Browsing by Author "Baguma, Steven"

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    Characteristics of the COVID-19 Patients Treated at Gulu Regional Referral Hospital, Northern Uganda: A Cross-Sectional Study
    (Journal of Infectious Diseases & Therapy, 2022) Okot, Christopher; Baguma, Steven; Alema Onira, Nelson; Odong Agings, Willis; Arwinyo, Baifa; Elima, James; Apiyo, Paska; Layet, Paska; Pebalo Pebolo, Francis; Acullu, Denis; Oloya, Johnson Nyeko; Oyat, Freddy Wathum Drinkwater; Oola, Janet; Aloyo, Judith; Ikoona, Eric Nzirakaindi; Kitara, David Lagoro
    Background: Coronavirus Disease 2019 (COVID-19) is a severe respiratory disease that results from infection with a new coronavirus (SARS-CoV-2). One of the most critical issues related to the COVID-19 is the high rate of spread, millions of people have been infected around the world, and hundreds of thousands of people have died till now. However, reports from Africa paint a different picture of the SARS-CoV-2 and its effects on the population. Objectives: The objective of this study was to describe the characteristics of the COVID-19 patients treated at the Gulu Regional Referral Hospital and determine factors associated with COVID-19 manifestations, socio-demographic characteristics, and treatment outcomes from March 2020 to October 2021. Methods: A retrospective data abstraction of all COVID-19 hospital admissions registered in the Gulu Health Management Information System (HMIS) database and other tools were conducted. The period of study was from March 2020 to October 2021. Data that met the inclusion criteria were consecutively abstracted from the Gulu Hospital HMIS database. A local IRB approved the study. SPSS version 25.0 was used for data analysis, and a p-value of 0.05 was considered significant. Results: Data suggests there were three waves of COVID-19 in Uganda. Those with comorbidities, e.g., Diabetes mellitus 38(5.7%), hypertension 83(12.5%), cardiovascular diseases 58(8.7%), HIV and AIDS 61(9.2%), and other comorbidities such as liver cirrhosis and Hepatitis B 40(6.0%) were more susceptible and presented with more severe forms of the disease. Antibiotics 662(99.7%), steroids 73(11.0%), vitamin C 564(84.9%), Ivermectin 7(1.1%), and Vitamin D 24(3.6%) were the most used medicines for the treatment of COVID-19 patients. Most COVID-19 patients were unvaccinated 661(99.5%). However, the recovery rate was 632(95.2%). The commonest complications were pneumonia 60(9.0%), chronic fatigue 49(7.4%), acute respiratory distress syndrome (ARDS) 37(5.6%), depression 20(3.0%), systemic infections 19(2.9%), nightmares 15(2.3%) and septic shock 8(1.2%). The Adjusted Odds Ratios (AOR) on factors associated with recovery were treatment with steroids AOR=138.835 at 95% CI:12.258-1572.50;p<0.000 and Vitamin D AOR=31.4780 at 95% CI:1.902520.98; p=0.016. Conclusion: This study showed successful management of COVID-19 patients in low-resource settings with a recovery rate of 95.2%. The admission pattern suggests Uganda had three waves of COVID-19, contrary to the official government position of two. Treatment with steroids and Vitamin D is associated with the recovery among COVID-19 patients. There is a need to conduct more extensive studies on the role played by the two drugs in the successful recovery of COVID-19 patients.
