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1.
Artigo em Inglês | MEDLINE | ID: mdl-38768308

RESUMO

BACKGROUND: Neglected tropical diseases (NTDs) affect millions of people in Africa, with Uganda bearing a significant burden. The World Health Organization (WHO) set a goal to reduce NTDs and improve access to diagnosis and management by 2030. However, NTDs have not been well integrated into primary healthcare in many countries, including Uganda, due to limited knowledge and resources among health workers. The study aimed to assess the readiness and capacity of primary healthcare centres to diagnose and manage soil-transmitted helminths (STHs) and schistosomiasis. METHODS: A cross-sectional quantitative study was conducted among 204 health workers in 20 health facilities in four districts bordering Lake Kyoga. In this study we evaluated health workers' knowledge of symptoms, diagnosis and management of STHs and schistosomiasis as well as the availability of resources and training. RESULTS: Our findings indicate that health workers have strong knowledge about STHs (86.76%), with lower knowledge levels regarding Schistosoma haematobium (59.72%) and Schistosoma mansoni (71.43%). Regarding resources and training, 95% of health facilities had laboratory services, but the majority lacked diagnostic equipment. Furthermore, only 17% of health workers reported prior training on schistosomiasis and related topics and only 25% had training on surveillance and reporting. CONCLUSIONS: While health workers in eastern Uganda demonstrated a good knowledge base for some NTDs, there were knowledge gaps and challenges in training on surveillance and reporting mechanisms. Continuously building the capacity of health workers along with investing in diagnostic infrastructure is essential for improved NTD control and ultimately reducing associated morbidity and mortality in the region.

2.
JAC Antimicrob Resist ; 5(5): dlad105, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37795426

RESUMO

Background: Antimicrobial resistance (AMR) is significantly driven by misuse and overuse of antibiotics. Graduate health profession interns often prescribe antimicrobials under minimum supervision. Objectives: This study explored the knowledge, perceptions and confidence of health profession interns in Uganda regarding AMR and rational prescription practices. Methods: This was a cross-sectional survey employing quantitative techniques carried out between October and November 2022 at six tertiary hospitals in Uganda. Health profession interns including doctors, nurses, midwives and pharmacists were recruited as study participants. Data were collected using online Kobo toolbox software. Data analysis was performed using STATA (StataCorp) version 16. Bivariate analysis and multivariable logistic regression were performed. P < 0.05 was considered statistically significant. Results: We recruited 281 participants with a mean age of 27 ±â€Š3.8 years, of which few (n = 53; 19%) had good knowledge about AMR and rational prescription. The use of professional organization guidelines as a source of information was significantly associated with good knowledge (adjusted OR = 1.9; 95% CI: 1.0-3.5; P = 0.046). Nurses had the least knowledge compared with doctors and pharmacists. Continuous medical education (99%) and availability of clinical guidelines (98%) were identified as the most helpful intervention to improve knowledge. Most participants were confident about accurately diagnosing infections and sepsis and selecting appropriate antimicrobials. Conclusions: Continuous medical education and availability of clinical and professional organization guidelines should be leveraged to improve the knowledge of AMR and rational prescription among health profession interns. Their high confidence in rational prescription practices should be pivotal to the fight against AMR.

3.
Health Sci Rep ; 6(8): e1448, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37529252

RESUMO

On August 21, 2022, healthcare authorities in the Democratic Republic of the Congo (DRC) announced an outbreak of Ebola virus disease in North Kivu Province, bringing the total to 15 outbreaks nationwide. On September 20, 2022, Uganda's authorities declared an outbreak of the Sudan strain of the Ebola virus following a confirmed a case in Mubende district. As of October 6, 2022, the reported numbers of cases were 63, with 29 deaths in Uganda and 1 case with 1 death in DRC, respectively. Ebola virus causes an acute and severely fatal illness, resulting in death within a very short time if left untreated. In addition, these outbreaks in DRC and Uganda pose a major threat to the health and socioeconomic well-being of the people of East Africa due to multiple cross-border activities. Adequate preparations need to be made by the healthcare authorities of the nations concerned; the government, healthcare workers, and the East-African community as a whole have important roles to play in the effective prevention and control of the spread of Ebola virus within and across their borders.

