Browsing by Author "Nakiyemba, Alice"

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    Acceptability of immediate CPAP for preterm infants in the delivery room to mothers, caregivers and healthcare workers in a low-resource setting: a qualitative study
    (BMC Pediatrics, 2025) Napyo, Agnes; Nakiyemba, Alice; Muduwa, Martha; Ssenkusu, M. John; Okello, Francis; Hagmann, Cornelia; Namuyonga, Judith; Hewitt-Smith, Adam; Loe, Kate; Abongo, Grace; Amorut, Denis; Wandabwa, Julius; Olupot-Olupot, Peter; Burgoine, Kathy
    Background: Preterm birth is the leading cause of childhood mortality, with respiratory distress syndrome as the predominant aetiology. Initiating continuous positive airways pressure (CPAP) immediately after birth may reduce CPAP failure, the need for ventilation, and surfactant use. In low-resource settings, without ventilation or surfactant, immediate CPAP could significantly reduce preterm mortality. We explored the experiences, perceptions, and acceptability of immediate CPAP among parents, caregivers, and healthcare workers in a Ugandan hospital. Methods: This qualitative study (April 2023–April 2024) was nested in a pilot randomised controlled trial of immediate delivery room CPAP for very low birthweight infants (VLBW, <1500 g) at a government hospital in Uganda. Data were collected through 12 key informant interviews and focus group discussions with 36 healthcare workers, and 37 parents and caregivers of enrolled infants. We applied deductive framework analysis using the Theoretical Framework of Acceptability (TFA) and coded transcripts using Nvivo 12. Results: Regarding affective attitude, healthcare workers, mothers and caregivers expressed positive feelings towards immediate CPAP. For perceived effectiveness, healthcare workers described immediate CPAP as a prophylactic intervention that reduces the severity of complications and shortens hospital stays, while mothers and caregivers believed it expands the infant’s lungs and increases chances of survival. Concerning burden, healthcare workers highlighted that successful implementation depends on a committed neonatal team, multidisciplinary team collaboration, adequate staffing, active maternal involvement, and the availability of sufficient CPAP machines. Opportunity costs were evident where limited staffing forced healthcare workers to choose between prioritising the mother or the infant. Under ethicality, cultural beliefs, religious views, and fear were identified as influential factors in decision making around immediate CPAP. Regarding intervention coherence, healthcare workers, mothers, and caregivers demonstrated a good understanding of the purpose and process of immediate CPAP. Finally, self-efficacy was linked to the availability of adequate staff, training, and necessary equipment to confidently engage in the intervention. Conclusions Immediate CPAP was found to be acceptable among healthcare workers and mothers/caregivers. Successful implementation requires adequate staff training, comprehensive health education, adequate human resources, and sufficient availability of CPAP machines. Trial registration Study is registered on Pan African Clinical Trials Registry (PACTR) PACTR202208462613789. Keywords Preterm, Very low birthweight, VLBW, Africa, Neonatal, CPAP, Respiratory distress syndrome, Low-resource setting, Acceptability, Barriers, Facilitators, Attitude
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    Comprehensive analysis of molecular markers linked to antimalarial drug resistance in Plasmodium falciparum in Northern, Northeastern and Eastern Uganda
    (Springer Nature, 2025) Olupot‑Olupot, Peter; Paasi, George; Katairo, Thomas; Alunyo, Patrick Jimmy; Nakiyemba, Alice; Ocen, Gilibrays Gilbert; Pande, Stephen; Alaroker, Florance; Okiror, William; Ocen, Emmaluel; Oula, Alex; Okalebo, Benard Charles; Ongodia, Paul; Amorut, Denis; Tukwasibwe, Stephen; Ndidde, Nabadda Susan; Sewanyana, Isaac; Nsobya, L. Samuel
    Background in Uganda, antimalarial resistance in Plasmodium falciparum poses serious public health and treatment challenges. Globally, recent data have highlighted the roles of following genes in malaria resistance: Plasmodium falciparum dihydrofolate reductase (Pfdhfr), Plasmodium falciparum dihydropteroate synthetase (Pfdhps), Plasmodium falciparum chloroquine resistance transporter (Pfcrt), Plasmodium falciparum multidrug resistance gene 1 (Pfmdr1), and Plasmodium falciparum K13 propeller domain (Pfk13). This study investigated the prevalence and characteristics of P. falciparum molecular markers linked to antimalarial resistance in Northern, Northeastern, and Eastern Uganda. Methods This cross-sectional study collected 200 dried blood samples from children (2 months to 12 years) in Northern, Eastern, and Northeastern Uganda. Samples were from malaria-positive cases confirmed by rapid diagnostic tests and microscopy. Genomic DNA was extracted from these samples and analysed using Molecular Inversion Probes to detect Plasmodium falciparum genetic mutations. The sequencing was performed on the Illumina MiSeq platform, and raw data was organized and analysed with