Browsing by Author "Katuramu, Richard"

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    Factors associated with willingness to use ecological sanitation toilets in Katine sub county Soroti district Uganda: a cross sectional study
    (Springer Nature, 2025) Ikiring, Osako Betty; Okia, David; Okolimong, Charles; Alunyo, Patrick Jimmy; Katuramu, Richard; Khainza, Tabitha Annet; Mukunya, David; Matovu, K. B. Joseph; Musoke, David; Olupot-Olupot, Peter; Wanume, Benon
    Ecological sanitation (EcoSan) toilets provide a sustainable approach to waste management by converting human excreta into usable agricultural inputs. Despite their environmental and health benefits, uptake remains low in many settings. This study investigated the proportion of community members in Katine sub-county, Soroti district, Eastern Uganda, who had ever used EcoSan toilets, their willingness to use them, and the factors associated with this willingness. A cross-sectional survey was conducted among 395 residents using structured questionnaires. Descriptive statistics estimated the proportions of prior use and willingness to use EcoSan toilets. Multivariable logistic regression was used to identify factors independently associated with willingness. Analyses were conducted in Stata 18, and results are presented in tables and figures. Only 18.5% (73/395) of respondents had used EcoSan toilets, and 13.7% (54/395) expressed willingness to use them. In multivariable analysis, key factors negatively associated with willingness included awareness of Ecosan toilets (adjusted odds ratio [AOR] 0.06, 95% CI 0.02–0.16; p<0.0001), willingness to use sanitized fecal matter (AOR 0.06, 95% CI 0.02–0.17; p<0.0001), and perceived ease of use (AOR 0.16, 95% CI 0.05–0.48; p=0.001). Adoption of EcoSan toilets remains low in this setting, primarily due to limited awareness, cultural reservations, and usability concerns. Community sensitisation, culturally appropriate messaging, and user centered toilet design are essential to improving uptake in similar rural environments. Keywords Ecological sanitation, Willingness, Rural sanitation, Uganda, Waste reuse
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    Perception of medical and nursing students plus clinical instructors towards objective structured clinical examination : a case study of five health training institutions in Sub-Saharan Africa.
    (Taylor & Francis, 2025) Kibuuka, Ronald; Mpasa, Ferestas; Kanyike, Andrew Marvin; Ndikom, Chizoma Millicent; Kaminga, Atipatsa Chiwanda; Owusu-Sekyere, Samuel; Ogah, Adenike; Amponsah, Abigail Kusi; Kiyimba, Kennedy; Obakiro, Samuel Baker; Munthali, Getrude; Msowoya, Wanangwa Kenneth; Kibuule, Dan; Phiri, Etta Chimbe; Baluwa, Masumbuko; Phiri, Tamara; Katuramu, Richard
    Background: Objective Structured Clinical Examination (OSCE) is the gold standard for assessing clinical competencies. However, resource constraints and logistical challenges in Sub-Saharan Africa (SSA) hinder its effectiveness. This study investigated the perceptions and experiences of medical and nursing students and clinical instructors toward OSCE in Sub-Saharan Africa (SSA). Methods: A mixed-methods sequential explanatory design was utilized involving 686 undergraduate health care students and 46 clinical instructors from Busitema University (Uganda), Mzuzu University (Malawi), University of Ibadan (Nigeria), Kwame Nkrumah University of Science and Technology (Ghana), and University of Zambia (Zambia). Quantitative responses were analyzed using IBM SPSS Statistics version 25, with comparisons between medical and nursing student responses made using chi-square test. Qualitative data were thematically analyzed. Results: A total of 686 students and 42 clinical instructors participated in the study. Majority of students 57.6% (n = 395, P-value <0.001) and 71.8% (n = 33) instructors recognized OSCE as a comprehensive tool for assessing clinical skills and knowledge, respectively. Among students, 80.8% (n = 554, P-value = 0.031), 66.6% (n = 457, P-value = 0.001), 66.6% (n = 456, P-value = 0.020) and 61.4% (n = 421, P-value = 0.001) cited anxiety, station timing, examiners’ behavior and content load as factors influencing performance. Of the clinical instructors 58.7% (n = 27) noted that it takes longer time to prepare scenarios, however 71.8% (n = 33) highlighted its objectivity. Students praised OSCE’s objectivity but criticized insufficient time on some stations and organizational issues. Facilitators cited objectivity and competence assessment but noted resource insufficiencies and student stress. Suggestions for improvement included mock OSCEs, training of clinical instructors, mixed method assessment and feedback to improve performance. Conclusion: In conclusion, while OSCE demonstrates significant strengths in promoting fairness in assessing clinical competencies, addressing logistical challenges, examiner variability, student anxiety, and timely feedback is crucial. Plain Language Summary: This study explored the perception of medical and nursing students and clinical instructors Objective Structured Clinical Examination (OSCE) in five sub-Saharan African health training institutions (Uganda, Malawi, Nigeria, Ghana, Zambia). We used questionnaires among 686 students and 46 clinical instructors, focused group discussions, and key informant interviews to find out their perception. Both students and clinical instructors mostly preferred OSCE because it is fair, organized, and tests real healthcare skills more than the conventional methods like long case. But students said the time on some stations was too short, stressful, and noted challenges during OSCE such as lack of some materials on some stations. Teachers agreed that OSCE is helpful but hard to do due to insufficient staffing and space. Both suggested more practice sessions through Pre OSCE, better training for teachers, and feedback to help students improve. The study confirms that OSCE is the most efficient way to evaluate nursing and medical students, however the study also highlights that a mixed method evaluation would be the best option for evaluation of clinical competence. Keywords: OSCE, health care professions education, Sub-Saharan Africa, medical assessment
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    Prevalence and factors associated with haematological side effects in MDR/RR-TB patients on linezolid-based regimens in Uganda : a multicentre retrospective study.