4.
Afr J Emerg Med ; 13(2): 86-93, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37124320

RESUMO

Background: A robust emergency care system is a cost-effective method of reducing preventable death and disability, especially in low-and middle-income countries. To scale emergency care expertise across the country, the Uganda Ministry of Health and Seed Global Health established the Emergency Medical Services (EMS) ECHO program. We describe the process of establishing the program in a resource-limited setting, best practices, and lessons learned in Uganda. Methods: Investigators conducted a mixed-methods evaluation to assess the initial 4 months' implementation of the EMS ECHO. We conducted pre/post-program assessments of healthcare worker knowledge, self-efficacy, and professional's satisfaction with the program. The analysis compared the differences between pre/post-test scores descriptively. Results: The EMS ECHO was initiated in November 2021. A phased curriculum was developed with the initial phase focusing on the ABCDE (Airway, Breathing, Circulation, Disability, and Exposure) approach to the emergency patient. This phase reached 2,030 health workers cumulatively across 200 health facilities. The majority of the participants were medical doctors (n = 751, 37%), and nurses (n = 568, 28%). Majority of participants (95%) rated the sessions as informative. On whether the ECHO sessions diminished professional isolation, 66% agreed or strongly agreed. Conclusions: Similar to other ECHO program evaluation results, Uganda's EMS ECHO program improved knowledge, skills, and the development of a virtual community of practice thereby diminishing professional isolation. It also demonstrates that through a planned stepwise process, virtual learning and telementorship can be used efficiently to improve healthcare worker knowledge,skills and multiply the limited number of emergency care experts available in the country.

5.
J Surg Case Rep ; 2023(2): rjad037, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36755936

RESUMO

Paracecal hernias are a rare form of internal hernias. This is a case of a spontaneous paracecal retroperitoneal hernia in an elderly patient. A 73-year-old male, a known patient of adenocarcinoma of the rectum, who had undergone neoadjuvant radiotherapy and chemotherapy a year ago, presented with a 2-day-history of exacerbated colicky peri-umbilical and right-sided non-radiating abdominal pain, with associated progressive abdominal distension, which were aggravated by feeding. A contrasted abdominal computed tomography scan showed features of small bowel obstruction. An exploratory laparotomy revealed herniation of gangrenous small bowel ~30 cm through a small, tight opening just below the base of the cecum. Resection and anastomosis and closure of the retroperitoneal pouch were done. Patient recovered and was discharged on the fourth post-operative day. Spontaneous retroperitoneal hernias can occur in elderly patients with additional risk factors like neoplasms, with a high risk of bowel ischemia, hence the urgent need for surgical intervention.

7.
Antimicrob Resist Infect Control ; 11(1): 145, 2022 11 25.
Artigo em Inglês | MEDLINE | ID: mdl-36434685

RESUMO

BACKGROUND: Antimicrobial resistance (AMR) is an important global health concern, projected to contribute to significant mortality, particularly in developing countries. This study aimed to determine the knowledge, perceptions of clinical health professions students towards antimicrobial resistance and rational use of medicine and confidence level to prescribe antimicrobials. METHODS: An online descriptive cross-sectional survey was conducted among clinical health professions students across 9 medical schools in Uganda. A semi-structured questionnaire using Kobo Toolbox form was shared among participants via WhatsApp Messenger (Meta, California, USA). Knowledge was categorized using modified Bloom's cut-off. One-way ANOVA, Chi-square or Fisher's exact test, and logistic regression were used to assess the association between dependent and independent variables. A p < 0.05 was considered statistically significant. RESULTS: We surveyed 681 participants, most were pursuing a Bachelor of Medicine and Surgery degree (n = 433, 63.6%), with a mean age of 24 (standard deviation: 3.6) years. Most participants (n = 596, 87.5%) had sufficient knowledge about antimicrobial resistance with a mean score of 85 ± 14.2%. There was a significant difference in mean knowledge scores of year 4 (86.6%) compared to year 3 (82.4%) (p = 0.002) and year 5 (88.0%) compared to year 3 (82.4%) (p < 0.001). Most participants (n = 456, 66.9%), were confident on making an accurate diagnosis of infection, and choosing the correct antimicrobial agent to use (n = 484, 71.1%). CONCLUSION: Health profession students exhibited good knowledge on antimicrobial resistance and high self-perceived confidence that should be leveraged to foster better future antimicrobial prescription practices. However, they still agreed that a separated course unit on AMR is necessary which responsible authorities should consider to consolidate the efforts.