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    Facemask wearing in COVID-19 pandemic:
    (medRxiv, 2023-10-24) Alema, Nelson Onira; Okot, Christopher; Olal, Emmanuel; Ikoona, Eric Nzirakaindi; Oyat, Freddy Wathum Drinkwater; Baguma, Steven; Ochula, Denish Omoya; Olwedo, Patrick Odong; Oloya, Johnson Nyeko; Pebolo, Francis Pebalo; Atim, Pamela Okot; Okot, Godfrey Smart; Nantale, Ritah; Aloyo, Judith; Kitara, David Lagoro
    Background: The WHO and the US. CDC documented that facemask-wearing in public situations is one of the most important prevention measures that can limit the acquisition and spread of COVID-19. Considering this, WHO and US. CDC developed guidelines for using facemasks in public settings. This study aimed to determine correlates and prevalence of facemask wearing during COVID-19 pandemic among adult population of Northern Uganda. Methods. We conducted a cross-sectional study on five hundred and eighty-seven adult population of northern Uganda. A single stage stratified, and systematic sampling methods were used to select respondents from twenty four Acholi subregion’s health facilities. Data was collected in a face-to-face questionnaire interview with an internal validity of Cronbach's α=0.72. A local IRB approved the study, and Stata 18 was used for data analysis at multivariable Poisson regression with a p-value set at ≤0.05. Results: The most substantial findings from this study were the high prevalence of face mask-wearing in public among respondents [88.7%,95%CI:86%-91%]. At a multivariable Poisson regression analysis, we found that obese respondents were 1.12 times more likely to wear facemasks than those who were not, [adjusted Interval Rates Ratios, aIRR=1.12,95%CI:1.04-1.19;p<0.01], and respondent who agreed to the lockdown measures were 1.23 times more likely to wear facemasks during COVID-19 pandemic than those who did not, [aIRR=1.23, 95%CI:1.07- 1.41;p<0.01]. Other sociodemographic characteristics such as sex, age, occupation, level of education, religion, tribes, marital status, nationality, race, and comorbidities were not statistically significant at 95% Confidence Intervals. Conclusion: The most significant findings from this study were the high prevalence of face mask-wearing among adult community members in northern Uganda. The correlates of facemask wearing in public were the obese and respondents who agreed with the presidential directives on the lockdown measures. Although this was within acceptable prevalence rates, the strict enforcement of face mask-wearing by security forces raised concerns among many community members and human rights advocates. We recommend more studies on communities' perspectives on the challenges and benefits of facemask-wearing during the COVID-19 pandemic.
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    Factors Associated With Mortality Among the COVID-19 Patients Treated at Gulu Regional Referral Hospital: A Retrospective Study
    (Frontiers Public Health, 2022-04-11) Baguma, Steven; Okot, Christopher; Onira Alema, Nelson; Paska, Apiyo; Layet, Paska; Acullu, Denis; Nyeko Oloya, Johnson; Ochula, Denis; Atim, Pamela; Odong Olwedo, Patrick; Okot, Smart Godfrey; Oyat, Freddy Wathum Drinkwater; Oola, Janet; Ikoona, Eric Nzirakaindi; Aloyo, Judith; Kitara, David Lagoro
    Background: The advent of the novel coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide. As of December 2021, there is inadequate data on the outcome of hospitalized patients suffering from COVID-19 in Africa. This study aimed at identifying factors associated with hospital mortality in patients who suffered from COVID-19 at Gulu Regional Referral Hospital in Northern Uganda from March 2020 to October 2021. Methods: This was a single-center, retrospective cohort study in patients hospitalized with confirmed SARS-CoV-2 at Gulu Regional Referral Hospital in Northern Uganda. Socio-demographic characteristics, clinical presentations, co-morbidities, duration of hospital stay, and treatments were analyzed, and factors associated with the odds of mortality were determined. Results: Of the 664 patients treated, 661 (99.5%) were unvaccinated, 632 (95.2%) recovered and 32 (4.8%) died. Mortality was highest in diabetics 11 (34.4%), cardiovascular diseases 12 (37.5%), hypertensives 10 (31.3%), females 18 (56.3%), ≥50-year-olds 19 (59.4%), no formal education 14 (43.8%), peasant farmers 12 (37.5%) and those who presented with difficulty in breathing/shortness of breath and chest pain 32 (100.0%), oxygen saturation (SpO2) at admission <80 4 (12.5%), general body aches and pains 31 (96.9%), tiredness 30 (93.8%) and loss of speech and movements 11 (34.4%). The independent factors associated with mortality among the COVID-19 patients were females AOR = 0.220, 95%CI: 0.059–0.827; p = 0.030; Diabetes mellitus AOR = 9.014, 95%CI: 1.726–47.067; p = 0.010; Ages of 50 years and above AOR = 2.725, 95%CI: 1.187–6.258; p = 0.018; tiredness AOR = 0.059, 95%CI: 0.009–0.371; p < 0.001; general body aches and pains AOR = 0.066, 95%CI: 0.007–0.605; p = 0.020; loss of speech and movement AOR = 0.134, 95%CI: 0.270–0.660; p = 0.010 and other co-morbidities AOR = 6.860, 95%CI: 1.309–35.957; p = 0.020. Conclusion: The overall Gulu Regional Hospital mortality was 32/664 (4.8%). Older age, people with diabetics, females, other comorbidities, severe forms of the disease, and those admitted to HDU were significant risk factors associated with hospital mortality. More efforts should be made to provide “additional social protection” to the most vulnerable population to avoid preventable morbidity and mortality of COVID-19 in Northern Uganda.
