritah; Oguttu, Faith; Epuitai, Joshua; Lume, Ivan; Wanume, Benon; Olupot‑Olupot, Peter; Amanya, Daphine; Kakuru, Abel
    Background: Malaria is a critical global health issue, particularly for children in endemic regions. However, factors associated with recurrent severe malaria in children under 5 years of age in Northern Uganda are poorly understood. This study aimed to identify factors associated with readmission due to severe malaria within six months post-discharge among children in this age group. Methods: A cross-sectional study was conducted in Otuke district, encompassing twelve health facilities. A total of 760 caregivers of children admitted with severe malaria were interviewed, and hospital records were reviewed to verify the readmission data. The primary outcome assessed was readmission with severe malaria within six months after initial discharge. Data analysis was performed via Stata version 15.0. Results: The prevalence of readmission with severe malaria among children under 5 years of age was 26.8% (198/739). Factors significantly associated with readmission included having sickle cell anaemia [adjusted prevalence ratio (aPR) 1.72; 95% confidence interval (CI) (1.95–3.14)], living in houses constructed with straw and thatch walls [(aPR 2.10; 95% CI (1.19–3.69)] and seeking care after 12 h when the child has a fever [aPR 2.01; 95% CI (1.23–3.29)]. Conclusion: The findings indicate a high proportion of severe malaria readmissions in children under 5 years of age. Sickle cell anaemia, living in houses built using straw and thatch walls and seeking care after 12 h when a child has fever were the key risk factors for readmission with severe malaria. This study highlights the importance of targeted post-discharge interventions, such as prophylactic anti malarials in addition to bed nets, to prevent recurrent infections especially among children with sickle cell disease. In addition, improvements in housing quality and timely treatment of children with malaria are essential for reducing the burden of malaria, particularly in endemic regions. Keywords Children under 5 years of age, Readmission, Associated factors, Severe malaria, Children, Uganda