Assuntos
Antibacterianos , Anti-Infecciosos , Humanos , Adulto Jovem , Adulto , Antibacterianos/uso terapêutico , Estudos Transversais , Farmacorresistência Bacteriana , Uganda , Conhecimentos, Atitudes e Prática em Saúde , Anti-Infecciosos/uso terapêutico , Ocupações em Saúde , Estudantes
8.
Adv Med Educ Pract ; 13: 1293-1304, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36267053

RESUMO

Background: There is an unmet need for internal medicine physicians in Uganda owing to the growing burden of diseases. This study aimed at evaluating the factors associated with career choices of undergraduate medical students regarding internal medicine in Uganda. Methods: We conducted a cross-sectional study in the first 3 weeks of October 2021 via WhatsApp messenger. Medical students in the 3rd to 5th year of study who had completed internal medicine clinical rotations and pursuing a Bachelor of Medicine and Bachelor of Surgery (MBChB) degree at 7 Ugandan universities (4 public and 3 private) were enrolled. Multivariable logistic regression model was constructed to determine factors associated with a career choice in internal medicine. Results: We enrolled 418 participants, median age was 24 (interquartile range (IQR): 23-26) years, 67.7% were male, and 36.1% had a family member or relative who was a doctor. Most of the students (84.0%) were interested in research. The top three most preferred specialties were internal medicine (52.6%), surgery (51.2%), and obstetrics and gynaecology (51.0%). Overall, 186 (44.5%) participants reported plans to pursue a Master of Medicine degree in internal medicine. Interest in research was the only factor independently associated with 2.5-fold higher odds of pursuing a career in internal medicine (adjusted odds ratio: 2.5, 95% CI: 1.4-4.6, p = 0.003). About 73% of the participants strongly agreed that internal medicine requires wide reading. Conclusion: There is a strong interest to pursue a career in internal medicine among Ugandan medical students. We recommend an increase in training opportunities in Internal Medicine, especially in view of the growing disease burden and increasing population growth.

9.
Front Psychiatry ; 13: 792217, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35722591

RESUMO

Background: Lockdown is an important public health approach aimed at curbing the raging effect of the coronavirus disease-2019 (COVID-19). This study aimed at determining the impact of prolonged lockdown on mental health and access to mental health services among undergraduate students in Uganda. Methods: An online cross-sectional study was conducted anonymously among undergraduates across 10 universities in Uganda. The Distress Questionnaire-5 (DQ-5) and the Patient Health Questionnaire-2 (PHQ-2) were used. Logistic regression analysis was conducted to determine factors associated with psychological distress. Results: We enrolled 366 participants with a mean age of 24.5 ± 4.6 years. The prevalence of psychological distress was 40.2% (n = 147) (cut off 14/25 based on DQ-5) while depression stood at 25.7% (n = 94; cut off 3/6 based on PHQ-2) with mean scores of 12.1 ± 4.6 and 1.7 ± 1.6 respectively. Female gender (aOR: 1.6, 95%CI: 1.0-2.6, p = 0.032), pursuing a non-medical program (aOR: 2.2, 95%CI: 1.3-3.7, p = 0.005) were factors associated with psychological distress while non-medical program (aOR: 2.2, 95%CI: 1.3-3.7, p = 0.005) was associated with increased depression. Access to mental health services was associated with both reduced distress (aOR: 0.5, 95%CI: 0.3-0.8, p = 0.005) and depression (aOR: 0.6, 95%CI: 0.3-0.9, p = 0.034). A majority (65.3%) of the participants reported knowing how to access mental health care and 188 (51.4%) reported having needed emotional support but, only 67 (18.3%) ever sought care from a mental health professional. Of those who had access, only 10 (7%), and 13 (9%) accessed a counselor or a mental health unit, respectively. The barriers to accessibility of mental health care included financial limitations (49.5%), lack of awareness (32.5%), lack of mental health professionals (28.4%), and stigma (13.9%). Conclusion: Among university students in Uganda during the COVID- 19 lockdown, the burden of psychological distress and depression was substantial. However, access to mental health services was limited by several factors.

