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Item Nutritional rickets among children admitted with severe pneumonia at Mulago hospital, Uganda: a cross-sectional study(Springer Nature, 2019-10-29) Piloya, Thereza; Odongkara, Beatrice; Were, Edward Maloba; Ameda, Faith; Mworozi, Edison; Laigong, PaulBackground: There’s abundant sunshine in the tropics but severe rickets is still observed. Nutritional rickets is associated with an increased risk of acute lower respiratory infections. Pneumonia is the leading cause of death in the under 5-year old children with the highest burden in developing countries. Both Pneumonia and rickets are common in the developing countries and may affect clinical presentation and outcome. This study aimed to determine the prevalence and associated factors of nutritional rickets in children admitted with severe pneumonia. Methods: This was a cross-sectional study of children aged 2–59 months presenting with severe pneumonia at an emergency unit. We enrolled 221 children between February and June 2012 after consent. A pre-coded questionnaire was used to collect data on socio-demographic, nutritional and past medical history. Physical exam was done for signs of rickets and anthropometric measurements. Serum calcium, phosphorus, and alkaline phosphatase (ALP) were assessed. Children with any physical signs of rickets or biochemical rickets (ALP > 400 IU); had a wrist x-ray done. Nutritional rickets was defined as the presence of radiological changes of cupping or fraying and/ or metaphyseal thickening. Severe pneumonia was defined using the WHO criteria. Statistical analysis was performed using the Stata 10 statistical package. P- value < 0.05 was significant. Results: The prevalence of nutritional rickets among children with severe pneumonia is 9.5%. However, 14.5% had raised ALP (biochemical rickets). The factors independently associated with rickets was an elevated alkaline phosphatase; p-value < 0.001, or 32.95 95% CI (10.54–102.93). Other factors like breastfeeding, big family size, birth order were not significantly associated with rickets. Low serum calcium was detected in 22 (9.9%) of the 221 participants. Overall few children with rickets had typical clinical features of rickets on physical examination. Conclusion: Rickets is a common problem in our setting despite ample sunshine. Clinicians should actively assess children for rickets in this setting and screen for rickets in those children at high risk even without clinical features. Keywords: Rickets, Pneumonia, Children, UgandaItem New Biologically Active Compounds from 1, 3-Diketones(Research Journal of Chemical Sciences, 2011-06-07) George, Mulongo; Jolocam, Mbabazi; Odongkara, B.; Twinomuhwezi, H; Mpango, G.B.The ready availability of cyclohexanones and the enhanced reactivity at their α-positions render them starting materials of choice in the present study. The synthesis of new compounds of antimicrobial activity was undertaken by the coupling of aromatic amines with 5,5-dimethyl cyclohexan-1,3-dione (dimedone). The products were refluxed with N–benzyl-N-phenylhydrazine in acetic acid. The structures of the products were elucidated using micro- and IR-spectral analyses. They were confirmed using 1H NMR at 60MHz and TMS as internal standard. The diketone derivatives were tested for their biological activity against gram-positive Cocci and Bacilli, and gram-negative Bacilli. The study showed that the derivatives gave a wide range of activity from inactive to highly active, which proves it to be of fresh pharmaceutical interest. Key words: Dimedone, Antimicrobial activity, Gram-positive Cocci and Bacilli, Gram-negative BacilliItem Neonatal hypothermia in Northern Uganda: a community- based cross- sectional study(BMJ OPEN, 2021-01-25) Mukunya , A David; Tumwine, James K.; Nankabirwa, Victoria; Odongkara, Beatrice; Tongun, Justin B.; Arach, Agnes A; Tumuhamye, Josephine; Napyo, Agnes; Zalwango, Vivian; Vicentina Achora,; Musaba , Milton W; Ndeezi, Grace; Tylleskär, ThorkildObjective To determine the prevalence, predictors and case fatality risk of hypothermia among neonates in Lira district, Northern Uganda. Setting Three subcounties of Lira district in Northern Uganda. Design This was a community- based cross- sectional study nested in a cluster randomised controlled trial. Participants Mother–baby pairs enrolled in a cluster randomised controlled trial. An axillary temperature was