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    Is the 14% cesarean section rate in Gulu Regional Referral Hospital justifiable?
    (. PAMJ Clinical Medicine, 2021-03-26) Pebolo, Francis Pebalo; Baguma, Steven; Auma, Anna Grace
    Worldwide, cesarean section (CS) rates haveincreased tremendously in recent years, especially among high-income countries, raising concernsabout the over-utilization of CS without added benefits, and in the sub-Saharan African region, therate is at its lowest (7.3%). In Uganda, the CS rate stands at 6% and is seen to be higher (11%) among first-order births indicating a high incidence of primary CS. Despite the low rate of CS in Uganda,there are massive gaps in the provision of obstetric procedure with some women receiving unnecessary surgeries, and the facility-based CS rate is projected to increase to 32% by end of 2021. Notwithstanding the increasing facility rates of CS, Gulu Regional Referral Hospital (GRRH) rate has remained low in the years 2017-2019, with lower levels maternal mortality ratio and fresh stillbirths´ rates compared to the national average. Prolonged labor is one of the commonest indications for primary CS accounting for more than 50% among nulliparous women and this is linked to progress of labor usually measured using cervical dilatation. World Health Organization (WHO) recommended a change in cervical dilatation from 4cm to 5cm as a threshold for the active phase of the first stage of labor, as away to reduce unnecessary labor intervention including the CS. Lack of standard reporting tools such as the WHO Robson´s ten group classification in Uganda make comparisons of CS rate between/within facility/facilities worrisomely difficult.
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    Perceptions of COVID-19 vaccination among different adult age group populations in Northern Uganda. A cross-sectional study.
    (Research squares, 2022-07-14) Oloya, Johnson Nyeko; Baguma, Steven; Okot, Christopher; Alema, Nelson Onira; Acullu, Denis; Ochula, Denis; Atim, Pamela; Olwedo, Patrick Odong; Okot, Smart Godfrey; Pebolo, Francis Pebalo; Freddy Wathum Drinkwater Oyat, Freddy Wathum Drinkwater; Ikoona, Eric Nzirakaindi; Aloyo, Judith; Oballim, Lawence; Kitara, David Lagoro
    Introduction: Although COVID-19 first spread slowly in the African continent, confirmed virus cases have risen steadily since March 2020. The rapid spread of SARS-CoV-2 can be attributed to its numerous characteristics, including its high transmissibility, asymptomatic persons’ ability to shed the virus, vast numbers of asymptomatic persons, or mild symptoms but with the ability to transmit the virus, new variants, and super-spreading events. Poor public health practices,disbeliefs, myths, and misconceptions about the virus and its origin in many African communities are the other reasons for its rapid spread. This study aimed to determine the perceptions of the adult population in northern Uganda on the COVID-19 vaccine acceptance, disaggregated by age groups. Methods: A cross-sectional study was conducted between March and April 2022 to assess COVID-19 vaccine acceptance among seven hundred and twentythree adult populations selected randomly from the nine districts of the Acholi sub-region. A five-point Likert scale with responses categorized as Strongly Agree, "SA," Agree, "A," Neutral, "N," Disagree, "DA," and Strongly Disagree, "SD" was used to assess participants' acceptance of the COVID-19 vaccines. Ethical approval was obtained from a local IRB, and SPSS version 20.0 was used to perform multivariable logistic regression to identify factors associated with vaccine acceptance. A p-value less than 0.05 was considered significant. Results: The most significant finding was that COVID-19 vaccine acceptance among the adult population in northern Uganda disaggregated by age groups was not statistically significant (χ2=3.956; p=0.142). COVID-19 vaccine acceptance among the age groups was associated with trust in the information from the mainstream media χ2=20.105; p=0.000; Government of Uganda χ2=19.900; p=0.028 and social media 10.745; p=0.030. The independent predictors on perceptions of the COVID-19 vaccine acceptance among age groups were; Participants strongly agreed on its importance to protect them from the virus AoR=4.99;95% CI:1.626-15.337;p=0.005; Agreed that the vaccine would protect them from the virus AoR=3.44;95%CI:1.225-9.650;p=0.019; strongly agreed that the side effects of the vaccine would stop