10.
Res Sq ; 2022 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-35378762

RESUMO

Background: Uganda has had the longest COVID-19-induced closures of schools world over of over 20 months, according to a recent UNICEF report, which has greatly affected learning and mental health of University students. This study assessed levels of anxiety, challenges and coping strategies of students at a university in Uganda during the COVID-19 pandemic lock down. Methods: We conducted an online, descriptive, cross-sectional study between 26th June and 26th July 2021 using mixed quantitative and qualitative methods among students of Busitema University in Eastern Uganda. The survey assessed anxiety levels of students using General Anxiety Disorder 7 (GAD-7) scale, and its associations using the Chi-Square or Fischer's exact test and multivariate logistic regression. We also explored the challenges and coping strategies employed by students through in-depth interviews. Results: A total of 338 students participated, 213 (63%) were male with median age of 23 years (21-25), majority from Faculty of health sciences (n = 153, 45%). Overall, 179 (53%) of the students had anxiety which was mostly mild anxiety (n = 127, 38%). Students concerned about inadequate internet facilities to support online learning were twice more likely to have anxiety (aOR 2.0, 95% CI 1.1-3.7; p = 0.021). Among those with anxiety, avoidance coping strategies had higher scores with a median of 8 (3-12) compared to other strategies (p < 0.001). In-depth interviews revealed challenges with online learning, academic progress, and changes to daily routine and fear of contracting COVID-19 and getting vaccinated. Conclusion: The largest number of students had anxiety especially those from faculty of health sciences and engineering of which most used avoidance strategies to cope up with the anxiety. This highlights areas where the university authorities should gear effort to design appropriate strategies to maintain mental health of students even after the pandemic.

11.
BMC Med Educ ; 22(1): 140, 2022 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-35241065

RESUMO

BACKGROUND: Uganda continues to depend on a health system without a well-defined emergency response system. This is in the face of the rising cases of out-of-hospital cardiac arrest contributed largely to the high incidence of road traffic accidents. Non-communicable diseases are also on the rise further increasing the incidence of cardiac arrest. Medical students are key players in the bid to strengthen the health system which warrants an assessment of their knowledge and attitude towards BLS inclusion in their study curriculum. METHODS: A descriptive cross-sectional study was conducted in 2021 among undergraduate medical students across eight public and private universities in Uganda. An online-based questionnaire was developed using Google forms and distributed via identified WhatsApp groups. Chi-square or Fisher's exact test and logistic regression were performed in STATA 15 to assess the association between knowledge of BLS and demographics. P < 0.05 was considered statistically significant. RESULTS: Out of the total 354 entries obtained, 351 were analyzed after eligibility screening. Of these, (n = 250, 71.2%) were male less than 25 years (n = 273, 77.8%). Less than half (n = 150, 42.7%) participants had undergone formal BLS training. Less than a third of participants (n = 103, 29.3%) had good knowledge (≥ 50%) with an overall score of 42.3 ± 12.4%. Age (p = 0.045), level of academic progress (p = 0.001), and prior BLS training (p = 0.033) were associated with good knowledge. Participants with prior training were more likely to have more BLS knowledge (aOR: 1.7, 95% CI: 1.1-2.7, p = 0.009). The majority (n = 348, 99.1%) believed that BLS was necessary and would wish (n = 343, 97.7%) to have it included in their curriculum. CONCLUSIONS: Undergraduate medical students have poor BLS knowledge but understand its importance. Institutions need to adopt practical teaching methods such as clinical exposures, field experience in collaboration with local implementers, and participating in community health promotion campaigns.