taken during a home visit using a lithium battery- operated digital thermometer. Primary and secondary outcomes The primary outcome measure was the prevalence of hypothermia. Hypothermia was defined as mild if the axillary temperature was 36.0°C to <36.5°C, moderate if the temperature was 32.0°C to <36.0°C and severe hypothermia if the temperature was <32.0°C. The secondary outcome measure was the case fatality risk of neonatal hypothermia. Predictors of moderate to severe hypothermia were determined using a generalised estimating equation model for the Poisson family. Results We recruited 1330 neonates. The prevalence of hypothermia (<36.5°C) was 678/1330 (51.0%, 95% CI 46.9 to 55.1). Overall, 32% (429/1330), 95% CI 29.5 to 35.2 had mild hypothermia, whereas 18.7% (249/1330), 95% CI 15.8 to 22.0 had moderate hypothermia. None had severe hypothermia. At multivariable analysis, predictors of neonatal hypothermia included: home birth (adjusted prevalence ratio, aPR, 1.9, 95% CI 1.4 to 2.6); low birth weight (aPR 1.7, 95% CI 1.3 to 2.3) and delayed breastfeeding initiation (aPR 1.2, 95% CI 1.0 to 1.5). The case fatality risk ratio of hypothermic compared with normothermic neonates was 2.0 (95% CI 0.60 to 6.9). Conclusion The prevalence of neonatal hypothermia was very high, demonstrating that communities in tropical climates should not ignore neonatal hypothermia. Interventions designed to address neonatal hypothermia should consider ways of reaching neonates born at home and those with low birth weight. The promotion of early breastfeeding initiation and skin- to- skin care could reduce the risk of neonatal hypothermia.Item Management of Diabetic Ketoacidosis and Hyperglycaemic Hyperosmolar States(Journal Gurus, 2024) Mungai, L N Wainaina; Abdalla, Asmahan T Msuya, levina J.; Odongkara, Beatrice; Iroro, Yarhere; Ameyaw, Emmanuel; Bodieu, Adele Chetcha; Majaliwa, Edna Siima; Mandilou, Steve Vassili Missambou; Omondi, Vincent O.; Hanas, Ragnar; Abdullah, MohamedThe global rise in diabetes mellitus prevalence has implications for Africa, with diabetic ketoacidosis (DKA) being its most severe acute complication. In Sub-Saharan Africa, DKA rates at first diagnosis among children and adolescents range from 24%-82% constituting 76% of paediatric endocrine admissions. DKA and hyperglycaemic hyperosmolar state (HHS) result in significant morbidity and mortality. Yet, healthcare disparities and unique issues such as severe malnutrition challenge African Management in Africa. Methodology: Diagnosis criteria for DKA include symptoms like polyuria, polydipsia, and weight loss combined with hyperglycaemia (>11 mmol/L), venous pH <7.3, and ketonemia (blood ß-hydroxybutyrate ≥3 mmol/L) or significant Ketonuria. Emergency management prioritizes restoring circulation, obtaining relevant laboratory samples, and initiating fluid and insulin therapy. Special attention is given to unique considerations, like administering oral rehydration solution (ORS) without IV fluids or handling severe malnutrition with RESOMAL. Treatment: Fluid therapy involves administering deficit replacement plus maintainance. Based on clinical conditions, potassium is added, and bicarbonate is reserved for severe cases. Insulin, vital for treatment, is introduced an hour after fluid therapy. Monitoring for cerebral oedema, especially in high-risk groups, is critical. Following the acute treatment phase, preventative measures are underscored to mitigate recurrence. For HHS, a subset of patients with particular diagnostic criteria, including elevated plasma glucose (>33.3 mmol/L) and higher pH levels, management focuses on restoring volume, renal perfusion, and a steady decline in serum sodium concentration and osmolality. The approach diverges from DKA regarding fluid volume, insulin timing, and monitoring specifics. Conclusion: Effective diagnosis and Management of DKA and HHS are pivotal in the African context, considering healthcare limitations and unique challenges. Guidelines that consider these intricacies ensure comprehensive care for affected individuals.Item Inequity in utilization of health care facilities during childbirth: a community-based survey in post-conflict Northern Uganda(Springer Nature, 2019-08) Mukunya, David; Tumwine, James K.; Ndeezi, Grace; Tongun, Tumuhamye, Josephine; Vincentina; Kizito, Samuel; Napyo, Agnes; Achora. Vincentina; Odongkara, Beatrice; Arach, Agnes Anna; Arach, Agnes AnnaAim To assess