MIPTools software. Results: The study sequenced over 50% of the samples at each site as follows: Apac 87.7% (43/49), Moroto 68.0% (34/50), Soroti 65.0% (13/20) and Mbale 53.1% (43/81). The Pfk13 A675V and C469Y mutations varied from 0 to 23.3% and 8.3–14.3%, in four sites, with consistently low prevalence in Apac. The Pfdhfr N51I and S108N mutations were fixed in all districts, while C59R was fixed in Moroto and nearing fixation (92–97%) in other regions. The emerging I164L mutation ranged from 1 to 10% in all sites. The Pfdhps A437G and K540E mutations were fixed in Soroti, with 3–5% wild-type prevalence in other sites. The A581G mutation showed 2.3% mixed genotypes in Mbale only. The Pfcrt K76T was predominantly wild type, except for 5% mutants in Mbale and Moroto. The pfmdr1 N86Y were wild type across all districts, except for 15% mixed genotypes in Soroti. Conclusion: This study reveal rising partial artemisinin resistance and widespread antifolate resistance surpassing WHO thresholds in Northern, Northeastern, and Eastern Uganda. Emerging super-resistant parasites pose a serious threat to malaria control, necessitating urgent enhanced surveillance and alternative treatment strategies. Keywords Antimalarial resistance, Uganda, Pfk13, Pfdhfr, Pfdhps Pfmdr1, Pfcrt
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    Population and breeding patterns of the pest rodent: Mastomys natalensis in a maize dominated agroecosystem in Lake Victoria crescent zone, Eastern Uganda
    (NSC, 2021) Mayamba, Alex; Byamungu, Robert Modest; Leirs, Herwig; Isabirye, Moses; Makundi, Rhodes H; Kimaro, Didas N; Massawe, Apia W; Kifumba, David; Nakiyemba, Alice; Mdangi, Mshaka E; Isabirye, Brian E; Mulungu, Loth S
    Multimammate mice (Mastomys natalensis) are a key rodent pest species to cereal crop production in Sub-Saharan Africa. This study aimed at generating information on the population fluctuation and breeding patterns of M. natalensis in a maize dominated agro-ecosystem in the Mayuge district, Eastern Uganda. The area is characterised by a bimodal rainfall pattern with rains in the periods March to May and August to November. A Capture–Mark–Recapture study was established in cultivated and fallow field habitats with, in each habitat, two plots of 60 m by 60 m with 49 evenly spaced trapping points. Trapping was conducted monthly for three consecutive nights, and the study extended from January 2016 to June 2018. A Generalised Linear Mixed Model analysis showed significantly higher population density estimates (β = 0.69, p < 0.0001) in fallow land compared to cultivated fields, and also significantly higher density estimates (β = 0.75, p = 0.006) in the first wet season and lowest in the first dry season. The percentage breeding females differed significantly across months (χ2 = 27.05, df = 11, p = 0.003) and seasons (χ2 = 17.64, p = 0.0003). Breeding females occurred throughout all the months of trapping, but with significantly higher percentages in the months of March to July (i.e. first wet season extending to second dry season) and generally lowest in the first dry months (i.e. January and February in 2017, and February 2018). The results of this study have important consequences for the timing of control efforts, and recommends that control should be initiated during the dry seasons prior to wet seasons to counteract potential damaging population build up in later wet seasons when crop planting is expected. Keywords: habitat type, multimammate mouse, population abundance, seasons, sexual activity
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    The Contribution of Cereal Grains to Food Security and Sustainability in Africa: Potential Application of UAV in Ghana, Nigeria, Uganda, and Namibia
    (MDPI, 2021) Raheem, Dele; Dayoub, Moammar; Birech, Rhoda; Nakiyemba, Alice
    Africa is a net importer of food, especially cereal grains, despite the importance of agriculture in the continent. The agricultural growth in Africa has been undermined by low investment in agriculture, poor infrastructure, high population growth rate, and low adoption of technologies. The agri-food value chain in many African countries will benefit from the adoption of appropriate technologies that are available in the digital landscape to leverage the agricultural sector, make it more attractive to the teeming youth population, and to reverse rural-urban migration. Attention to indigenous cereal grains and other crops that are grown locally and processed into different local foods would ensure food security. However, the availability of these crops in the market is often reduced due to damage before harvest by pests and predators leading to economic losses for farmers. In this article, we review the literature from a multidisciplinary perspective on the relevance of African indigenous food grains to food security in general and we highlight the potential application of drones to increase the yield of cereal grains in three regions of the continent—eastern, western, and southern Africa. Keywords: food security; food sovereignty; precision agriculture; cereal grains; Ghana; Nigeria; Uganda; Namibia; Africa