Assuntos
Reanimação Cardiopulmonar , Estudantes de Medicina , Reanimação Cardiopulmonar/educação , Estudos Transversais , Currículo , Humanos , Masculino , Uganda
12.
J Med Case Rep ; 16(1): 100, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-35232458

RESUMO

BACKGROUND: Coronavirus disease 2019 has been associated with adverse pregnancy outcomes, including preeclampsia. Coronavirus disease 2019 and preeclampsia have overlapping clinical features and are therefore challenging to differentiate. Since pregnant women are not routinely tested for coronavirus disease 2019, it is prudent to test for it among patients presenting with preeclampsia or eclampsia. CASE PRESENTATION: A 23-year-old female, a Munda, gravida 1 para 0, at 36 weeks and 5 days of amenorrhea presented to Mal Super Specialty Hospital as a referral in a semiconscious state after a severe attack of tonic-clonic seizures. Detailed history from the husband was insignificant except for a persistent cough for the last 7 days. She had denied any visual changes, headaches, or vaginal discharge. Physical examination revealed tachycardia (150 beats per minute), elevated blood pressure (187/111 mmHg), tachypnea (36 breaths per minute), and oxygen saturation of 94% on room air. Routine coronavirus disease 2019 rapid test was positive, and urine dipstick was +3. Additional tests revealed leukocytosis and elevated liver enzymes. Chest radiograph revealed prominent interstitial markings, and a bedside transabdominal ultrasonography showed a live single intrauterine fetus in cephalic presentation with normal cardiac activity and movements. A diagnosis of a prime gravida with eclampsia and coronavirus disease 2019 was made. She was managed with intravenous labetalol; she had already received a loading dose of intravenous magnesium sulfate, and we administered two maintenance doses during monitoring. Within an hour of admission, she had a spontaneous rupture of the amniotic membranes, with meconium-stained liquor (grade 2), and the fetal heart rate (148 beats per minute) was reassuring. She had an uncomplicated vaginal delivery of a live male newborn. Shortly after delivery, she developed slight respiratory distress and significant fluid overload that was managed with furosemide. Coronavirus disease 2019 reverse-transcription polymerase chain reaction test came back negative for the neonate and positive for the mother. She was shifted to the coronavirus disease 2019 treatment unit, and her contact with the child was limited. She was kept on a course of tablets ivermectin, zinc, vitamin C, montelukast, azithromycin, metronidazole, and injectable pantoprazole. The mother and child were discharged on day 15 after recovery with negative COVID nasopharyngeal swab. CONCLUSION: A diagnosis of preeclampsia or eclampsia should prompt testing for coronavirus disease 2019.


Assuntos
COVID-19 , Eclampsia , Complicações na Gravidez , Adulto , Criança , Eclampsia/diagnóstico , Eclampsia/tratamento farmacológico , Feminino , Hospitalização , Humanos , Recém-Nascido , Masculino , Gravidez , SARS-CoV-2 , Adulto Jovem
13.
Pan Afr Med J ; 40: 63, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34804331

RESUMO

The objectives of this study were to explore the content of web-based communication on COVID-19 by religious authorities (RAs) in Uganda and to assess the level of integration of the Uganda Ministry of Health (MoH) and World Health Organisation (WHO) COVID-19 risk communication guidelines into the statements released by these RAs. A grey literature review was conducted by searching the websites of intra- and inter-religious bodies for the terms "COVID-19" and "coronavirus". Thematic analysis was used to assess the content of RA statements which were also mapped to the items of the MoH and WHO statements. Results indicate that RA communications were centred on COVID-19 description and management; the need to adhere to established guidelines; and the adoption of health-protective behaviours, notably, social distancing and avoidance of misinformation. RAs also discussed the effects of COVID-19 and its control measures on the population and spoke against pandemic-aggravated injustices (gender-based violence and embezzlement). The RA messages incorporated the WHO statement to a greater extent than the MoH statement. In conclusion, RAs played a critical role in delivering public health messages in Uganda during the COVID-19 pandemic, a position we believe should be maximized by public health authorities for effective communication during emergencies.