inequity in utilization of health care facilities during childbirth and factors associated with home births in Lira district, Northern Uganda. Subjects and methods In 2016, we surveyed 930 mothers with children under the age of 2 years in Lira district, Northern Uganda. We used multiple correspondence analysis to construct the wealth index in quintiles, based on household assets. The concentration index is the measure of socioeconomic inequality used in this article, which we calculated using the Stata DASP package. We also conducted multivariable logistic regression to assess factors associated with home births. Results A third of mothers (n=308) gave birth from home [33%, 95% confidence interval (CI) (26%–41%)]. Giving birth at a health facility was pro-rich with a concentration index of 0.10 [95% CI(0.05–0.14)]. Upondecomposing the concentration index, the most important determinant of inequity was the mother's residence. Factors associated with home births in multivariable logistic regression included rural residence [adjusted odds ratio (AOR) 3.1, 95% CI (1.8–5.3)], precipitate labor [AOR 4.18, 95% CI (2.61–6.71)], and labor starting in the evening or at night. Mothers who had previously given birth from home were more likely to give birth at home again [AOR 40.70, 95% CI (18.70–88.61)], whereas mothers who had experienced a complication during a previous birth were less likely to give birth at home [AOR 0.45, 95% CI (0.28–0.95)]. Conclusion There was inequity in the utilization of health facilities for childbirth. Programs that promote health facility births should prioritize poorer mothers and those in rural areas. Keywords Inequity .Homebirths .Uganda .Post-conflict .Healthfacilitybirth . HospitaldeliveryItem Infant behaviour and maternal adaptation after uninterrupted skin-to-skin contact for 1 hour following birth in northern Uganda(AJM, 2019-09-25) Svensson, Kristin; Mbalinda, Scovia; Nissen, Eva; Odongkara, Beatrice Mpora; Waiswa, Peter; Hjelmstedt, AnnaBackground/aims Uninterrupted skin-to-skin contact in the first hour after birth increases the chance of exclusive breastfeeding, a practice which improves health outcomes for both mothers and neonates. This study aimed to compare mother–infant pairs who had or did not have skin-to-skin contact 1 hour after birth and investigate infant behaviour and maternal adaptation as a result. Methods This study investigated the impact of skin-to-skin contact on a number of health indicators after birth of both mother and child. Two groups were included: 51 mother–infant pairs with skin-to-skin contact and 152 with no skin-to-skin contact, who were observed for 1 hour after birth. Mothers were interviewed at discharge and at 14 weeks postpartum about their sociodemographic background, ability to interpret their infant’s signals and interaction with the infant, their own health and their infant’s health and feeding. The Student’s t-test and Chi squared test were used to assess the associations between the groups and sociodemographic characteristics. The Cramer’s V test was used to assess the effect size for variable latch on. Factor analysis was conducted on statements from interviews on mothers’ feelings regarding motherhood. Results More infants latched on in the skin-to-skin contact group and the first breastfeeding was more often directed by the infants, compared to the no skin-to-skin contact group. Mothers in the skin-to-skin contact group were less likely to need help to breastfeed and tended to be more confident that they could provide sufficient milk for their child. They were also more likely to breastfeed longer and took no initiative to supplement the infant during the hospital stay, while mothers in the non-skin-to-skin contact group did so. More mothers in the skin-to-skin contact group believed that their infant could comfort itself. conclusions The results suggest benefits to uninterrupted skin-to-skin contact between mothers and newborns 1 hour after birth in regard to initiation of breastfeeding, intended time to breastfeed, maternal self-confidence and infant self-regulation. Interventions to promote skin-to-skin contact should be implemented in this setting. Key words: Breastfeeding; Breastfeeding self-efficacy; Feelings about motherhood; Infant interaction; Interpretation of infant cues; Skin-to-skin contactItem Health seeking behaviour of small income market vendors: Diabetes primary care in Gulu