Browsing by Author "Nantale, Ritah"

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    Changes in haematological indices among children with sickle cell disease on hydroxyurea treatment for at least 1 year : a cohort study.
    (PLOS One, 2025) Emuli, Stephen; Tegu, Crispus; Oguttu, Faith; Nantale, Ritah; Ochieng, Paul; Paasi, George; Abeso, Julian; Wamulugwa, Joan; Musaba, Milton W.; Namazi, Ruth; Kiguli, Sarah; Mukunya, David
    Background Sickle cell disease is the 12th cause of under-five mortality in Africa, with over 81,000 deaths attributed to sickle cell disease annually. Hydroxyurea is one of the few disease-modifying therapies available for the management of sickle cell disease. This study aimed to assess changes in haematological indices among children who had been initiated on hydroxyurea for at least one year in a non-trial setting at a regional referral hospital in Eastern Uganda. Methods We conducted a cohort study, which included children who attended the sickle cell clinic from 21/Aug/2024 to 30/Oct/2024. Data were analyzed using Stata version 18.0. We conducted a paired sample t-test comparing the haematological indices of children with sickle cell disease at baseline and at least one year later. Results We included 324 children. Nearly half 155/324 (47.8%) of the participants had good monthly adherence to hydroxyurea. The mean haemoglobin level at follow-up increased by 0.77g/dl (p <0.001) from 7.07g/dl (SD 0.10) at baseline to 7.84g/dl (SD 0.09). There was an increase in the mean corpuscular volume [0.97fl (p=0.645)] and mean corpuscular haemoglobin [0.58pg (p=0.120)]. The white blood cell count decreased by 6.17x103/µl (p<0.001) from 20.77x103/µl (SD ± 0.806) at baseline to 14.60x103/µl (SD ± 0.613) at follow-up. The differential white cell counts of neutrophils, lymphocytes, monocytes, and basophils also decreased. Conclusion Hydroxyurea resulted in an increase in mean haemoglobin level and a decrease in absolute and differential white blood cell count. The benefit was more pronounced among children with good adherence to hydroxyurea. We add our voice to calls for continued advocacy for the availability of hydroxyurea for use by children with sickle cell disease in low-resource settings. We also recommend a routine complete blood count to monitor response to treatment and also guide patient management among children with sickle cell disease initiated on hydroxyurea.
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    Exploring barriers and facilitators of preceptorship in undergraduate health professions education : insights from a qualitative needs assessment among preceptors in Eastern Uganda.
    (BMC, 2025) Wani, Solomon; Nantale, Ritah; Atuhairwe, Irene; Makoko, Brian Tonny; Okello, Francis; Waako, Paul; Twineamatsiko, Andrew; Agaba, Brian; Nyalihama, Alain; Kibuule, Dan; Kagoya, Enid Kawala
    Background: Clinical preceptorship plays a critical role in bridging theoretical knowledge and practical skills for health professions students. In resource-constrained settings like Eastern Uganda, understanding what facilitates effective preceptorship is essential for improving clinical education outcomes. This study explores the barriers and facilitators to preceptorship among clinical preceptors and faculty at Busitema University, Mbale College of Health Sciences, and Mbale Regional Referral Hospital. Methods: We conducted 15 in-depth interviews with clinical preceptors, including faculty and clinical staff from Busitema University, Mbale College of Health Sciences, and Mbale Regional Referral Hospital. Participants were purposively selected based on experience, education level, medical care, and leadership roles. We conducted the interviews between May 2024 and June 2024, audio-recorded, were transcribed verbatim, and thematically analyzed using Atlas.ti version 9. Results: Three key facilitators and six barriers to preceptorship emerged from the analysis. The facilitators included: support from Seed Global Health through donations of medical tools, equipment, and healthcare worker training; strong commitment and willingness among health workers at Mbale Regional Referral Hospital to teach students; and, support from faculty and postgraduate students at Busitema University. Barriers were: high numbers of students in clinical settings; poor communication and coordination between academic institutions and clinical sites; limited preceptorship skills and knowledge among clinical preceptors; shortages of faculty preceptors; insufficient time for clinical rotations; and inadequate models and equipment for simulation-based teaching. To address these challenges, preceptors recommended better coordination and student orientation, phased placement in smaller groups, training and refresher courses to strengthen preceptorship capacity, increased faculty presence in wards, and provision of essential medical equipment. Conclusion: Effective preceptorship in resource-limited settings depends on leveraging facilitators while addressing persistent barriers. External partnerships, staff commitment, and faculty support are valuable enablers, but their impact is undermined by overcrowding, poor coordination, and resource shortages. Actionable strategies such as structured communication between training institutions and hospitals, phased student placement, targeted preceptor training, and investments in teaching equipment can mitigate barriers and reinforce facilitators. Strengthening these systems is vital for sustaining high-quality clinical education in Uganda and similar contexts. Keywords: Preceptorship, Barriers, Facilitators, Medical education, Uganda
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    “I can no longer give take-home exams”: health professionals educators’ experiences and perceptions regarding the use of artificial intelligence in health professions education in Uganda.