Assuntos
COVID-19/prevenção & controle , Comunicação , Saúde Pública , Fidelidade a Diretrizes , Guias como Assunto , Humanos , Internet , Religião , Uganda
14.
Int Med Case Rep J ; 14: 683-687, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34611447

RESUMO

Postpartum hemorrhage (PPH), the loss of more than 500 mL of blood following childbirth, is a leading cause of maternal mortality worldwide. The current coronavirus disease 2019 (COVID-19) pandemic has strained health-care systems globally. Pregnant women are a vulnerable group at a high risk of severe infection with COVID-19 due to the physiological changes in their immune state. Although the infection can be asymptomatic, severe COVID-19 infection is associated with respiratory distress, fever and coagulopathies that can complicate an already hypercoagulable pregnancy state. There is a dearth of existing literature regarding the complications of COVID-19 infection during pregnancy, and much is yet to be known about this rapidly evolving pandemic. In our case report, we received a 23-year-old gravida 2 para 1 woman who was COVID-19 positive but asymptomatic; she presented to the obstetric department with labor pains which progressed to severe postpartum hemorrhage and development of mild respiratory distress.

15.
Trop Med Health ; 49(1): 37, 2021 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-33985592

RESUMO

BACKGROUND: COVID-19 is still a major global threat for which vaccination remains the ultimate solution. Uganda reported 40,751 cases and 335 deaths as of 9 April 2021 and started its vaccination program among priority groups like health workers, teachers, those with chronic diseases among others in early March 2021. Unanimous uptake of the COVID-19 vaccine is required to subsequently avert its spread; therefore, we assessed COVID-19 vaccine acceptability, hesitancy, and associated factors among medical students in Uganda. METHODS: This study employed an online descriptive cross-sectional survey among medical students across 10 medical schools in Uganda. A structured questionnaire via Google Form was conveniently sent to eligible participants via WhatsApp. Each medical school had a coordinator who consistently shared the data tool in the WhatsApp groups. Chi-square or Fisher's exact test, and logistic regression were used to assess the association between vaccine acceptability with demographics, COVID-19 risk perception, and vaccine hesitancy. RESULTS: We surveyed 600 medical students, 377 (62.8%) were male. COVID-19 vaccine acceptability was 37.3% and vaccine hesitancy 30.7%. Factors associated with vaccine acceptability were being male (adjusted odds ratio (aOR) = 1.9, 95% CI 1.3-2.9, p=0.001) and being single (aOR= 2.1, 95% CI 1.1-3.9, p=0.022). Very high (aOR= 3.5, 95% CI 1.7-6.9, p<0.001) or moderate (aOR =2.2, 95% CI 1.2-4.1, p=0.008) perceived risk of getting COVID-19 in the future, receiving any vaccine in the past 5 years (aOR= 1.6, 95% CI 1.1-2.5, p=0.017), and COVID-19 vaccine hesitancy (aOR 0.6, 95% CI 0.4-0.9, p=0.036). CONCLUSIONS: This study revealed low levels of acceptance towards the COVID-19 vaccine among medical students, low self-perceived risks of COVID-19, and many had relied on social media that provided them with negative information. This poses an evident risk on the battle towards COVID-19 in the future especially when these future health professions are expected to be influencing decisions of the general public towards the same.

