Browsing by Author "Wandabwa, Julius"

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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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    Community perspectives regarding preparedness, response and prevention of ebola virus disease amidst COVID-19 pandemic, an exploratory descriptive qualitative study using a community engagement approach in Mbale City.
    (Research Square, 2024) Kagoya, Enid Kawala; Nsubuga, Allan G.; Ewing, Helen; Atuhairwe, Irene; Ijangolet, Esther; Otim, Eric; Ronald, Kibuuka; Jesca, Atugonza; Okello, Francis; Nakattudde, Prossy; Nyangoma, Faith; Namara, Racheal; Nakabaale, Mark; Nakawuka, Betty; Nakawuki, Ashley; Kizito, Prisca; Waako, Paul; Wandabwa, Julius; Makoko, Tonny Brian; Musaba, Milton; Ahaisibwe, Bonaventure; Barugahare, Banson
    Background: Ebola virus disease (EVD) is a rare and deadly infectious hemorrhagic fever disease. Four of the 6 known Ebola virus species can cause human disease. Since 1976, EVD outbreaks have been recorded sporadically in East, Central, and West Africa. Uganda has experienced 6 documented outbreaks of EVD since 2000 that can be attributed to 3 species of Ebola viruses (Zaire, Sudan, and Bundibugyo). Despite substantial advances in clinical management, the case fatality ratio for EVD remains high, reaching more than 60% for the Zaire Ebola virus in 2018–2020. Methods. The study followed a descriptive qualitative study design. Data were collected using an interviewer-administered questionnaire with both closed and open-ended questions. Data were analysed using ATLAS Pro. Results: Our results illustrate the lack of health education in the community among the different categories of people and this comes from an emic perspective. We identified 4 high-level themes and 19 subthemes, (1) Knowledge of Ebola Virus Disease, (2) Prevention of EVD in the community, (3) Preparedness for Ebola Virus Disease, and (4) Community response to Ebola Virus Disease and the final thematic area (4) which included giving first aid, using traditional medicines, and approaching a health facility among others. Conclusions: With all the available information about the previous outbreaks in Uganda, it is surprising that less effort was made this time round to take local sensibilities and culture into account among other social factors contributing to the poor practices of masses toward the EVD, preparedness, prevention, and response. Keywords: Ebola Virus Disease, Preparedness, Response and Prevention, Community Engagement
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    Covariates of pica among pregnant women attending antenatal care at Kawempe hospital, Kampala, Uganda: a cross-sectional study
    (The American Society of Tropical Medicine and Hygiene, 2021) Nakiyemba, Olivia; Obore, Susan; Musaba, Milton; Wandabwa, Julius; Kiondo, Paul
    Pica is the craving and purposive eating of nonfood items. It is common worldwide and presents among vulnerable populations like children and pregnant women. Its etiology and health consequences are not well understood. The aim of this study was to determine the prevalence and covariates of pica among pregnant women attending antenatal clinic at Kawempe hospital in Uganda. We conducted a cross-sectional study from July 2019 to December 2019. Participants in this study were 307 pregnant women who had come to attend antenatal clinic at the hospital. The prevalence of pica was computed. Bivariate and multivariable analysis was done to establish the factors that were independently associated with pica. The prevalence of pica was 57%. The most common type of pica was geophagia (eating clay and sand) followed by pagophagia (eating ice). Of the women who practiced pica, half consumed the nonfood items daily. Factors independently associated with pica were being in the third trimester (adjusted OR [aOR]: 3.60; 95% CI: 1.36–9.48] and having nausea in pregnancy (aOR: 2.11; 95% CI: 1.20–3.70). At Kawempe hospital, pica is common among women who attend the antenatal clinic and is associated with having nausea in pregnancy and being in the third trimester. Health workers need to counsel pregnant women about the dangers of pica so as to reduce helminth infections and micronutrient deficiency associated with it.
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    Feasibility, acceptability and preliminary effects of a social network-based, peer-led HIV self-testing intervention among men in two Ugandan fishing communities, 2022.
