Contribution of community health workers to the treatment of common illnesses among under 5-year-olds in rural Uganda.

BACKGROUND: The control of malaria, pneumonia, and diarrhoea is important for the reduction in morbidity and mortality among children under 5 years. Uganda has adopted the Integrated Community Case Management strategy using Community Health Workers (CHWs) to address this challenge. The extent and trend of these three conditions managed by the CHWs are not well documented. This study was done to describe the epidemiology and trends of the three common illnesses treated by the CHWs in Bugoye Sub-County in rural Uganda. METHODS: A retrospective review of monthly morbidity data for children less than 5 years of age for the period April 2014-December 2018 for CHWs in rural Bugoye Sub-County in Kasese district, Uganda was done. The total number reviewed was 18,430 records. The data were analysed using STATA version 14. RESULTS: In total male were 50.2% of the sample, pneumonia was the highest cause of illness among the infants (< 1 year), while malaria was the highest among the children 1 year-59 months. Infection with a single illness was the commonest recorded cause of presentation but there were some children recorded with multiple illnesses. All the CHWs were managing the three common illnesses among children under 5 years. The trend of the three common illnesses was changing from malaria to pneumonia being the commonest. Children aged 12-24 months and 25-59 months were at 2.1 times (95% CI 1.7-2.4) and 5.2 times (95% CI 4.6-5.9), respectively, more likely to get malaria but less likely to get pneumonia and diarrhoea. CONCLUSION: Community Health Workers in rural Uganda are contributing significantly to the management of all the three commonest illnesses among under-5 years-old children. The trend of the commonest illness is changing from malaria to pneumonia. Children under 1 year are at a higher risk of getting pneumonia and diarrhoea and at a lower risk of getting malaria.

Predictors of Premature Rupture of Membranes among Pregnant Women in Rural Uganda: A Cross-Sectional Study at a Tertiary Teaching Hospital.

BACKGROUND: Premature rupture of membranes (PROM) is a common condition in developed and developing countries and poses a serious threat to the maternal and fetal well-being if not properly managed. This study delineated the prevalence and predictors of PROM in the western part of Uganda so as to guide specific preventive measures. METHODS: A cross-sectional study design was conducted in the months of September 2019 to November 2019. A total of 334 pregnant women above 28 weeks of gestation admitted at the maternity ward of KIU-TH were consecutively enrolled. Interviewer-administered questionnaires were used to obtain the data. Descriptive statistics followed by binary logistic regression were conducted. All data analyses were conducted using STATA 14.2. RESULTS: Of the 334 pregnant women enrolled, the prevalence of PROM was found to be 13.8%. The significant independent predictors associated with lower odds of PROM were no history of urinary tract infection (UTI) in the month preceding enrollment into the study (aOR = 0.5, 95% CI: 0.22-0.69, p = 0.038) and gestational age of 37 weeks or more (aOR = 0.3, 95% CI: 0.14-0.71, p = 0.038) and gestational age of 37 weeks or more (aOR = 0.3, 95% CI: 0.14-0.71, p = 0.038) and gestational age of 37 weeks or more (aOR = 0.3, 95% CI: 0.14-0.71. CONCLUSIONS: Majorly urinary tract infections, low gestational age, and abortions influence premature rupture of membranes among women. There is a great need for continuous screening and prompt treatment of pregnant women for UTI especially those with history of 3 or more abortions at less than 34 weeks of gestation.