    (BMC, 2025) Mukunya, David; Nantale, Ritah; Paungholi, Kennedy; Epuitai, Joshua; Kayemba, Frank; Jemba, Brian; Ajalo, Elizabeth; Afodun, Adam; Musaba, Milton W.; Munabi, Ian G.; Kiguli, Sarah; Mubuuke, A. G.
    Introduction: Artificial intelligence (AI) tools offer immense opportunities and challenges for medical education. However, there is limited information about the use of AI among health professional educators, particularly in low and middle-income countries. We aimed to explore the experiences and perceptions regarding AI use in health professional education. Methods and materials: We collected qualitative data using in-depth interviews with 19 health professional educators. The interviews were audio-recorded and transcribed verbatim. We used Atlas Ti version 9.1 to organise the data. We used Braun and Clarke’s six-step thematic analysis for data analysis. The study was approved by the Busitema University Research and Ethics Committee (BUFHS-2023-79). Results: Three major themes were identified from the data: uptake and use of AI, perceived benefits of AI in health professional education, and concerns regarding AI use. We noted initial reluctance to support AI use, while its use varied from no or infrequent use to frequent use. Health professional educators used AI for various reasons, such as for teaching, student assessment, research, and personal work. AI was perceived to be beneficial in improving the clarity of writing, providing access to individual-tailored information, teaching, learning, and assessment, and research purposes. The barriers to AI use included a lack of institutional policies to guide AI use, limited capacity to afford paid AI versions, and reluctance to use AI. AI was seen to have inherent limitations, which included inaccurate information and a lack of contextual information for resource-limited settings. The fears of AI use included the risk of over-reliance on AI, academic misconduct, examination malpractice, ethical conflicts, and integrity. Conclusion: AI use in health professional education was perceived to have some benefits, amidst concerns that may derail its use in health professional education. The lack of policy and guidelines to govern the use of AI in health professions education underscores the need to develop policies and guidelines that safeguard and promote responsible and ethical use of AI. Keywords Health professional education, Artificial intelligence, Educators, Uganda
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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
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    Tuberculosis treatment success rate and its predictors among TB HIV co-infected patients in East and North Eastern Uganda.
    (Springer Nature, 2025) Omara, Godfrey; Bwayo, Denis; Mukunya, David; Nantale, Ritah; Okia, David; Matovu, K. B. Joseph; Wanume, Benon; Alunyo, Patrick Jimmy; Olupot-Olupot, Peter
    TB/HIV co-infection is associated with poorer treatment outcomes compared to TB alone. This study assessed the TB treatment success rate and its predictors among TB/HIV co-infected patients in East and North Eastern Uganda. A retrospective cohort design was used, involving 324 patients treated between July 2019 and July 2021 at three regional referral hospitals. Treatment success, defined as completing therapy with or without bacteriologic confirmation, was achieved by 71.9% of patients (95% CI 67–77%). Loss to follow-up was 12%, mortality 9.9%, treatment failure 0.3%, and 5.2% were not evaluated. Patients lacking sputum monitoring at five months were significantly less likely to achieve treatment success (aRR 0.48, 95% CI 0.34–0.66). These findings underscore the importance of effective follow-up to improve outcomes for TB/HIV co-infected patients. Keywords Tuberculosis, Treatment success rate, Treatment outcomes, HIV, Uganda
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    Utilisation of ChatGPT and other Artificial Intelligence tools among medical faculty in Uganda : a cross-sectional study.
