Browsing by Author "Musiime, Victor"

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    Effect of nutritional supplementation with lipid-based therapeutic food on body composition of non-severely malnourished African children aged 6–59 months hospitalized with severe pneumonia
    (Oxford University Press, 2025) Nalwanga, Damalie; Musiime, Victor; Kiguli, Sarah; Olupot-Olupot, Peter; Alaroker, Florence; Opoka, Robert; Tagoola, Abner; Mnjala, Hellen; Mogaka, Christabel; Nabawanuka, Eva; Giallongo, Elisa; Karamagi, Charles; Briend, Andr’e; Maitland, Kathryn
    Pneumonia remains an important cause of morbidity and mortality among children in low- and middle-income countries. Poor outcomes are associated with undernutrition. Nutritional supplementation may be beneficial. We examined the effect of supplementation with lipid-based ready-to-use therapeutic food (RUTF) on the body composition of children with severe pneumonia. Non-severely malnourished children (6–59 months) with severe pneumonia enrolled into the Children’s Oxygen Administration Strategies and Nutrition trial in Uganda and Kenya and randomized to receive a diet supplemented with RUTF (500 Kcal/day) for 56 days versus usual diet alone (control) were included. We assessed arm anthropometry and bioimpedance analysis at admission and days 28, 90, and 180 of follow-up. We used mixed effects linear regression to compare body composition between groups. We included 737 participants (369 in intervention; 368 in control group). The median age was 16 months (IQR; 9, 26), and 58.1% were male. Overall, baseline mean arm fat area (AFA), arm muscle area and arm muscle circumference were 5.8 ± 1.8 cm2, 11.6 ± 2.3 cm2, and 12.3 ± 1.2 cm2, respectively. The mean fat mass and fat-free mass calculated in 116 participants were 5.5 ± 1.5 kg and 5.5 ± 1.5 kg, respectively. There were modest increases in most body composition parameters. RUTF significantly increased AFA at days 28 and 90 but not at day 180 (P-value ¼ .03, .02, and .99, respectively). RUTF did not change other body composition parameters. Despite initial increases in AFA, RUTF did not change the body composition of children with severe pneumonia. KEYWORDS: bio-impedance analysis; body composition; children; fat-free-mass fat-mass; malnutrition; pneumonia; ready-to-use therapeutic food
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    Specialty career preferences among final year medical students at Makerere University College of health sciences, Uganda :
    (BMC, 2021) Kuteesa, Job; Musiime, Victor; Munabi, Ian G.; Mubuuke, Aloysius G.; Opoka, Robert; Mukunya, David; Kiguli, Sarah
    Background: Uganda has an imbalanced distribution of the health workforce, which may be influenced by the specialty career preferences of medical students. In spite of this, there is inadequate literature concerning the factors influencing specialty career preferences. We aimed to determine the specialty career preferences and the factors influencing the preferences among fifth year medical students in the School of Medicine, Makerere University College of Health Sciences (MakCHS). Methods: A sequential explanatory mixed methods study design with a descriptive cross-sectional study followed by a qualitative study was used. A total of 135 final year medical students in MakCHS were recruited using consecutive sampling. Self-administered questionnaires and three focus group discussions were conducted. Quantitative data was analysed in STATA version 13 (StataCorp, College Station, Tx, USA) using descriptive statistics, chi-square tests and logistic regression. Qualitative data was analysed in NVIVO version 12 (QRS International, Cambridge, MA) using content analysis. Results: Of 135 students 91 (67.4%) were male and their median age was 24 years (IQR: 24, 26). As a first choice, the most preferred specialty career was obstetrics and gynecology (34/135, 25.2%), followed by surgery (27/135, 20.0%), pediatrics (18/135, 13.3%) and internal medicine (17/135, 12.6%). Non-established specialties such as anesthesia and Ear Nose and Throat (ENT) were not selected as a first choice by any student. Female students had 63% less odds of selecting surgical related specialties compared to males (aOR = 0.37, 95%CI: 0.17–0.84). The focus group discussions highlighted controlled lifestyle, assurance of a good life through better financial remuneration and inspirational specialists as facilitators for specialty preference. Bad experience during the clinical rotations, lack of career guidance plus perceived poor and miserable specialists were highlighted as barriers to specialty preference. Conclusion: Obstetrics and Gynecology, Surgery, Pediatrics and Internal Medicine are well-established disciplines, which were dominantly preferred. Females were less likely to select surgical disciplines as a career choice. Therefore, there is a need to implement or establish career guidance and mentorship programs to attract students to the neglected disciplines. Keywords: Career, Medical, Preferences, Specialty, Student
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    Supplementation with ready-to-use therapeutic food has no effect on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia.
    (Frontiers, 2025) Nalwanga, Damalie; Giallongo, Elisa; Musiime, Victor; Kiguli, Sarah; Olupot Olupot, Peter; Alaroker, Florence; Opoka, Robert; Tagoola, Abner; Hamaluba, Mainga; Mogaka, Christabel; Nabawanuka, Eva; Karamagi, Charles; Briend, André; Maitland, Kathryn
    Objectives: To investigate the effect of supplementation with ready-to-use therapeutic food (RUTF) on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia. Methods: This secondary analysis of the COAST-Nutrition (ISRCTN10829073) included children hospitalized for severe pneumonia in Uganda and Kenya. Undernutrition was defined as having either a weight-for-age z score, heightfor-age z score, or weight for-height/length z score below the median of the WHO reference population (< 0) or mid-upper arm circumference (MUAC) below 13.5 cm. Participants were randomized to receive 1 sachet of RUTF daily for 8 weeks in addition to the usual diet (intervention) or usual diet alone (control). The primary composite outcome for adverse events was any one of mortality, re-admission, or deterioration of nutritional status by day 90 of follow-up. Results: Of 846 main trial participants, 741 (88%) met the inclusion criteria (intervention: 374 versus control: 367). Of 687 (93%) participants in whom the primary outcome was assessed, 370 (54%) experienced an adverse event, [intervention: 184/348 (53%) versus control: 186/339(54%)]. There was no difference in the primary outcome between groups, aOR 0.92 (95% CI 0.68, 1.24), p = 0.572. Adverse outcome risk reduced with increasing age, aOR 0.53, (95% CI 0.45, 0.62), p < 0.001. Conclusion: RUTF supplementation did not reduce the high frequency of adverse outcomes in children aged 6–59 months following hospital admission with severe pneumonia. Nutritional support directly targeting metabolic needs post-pneumonia should be considered in the future.