16.
PLoS One ; 16(1): e0245036, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33400703

RESUMO

BACKGROUND: Irrational prescription of drugs can lead to high cost of treatment thus limiting access to essential medicines. We assessed the affordability and appropriateness of prescriptions written for diabetic patients in Eastern Uganda. METHODS: We collected secondary data from the health management information system registers of patients who attended the outpatient medical clinic at Mbale regional referral hospital from January 2019 to December 2019. The average cost of the prescriptions was calculated and adjusted odds ratios for predictors for unaffordability estimated using logistic regression. Computed scores for indicators of rational drug prescription were used to assess the extent of rational prescribing. RESULTS: The median cost per prescription was USD 11.34 (IQR 8.1, 20.2). Majority of the diabetic patients (n = 2462; 94.3%, 95% CI: 93.3-95.1%) could not afford the prescribed drugs. Predictors for unaffordability were if a prescription contained: ≥ 4 medicines (AOR = 12.45; 95% CI: 3.9-39.7); an injectable (AOR = 5.47; 95%CI: 1.47-20.32) and a diagnosis of diabetes mellitus with other comorbidities (AOR = 3.36; 95%CI: 1.95-5.78). Having no antidiabetic drug prescribed was protective for non-affordability (AOR = 0.38; 95%CI: 0.24-0.61). The average number of drugs per prescription was 2.8. The percentage prescription of drugs by generic name and from the essential medicine and health supplies list of Uganda were (6160/7461; 82.6%, 96% CI: 81.7%-83.4%) and (6092/7461; 81.7%, 95% CI: 80.8%-82.5%) respectively against WHO standard of 100%. CONCLUSION: The majority of diabetic patients (94.3%) in Eastern Uganda cannot afford to buy prescribed medicines. The government should therefore ensure that essential medicines are readily accessible in public health facilities.


Assuntos
Custos e Análise de Custo , Diabetes Mellitus/tratamento farmacológico , Medicamentos Essenciais/uso terapêutico , Medicamentos sob Prescrição/uso terapêutico , Estudos Transversais , Diabetes Mellitus/economia , Medicamentos Essenciais/economia , Humanos , Medicamentos sob Prescrição/economia , Indicadores de Qualidade em Assistência à Saúde , Estudos Retrospectivos , Centros de Atenção Terciária , Uganda
17.
JMIR Public Health Surveill ; 6(2): e19847, 2020 06 19.
Artigo em Inglês | MEDLINE | ID: mdl-32530815

RESUMO

BACKGROUND: The coronavirus disease (COVID-19) pandemic is a global public health concern affecting over 5 million people and posing a great burden on health care systems worldwide. OBJECTIVE: The aim of this study is to determine the knowledge, attitude, and practices of medical students in Uganda on the COVID-19 pandemic. METHODS: We conducted an online, descriptive cross-sectional study in mid-April 2020, using WhatsApp Messenger. Medical students in 9 of the 10 medical schools in Uganda were approached through convenience sampling. Bloom's cut-off of 80% was used to determine good knowledge (≥12 out of 15), positive attitude (≥20 out of 25), and good practice (≥12 out of 15). RESULTS: The data of 741 first- to fifth-year medical students, consisting of 468 (63%) males with a mean age of 24 (SD 4) years, were analyzed. The majority (n=626, 84%) were pursuing Bachelor of Medicine and Bachelor of Surgery degrees. Overall, 671 (91%) had good knowledge, 550 (74%) had a positive attitude, and 426 (57%) had good practices. Knowledge was associated with the 4th year of study (adjusted odds ratio [aOR] 4.1, 95% CI 1.6-10.3; P<.001). Attitude was associated with the female sex (aOR 0.7, 95% CI 0.5-1; P=.04) and TV or radio shows (aOR 1.1, 95% CI 0.6-2.1; P=.01). Practices were associated with the ≥24 years age category (aOR 1.5, 95% CI 1.1-2.1; P=.02) and online courses (aOR 1.8, 95% CI 1.1-3.2; P=.03). In total, 592 (80%) medical students were willing to participate in frontline care if called upon. CONCLUSIONS: Medical students in Uganda have sufficient knowledge of COVID-19 and will be a large reservoir for health care response when the need arises.


Assuntos
Infecções por Coronavirus/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Pandemias , Pneumonia Viral/epidemiologia , Estudantes de Medicina/psicologia , Adolescente , Adulto , COVID-19 , Estudos Transversais , Feminino , Humanos , Masculino , Faculdades de Medicina , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Uganda/epidemiologia , Adulto Jovem
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