    (Research Square, 2025) Apio, Esther; Baluku, Joseph Baruch; Bwayo, Denis; Masaba, Peter J; Kirabo, Erias; Kebesu, Jasper; Nankunda, Oreb; Imalignat, Julius; Katuramu, Richard
    Background: Linezolid holds a critical role in the management of multidrug-resistant and rifampicinresistant tuberculosis (MDR/RR-TB), a severe global health threat. The World Health Organisation strongly recommends its inclusion in treatment regimens for these challenging forms of tuberculosis. Despite its efficacy, linezolid is frequently associated with haematological toxicity, a complication insufficiently documented in resource-limited settings like Uganda. Objective: This study aimed to ascertain the prevalence and identify associated factors of haematological side effects in MDR/RR-TB patients receiving linezolid-based regimens in Uganda. Methods: A multicentre retrospective study was conducted, reviewing patient records from four Ugandan hospitals (2020 – 2024). Data were collected on the prevalence of anaemia: Haemoglobin (Hb) level below 12 g/dL for women or below 13 g/dL for men. Thrombocytopenia: Platelet count below 150,000/µL. Leukopenia: White blood cell (WBC) count below 3,700/mm³.Modified Poisson regression with robust error variance identified independent risk factors for these haematological side effects. Results: Out of 412 eligible patients, 62.9% developed at least one haematological side effect. Thrombocytopenia (56.6%) and leukopenia (56.3%) were the most common, followed by anaemia (43.7%). Most of these side effects occurred within the first month of linezolid initiation. Risk factors for developing at least one of the side effects included rural residence (adjusted Prevalence Ratio (aPR) 1.6; 95% CI: 1.11–2.33), divorced/widowed status (aPR 4.1; 95% CI: 1.58–10.77), and smoking (aPR 1.7; 95% CI: 1.28–2.80). Despite the high prevalence of side effects, 86% achieved treatment success (cure and completion); however, loss to follow-up was higher among those with toxicities, at 15.1% (39/259) and 5.9% (9/153) in those without hematologic side effects. Conclusion: Linezolid-related haematological toxicities are common and occur early in treatment. Targeted monitoring of high-risk patients may improve treatment adherence and outcomes. Keywords: MDR-TB, Linezolid, Haematological toxicity, Anaemia, Thrombocytopenia, Leukopenia, Treatment outcomes
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    Systematic review and meta-analysis of the prevalence and clinical profile of lean type 2 diabetes mellitus in Africa.
    (Elsevier Ltd., 2025) Oreb, Nankunda; Katuramu, Richard; Bwayo, Denis; Waheed, Ahmed
    Introduction Lean Type 2 diabetes mellitus (T2DM), defined as individuals with body mass index (BMI) < 25 kg/m2, presents distinct clinical and biochemical characteristics across populations, particularly in Africa. This review assessed the prevalence and clinical-biochemical profiles of lean T2DM in Africa, aiming to improve understanding and management strategies. Methods This systematic review and meta-analysis involved 11 observational studies on lean T2DM in African adults. Specific BMI definitions [<25 Kg/m2] and clinical parameters were assessed, while non-observational studies were excluded. Data was analysed using STATA 18. Results The pooled prevalence of lean T2DM in African populations was 38.5 % (95 % CI: 26.8 %-50.9 %, I2 = 96.71 %, p < 0.001]). Clinical characteristics reveal a mean age of 48.35 years and a pooled mean BMI of 25.45 kg/m2. Metabolic assessments indicated raised HbA1c levels with a pooled median 9.34 % [95 %CI: 8.60–10.08 %, I2 = 97.44 %, p < 0.001]). Insulin resistance was low, as indicated by HOMA2-IR levels. Conclusions This review revealed a high prevalence of lean T2DM in Africa and identified unique clinical and biochemical characteristics. The findings suggest a potential need for more tailored approaches in assessing this phenotype, which remains underrepresented in current guidelines. Larger, well-designed studies are needed to strengthen the evidence base and inform effective treatment strategies.