    (MedEdPublish, 2025) Mukunya, David; Nantale, Ritah; Kayemba, Frank; Ajalo, Elizabeth; Pangholi, Kennedy; Babuya, Jonathan; Akuu, Suzan Langoya; Namiiro, Amelia Margaret; Tweheyo, Ronald; Ekak, Steven; Nakitto, Brenda; Nantongo, Kirsten; Mpagi, Joseph Luwaga; Musaba, Milton W.; Oguttu, Faith; Kuteesa, Job; Mubuuke, Aloysius Gonzaga; Munabi, Ian Guyton; Kiguli, Sarah
    Background ChatGPT is a large language model that uses deep learning techniques to generate human-like texts. ChatGPT has the potential to revolutionize medical education as it acts as an interactive virtual tutor and personalized learning assistant. We assessed the use of ChatGPT and other Artificial Intelligence (AI) tools among medical faculty in Uganda. Methods We conducted a descriptive cross-sectional study among medical faculty at four public universities in Uganda from November to December 2023. Participants were recruited consecutively. We used a semi-structured questionnaire to collect data on participants’ sociodemographics and the use of AI tools such as ChatGPT. Our outcome variable was the use of ChatGPT and other AI tools. Data were analyzed in Stata version 17.0. Results We recruited 224 medical faculty, majority [75% (167/224)] were male. The median age (interquartile range) was 41 years (34–50). Almost all medical faculty [90% (202/224)] had ever heard of AI tools such as ChatGPT. Over 63% (120/224) of faculty had ever used AI tools. The most commonly used AI tools were ChatGPT (56.3%) and Quill Bot (7.1%). Fifty-six faculty use AI tools for research writing, 37 for summarizing information, 28 for proofreading work, and 28 for setting exams or assignments. Forty faculty use AI tools for nonacademic purposes like recreation and learning new skills. Faculty older than 50 years were 40% less likely to use AI tools compared to those aged 24 to 35 years (Adjusted Prevalence Ratio (aPR):0.60; 95% Confidence Interval (CI): [0.45, 0.80]). Conclusion The use of ChatGPT and other AI tools was high among medical faculty in Uganda. Older faculty (>50 years) were less likely to use AI tools compared to younger faculty. Training on AI use in education, formal policies, and guidelines are needed to adequately prepare medical faculty for the integration of AI in medical education. Keywords ChatGPT, medical faculty, Bing, Bard, Uganda, generative AI, medical education
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    Widespread use of ChatGPT and other Artificial Intelligence tools among medical students in Uganda : a cross-sectional study.
    (PLOS One, 2025) Ajalo, Elizabeth; Mukunya, David; Nantale, Ritah; Kayemba, Frank; Pangholi, Kennedy; Babuya, Jonathan; Akuu, Suzan Langoya; Namiiro, Amelia Margaret; Nsubuga, Yakobo Baddokwaya; Mpagi, Joseph Luwaga; Musaba, Milton W.; Oguttu, Faith; Kuteesa, Job; Mubuuke, Aloysius Gonzaga; Munabi, Ian Guyton; Kiguli, Sarah
    Background Chat Generative Pre-trained Transformer (ChatGPT) is a 175-billion-parameter natural language processing model that uses deep learning algorithms trained on vast amounts of data to generate human-like texts such as essays. Consequently, it has introduced new challenges and threats to medical education. We assessed the use of ChatGPT and other AI tools among medical students in Uganda. Methods We conducted a descriptive cross-sectional study among medical students at four public universities in Uganda from 1st November 2023 to 20th December 2023. Participants were recruited by stratified random sampling. We used a semi-structured questionnaire to collect data on participants’ socio-demographics and use of AI tools such as ChatGPT. Our outcome variable was use of AI tools. Data were analyzed descriptively in Stata version 17.0. We conducted a modified Poisson regression to explore the association between use of AI tools and various exposures. Results A total of 564 students participated. Almost all (93%) had heard about AI tools and more than two-thirds (75.7%) had ever used AI tools. Regarding the AI tools used, majority (72.2%) had ever used ChatGPT, followed by SnapChat AI (14.9%), Bing AI (11.5%), and Bard AI (6.9%). Most students use AI tools to complete assignments (55.5%), preparing for tutorials (39.9%), preparing for exams (34.8%) and research writing (24.8%). Students also reported the use of AI tools for nonacademic purposes including emotional support, recreation, and spiritual growth. Older students were 31% less likely to use AI tools compared to younger ones (Adjusted Prevalence Ratio (aPR):0.69; 95% CI: [0.62, 0.76]). Students at Makerere University were 66% more likely to use AI tools compared to students in Gulu University (aPR:1.66; 95% CI:[1.64, 1.69]). Conclusion The use of ChatGPT and other AI tools was widespread among medical students in Uganda. AI tools were used for both academic and non-academic purposes. Younger students were more likely to use AI tools compared to older students. There is a need to promote AI literacy in institutions to empower older students with essential skills for the digital age. Further, educators should assume students are using AI and adjust their way of teaching and setting exams to suit this new reality. Our research adds further evidence to existing voices calling for regulatory frameworks for AI in medical education.