them from receiving the vaccine AoR=0.330; 95%CI:0.125-0.856; p=0.023; They were neutral on whether the side effects of the COVID-19 vaccine would stop them from getting a COVID-19 jab AoR= 0.320; 95%CI:0.108-0.952;p=0.027; would not accept to pay for the COVID-19 vaccine AoR=0.280;95%CI:0.093-0.866; p=0.027; Agreed that children could take a COVID-19 vaccine AoR= 0.260; 95%CI:0.105-0.626;p=0.003; Strongly agreed that children could return to school before the COVID-19 vaccination AoR= 2.330; 95%CI:1.103-4.916;p=0.027; and agreed that children could return to school before taking COVID-19 vaccines AoR= 3.320; 95%CI:1.225-9.014;p=0.018. Conclusion: COVID-19 vaccine acceptance among the study population disaggregated by age group was not significant despite the disinformation and misinformation in the Ugandan media. The independent determinants of COVID-19 vaccine acceptance were the importance of the vaccine in protecting against the virus, that the vaccine’s side effects could stop them from taking the vaccine, and that children could take the COVID-19 jab but could return to school before taking the COVID-19 jab. The fear of family members contracting the virus and self-isolation when infected contributed significantly to the COVID-19 vaccine acceptance among participants in northern Uganda. There is a need for health managers to engage, sensitize and mobilize the population by addressing concerns about long-term and immediate side effects to increase the COVID-19 vaccine uptake in this community.
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    Perceptions of COVID-19 vaccine among different adult age group populations in Northern Uganda: a cross-sectional study
    (Journal of Global Health Reports., 2022-07-28) Kitara, David L; Baguma, Steven; Okot, Christopher; Acullu, Denis; Ochula, Denis; Okot, Pamela A; Odong, Patrick O; Okot, Smart G; Pebolo, Francis P; Oyat, Freddy W Drinkwater; Ikoona, Eric N; Alema, Nelson O; Oloya, Johnson N; Aloyo, Judith; Oballim, Lawence
    Background: At the time when COVID-19 was declared a pandemic in March 2020, its spread in the African continent was slow. However, confirmed cases of the virus have since risen steadily over the years in the African continent for many reasons. This study aimed to determine factors associated with perceptions of COVID-19 vaccines among adult age-group populations in northern Uganda. Methods: We conducted this study as part of a larger study to determine factors associated with COVID-19 vaccine hesitancy/acceptance among 723 adult age-group populations selected by stratified and systematic sampling approaches from northern Uganda. We used a questionnaire with an internal validity of Cronbach’s α= 0.772. A five-point Likert scale, with responses categorized as strongly agree “SA”, agree “A”, neutral “N”, disagree “DA”, and strongly disagree “SD”, was used to assess participants’ perceptions on COVID-19 vaccines. A multivariable regression analysis was conducted with P-value set at <0.05. Results: Overall, 723 participated in the study with a mean age of 31.4 years (standard deviation,SD, +10.1). The majority 54.5% (n=394) were males. There were no significant differences in perceptions of COVID-19 vaccines among age-group populations (adjusted odds ratio, aOR=0.99, 95% confidence interval, CI=0.98-1.01). Key finding include: (i) it was important to take a COVID-19 vaccine (aOR=1.02, 95% CI=1.00-1.04); (ii) vaccines have unlikely unforeseen side effects (aOR=0.98, 95% CI=0.97-0.99); (iii) vaccines were unlikely being promoted for commercial gains (aOR=0.98, 95% CI=0.97-0.99); and children could take COVID-19 vaccines (aOR=1.02, 95% CI=1.00-1.03). Stratified by age-groups, the 20–29-year-old perceived COVID-19 vaccines developed in Uganda as unlikely safe and effective (aOR=0.59, 95% CI=0.35-0.97), and COVID-19 vaccines have likely unforeseen side-effects (aOR=2.1, 95% CI=1.3-3.6). While the ≥50-year-old group perceived that COVID-19 vaccines were unlikely being promoted for commercial gains (aOR=0.2, 95% CI=0.1-0.6). Conclusions: There were no substantial differences in perceptions on COVID-19 vaccines in adult age-group populations in northern Uganda. The determinants of COVID-19 vaccine perceptions were its importance against the virus; vaccines have unlikely unforeseen side-effects, and children could take it. Stratified by age-groups, some age-groups perceived COVID-19 vaccines developed in Uganda as unlikely safe and unlikely being promoted for commercial gains