Browsing by Author "Waako, Paul"

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    Effect of pre-operative bicarbonate infusion on maternal and perinatal outcomes among women with obstructed labour in Mbale hospital: A double blind randomized controlled trial
    (PLOS One, 2021) Musaba, Milton W.; Wandabwa, Julius N.; Ndeezi, Grace; Weeks, Andrew D.; Mukunya, David; Waako, Paul; Nankabirwa, Victoria; Tulyamuhika Mugabe, Kenneth; Semakula, Daniel; Tumwine, James K.; Barageine, Justus K.
    Introduction Oral bicarbonate solution is known to improve both maternal and perinatal outcomes among women with abnormal labour (dystocia). Its effectiveness and safety among women with obstructed labour is not known. Objective To determine the effect and safety of a single-dose preoperative infusion of sodium bicarbonate on maternal and fetal blood lactate and clinical outcomes among women with obstructed labour (OL) in Mbale hospital. Methods We conducted a double blind, randomised controlled trial from July 2018 to September 2019. The participants were women with OL at term (>37 weeks’ gestation), carrying a singleton pregnancy with no other obstetric emergency, medical comorbidity or laboratory derangements. Intervention A total of 477 women with OL were randomized to receive 50ml of 8.4% sodium bicarbonate (238 women) or 50 mL of 0.9% sodium chloride (239 women). In both the intervention and controls arms, each participant was preoperatively given a single dose intravenous bolus. Every participant received 1.5 L of normal saline in one hour as part of standard preoperative care. Outcome measures Our primary outcome was the mean difference in maternal venous blood lactate at one hour between the two arms. The secondary outcomes were umbilical cord blood lactate levels at birth, neonatal sepsis and early neonatal death upto 7 days postnatal, as well as the side effects of sodium bicarbonate, primary postpartum hemorrhage, maternal sepsis and mortality at 14 days postpartum. Results The median maternal venous lactate was 6.4 (IQR 3.3–12.3) in the intervention and 7.5 (IQR 4.0–15.8) in the control group, with a statistically non-significant median difference of 1.2 mmol/L; p-value = 0.087. Vargha and Delaney effect size was 0.46 (95% CI 0.40–0.51) implying very little if any effect at all. Conclusion The 4.2g of preoperative intravenous sodium bicarbonate was safe but made little or no difference on blood lactate levels.
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    Incidence and determinants of perinatal mortality among women with obstructed labour in eastern Uganda: a prospective cohort study
    (Springer Nature, 2021) Musaba, Milton W.; Ndeezi, Grace; Barageine, Justus K.; Weeks, Andrew D.; Wandabwa, Julius N.; Mukunya, David; Waako, Paul; Odongkara, Beatrice; Arach, Agnes; Tulya-muhika Mugabe, Kenneth; Kasede Napyo, Agnes; Nankabirwa, Victoria; Tumwine, James K.
    Background: In Uganda, the incidence and determinants of perinatal death in obstructed labour are not well documented. We determined the incidence and determinants of perinatal mortality among women with obstructed labour in Eastern Uganda. Methods: Between July 2018 and September 2019, 584 with obstructed labour were recruited and followed up to the 7th day postnatal. Information on maternal characteristics, obstetric factors and laboratory parameters was collected. Each patient received the standard perioperative care. We used a generalized linear model for the Poisson family, with a log link and robust variance estimation to determine the association between the exposure variables and perinatal death. Results: Of the 623 women diagnosed with obstructed labour, 584 met the eligibility criteria. There were 24 fresh still births (FSB) and 32 early neonatal deaths (ENND) giving an FSB rate of 43.8 (95% CI 28.3–64.4) deaths per 1000 total births; early neonatal death rate of 58.4 (95% CI 40.3–81.4) deaths per 1000 and an overall perinatal mortality rate of 102.2 (95% CI 79.4–130.6) deaths in the first 7 days of life. A mother being referred in active labour adjusted risk ratio of 2.84 (95% CI: 1.35–5.96) and having high blood lactate levels at recruitment adjusted risk ratio 2.71 (95% CI: 1.26–4.24) were the determinants of perinatal deaths. Conclusions: The incidence of perinatal death was four times the regional and national average. Babies to women referred in active labour and those with high maternal blood lactate were more likely to die. Keywords: Obstructed labour, Perinatal death, Determinants, Lactate
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    Integrating STEM Education in Uganda’s Higher Education to Produce Skills Required to Stimulate Industrialisation and Sustainable Economic Growth.
    (The Uganda Higher Education Review Journal, 2024) Nalule, Rebecca Muhumuza; Muhumuza, Asaph Keikara; Mbabazi, Fulgensia Kamugisha; Kyomuhangi, Annet; Mwasa, Abubakar; Oyem, Anselm O.; Kadedesya, Stephen; Nabirye, Topista; Nanyondo, Josephine; Wamakote, Leonard; Muweesi, Charles; Atibuni, Dennis; Ocen, Gilbert; Semwogerere, Twaib; Olema, David C.; Kanyarusoke, Kant; Rwahwire, Samson; Nabasa, Lillian Gimugumi; Aguti, Jessica Norah; Biira, Saphina; Kucel, Samuel Baker; Waako, Paul; Mwesigwa, Sheldon Fred
    The high cost of education, coupled with the high rate of unemployment, is a major concern for developing countries, including Uganda. The economic growth of any developing nation heavily relies on its capacity to create sustainable job opportunities across various sectors. An education based on Science, Technology, Engineering and Mathematics (STEM) can serve as a powerful driving force to overcome barriers and achieve this crucial milestone. The traditional methods of teaching, learning and research in higher institutions of learning (HIL) in Uganda mainly emphasise theoretical knowledge rather than practical skills development. This leads to a wider gap in the skills required of graduates for job creation, industrialisation and stimulating economic growth. This study aims to investigate the key factors that should be considered for the effective integration of STEM education into Uganda’s higher education (HE) in relation to the needs of industry and community development. By adopting integrated STEM education, we envision that empowered graduates will become innovators and job creators. To gather comprehensive insights into the perception of integrated STEM education in HIL, qualitative data was collected from 42 respondents using an online semi structured questionnaire. The data was analysed using descriptive statistics. The study established that although some integrated STEM education exists in academia, industry and the community, its full integration is limited by the inadequacy of quality staff, funding and the rather weak collaboration and partnership between academia, industry and community. The study recommends that there is need to enhance the integration of STEM education into Uganda’s HIL by recruiting quality staff, increasing funding and strengthening collaboration and partnership between academia, industry and community. This will produce skilled graduates who are job creators and highly employable in industry, a requisite for sustainable economic growth in the 21st century. Keywords: STEM education; Higher education; Job creation; Industrialisation; Sustainable economic growth.