    (BMC, 2025) Matovu, KB Joseph; Namwama, Aisha Twahiri; Kemigisha, Linda; Taasi, Geoffrey; Nakabugo, Jennipher; Wandabwa, Julius; Bogart, M. Laura; Fakier, Nuraan; Wanyenze, K. Rhoda; Olupot-Olupot, Peter; Musinguzi, Joshua; Serwadda, David
    Background: Social network-based interventions can improve uptake of health interventions. However, limited evidence exists on their feasibility and acceptability in fishing community settings. We assessed the feasibility, acceptability and preliminary effects of a social network-based, peer-led HIV self-testing (HIVST) intervention among men in Uganda. Methods: The PEer-led HIVST intervention for MEN (PEST4MEN) is a pilot intervention conducted among men in Kalangala and Buvuma districts. Baseline data were collected in July 2022 and follow-up data in September 2022. The intervention was implemented through 22 trained lay men (“peer-leaders”) who received training in HIVST use and distribution processes and requested to refer at least 20 male members from their social networks for study eligibility screening. To be eligible, men had to be aged 15 years or older with unknown or HIV-negative status. After the baseline interview, men were requested to pick two oral fluid-based HIVST kits from their peer-leaders. The intervention was deemed feasible if peer-leaders gave-out >80% of the kits and acceptable if>80% of the kits’ recipients used them to self-test for HIV. At the follow-up interview, newly diagnosed HIV-positive men were asked if they had linked to HIV care. Data were descriptively analyzed using STATA version 16.0. Results: Of 475 screened men, 400 (84.2%) met the eligibility criteria and completed the baseline interview. Of these, 56.7% (n=227) were engaged in fishing or fishing-related activities. At follow-up, 361 men (90.2%) were interviewed; 98.3% (n=355) received at least one kit from their peer-leaders. Nearly all (99.1%, n=352) kits’ recipients used them to self-test for HIV. Of the 352 HIV self-testers, 51 men (14.5%) had reactive (positive) HIV self-test results. Nearly onethird of the HIV self-tested men (31.4%, n=16) were first-time HIV-positive testers. Of these, 87.5% (n=14) went for confirmatory HIV testing, 50.0% (n=7) were confirmed as HIV-positive and 71.4% (n=5) were linked to HIV care. Conclusion: Our peer-led HIVST intervention was feasible and acceptable and identified newly diagnosed HIVpositive men who were linked to HIV care. However, while these results are promising, we recommend additional research in a randomized controlled trial prior to the eventual roll-out of this intervention. Trial registration ClinicalTrials.Gov: NCT05685498 (retrospectively registered on January 17, 2023). Keywords Peer-led, HIVST, Men, Fishing communities, Uganda
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    Watching over life : practices and meanings of postpartum vital signs monitoring in eastern Uganda.
    (medRxiv, 2025) Babuya, Jonathan; Kayemba, Frank; Waiswa, Sinani; Nsubuga, Allan G.; Ewing, Helen; Atuhairwe, Irene; Ijangolet, Esther; Otim, Eric; Ronald, Kibuuka; Jesca, Atugonza; Okello, Francis; Nakattudde, Prossy; Nyangoma, Faith; Nakawuka, Betty; Kabahinda, Nichola; Kamwesigye, Assen; Apoya, Jill; Waako, Paul; Wandabwa, Julius; Musaba, Milton; Bonaventure, Ahaisibwe; Aeby, Tod; Nandutu, Sarah; Mugabe, Kenneth; Pangholi, Kennedy; Nahurira, Doreck; Agaba, Brian; Mbwali, Immaculate; Bahati, Johnson; Kagoya, Enid Kawala
    Introduction Postnatal deaths account for about one-third of maternal mortality in Low- and middle-income countries (LMICs). Nearly half occur within the first 24 hours and are preventable through continuous inpatient monitoring. This study assessed maternal mortality within the first 24 postnatal hours; and the current postpartum monitoring practices, including the availability of monitoring charts and the frequency of vital sign assessments in eastern Uganda. Methods This cross-sectional study reviewed the medical records of all postpartum women admitted at Mbale Regional Referral Hospital, Eastern Uganda, between August 2022 and February 2023. A semi-structured data extraction form was used. The outcome variable was postpartum monitoring; categorized as "No" for women with no vital signs monitored and "Yes" for those with at least one vital sign monitored. Descriptive analysis was performed using Stata Version 17.0, and Poisson regression was employed to explore the association between various factors and postpartum monitoring. Results Medical records of 2,717 postpartum mothers were reviewed. The median (interquartile range) age was 25(20-30) years. A minority (34%; 910/2717) of mothers had vital sign observation charts in their medical records and very few (4%; 110/2717) had a fluid balance chart. About 49 24% (651/2717) of mothers had at least one vital sign recorded. Blood pressure was the most (16.8%; 456/2717) recorded vital sign followed by pulse rate (13.6%; 369/2717). Respiratory rate and temperature were the least monitored vital signs with 1.2% and 1.1% records respectively. Mothers who delivered by C-section had a 151% higher prevalence of postpartum monitoring compared to those who had a vaginal delivery (aPR: 2.51; 95% CI: 2.19–2.89). Maternal mortality rate on the first postpartum day was 8.8 per 1000, with postpartum hemorrhage accounting for 61%. Conclusion Postpartum vital signs monitoring was low. LMICs need to devise means of automating the monitoring process.