Municipality, northern Uganda(South Sudan Medical Journal, 2020-08) Loum, S.L.; Wanyama, Ronald; Anywar, Denis; Odongkara, Beatrice M.; Odongo, PancrasIntroduction: Uganda faces a serious threat of non-communicable diseases including type 2 diabetes; sedentary lifestyles predispose people to these diseases. Objective: To understand the diabetes health seeking behaviour of market vendors at the main market, Gulu Municipality. Method: This cross-sectional study used quantitative and qualitative methods to understand experiences of market vendors on health seeking behaviour. After general sensitization and mobilisation in the market, 400 participants were enrolled for the study, however quantitative analysis was done only on data from 375 participants (316 women and 59 men); 25 participants had missing data; 30 of these 375 were interviewed and the qualitative analyses of their responses offered further insight on health seeking – and is reported here. The qualitative data will be reported later. Results: Mixed responses were obtained from these 30 market vendors about their health seeking behaviour for diabetes. The factors were responsible for their overall health seeking behaviour included crowded hospitals and low frequency of clinic days; lack of accurate knowledge, and uninformed beliefs on diabetes, and poor work-life balance. Major impediments to health seeking were the fear of losing work time and money, and feeling healthy and hence seeing no need for health check-ups or medical care. Conclusion: Awareness of diabetes and the need to seek health care exists, but market vendors are not well informed on tests and care. We recommend that more comprehensive simple-message sensitisation is undertaken to change health seeking behaviour and prevent escalation of non-communicable diseases in northern Uganda and beyond. Key words: health seeking behaviour; healthcare services; diabetes; sedentary lifestyle; hypertension; market vendors, UgandaItem Factors associated with delayed initiation of breastfeeding: a survey in Northern Uganda(Taylor & Francis, 2017-12-15) Mukunya, David; Tumwine, James K; Nankabirwa, Victoria; Ndeezi, Grace; Odongo, Isaac; Tumuhamye, Josephine; Tongun, Justin Bruno; Kizito, Samuel; Napyo, Agnes; Achora, Vincentina; Odongkara, Beatrice; Tylleskar, ThorkildBackground: Initiation of breastfeeding later than 1 hour after birth is associated with increased neonatal morbidity and mortality. Objective: To determine the prevalence and factors associated with delayed initiation of breastfeeding. Methods: We conducted a survey in 2016 of 930 children under the age of 2 years in Lira district, northern Uganda. Mothers of the children were interviewed and data was collected on mobile phones using Open Data Kit software (https://opendatakit.org). Multivariable logistic regression was used to determine factors associated with delayed initiation of breastfeeding. Results: Almost half [48.2%, 95% confidence interval (CI) (44.3–52.1)] of the mothers delayed initiation of breastfeeding. Factors significantly associated with delayed initiation of breast feeding in multivariable analysis included caesarean delivery [Adjusted Odds Ratio (AOR) 11.10 95% CI (3.73–33.04)], discarding initial breast milk [AOR 2.02 95% CI (1.41–2.88)], home delivery [AOR 1.43 95% CI (1.04–1.97)] and mother being responsible for initiating breastfeed ing as compared to a health worker or relative [AOR 1.73 95% CI (1.33–2.26)]. Mothers having a secondary education were less likely [AOR 0.54 95% CI (0.30–0.96)] to delay initiation of breastfeeding as compared to those with no education. Conclusion: About half the mothers delayed initiation of breastfeeding until after 1 hour after birth. Programs to promote, protect and support breastfeeding in this post conflict region are urgently needed.Item Domestic violence in Gulu, Northern Uganda.(COSECSA/ASEA, 2012-04) Kitara, D.L.; Odongkara, B.M.; Anywar, D.A.; Atim, P.; Amone, C.; Komakech, D.Background: When guns fell silent in the post conflict northern Uganda, another form of physical injuries has come in place, Domestic Violence also commonly referred to as Gender based violence. This injury from violence leading to physical trauma is one of the leading public health problems in this region. We describe the occurrence and reasons for admission due to domestic violence to surgical ward of Gulu Hospital. Methods: A prospective observational study was conducted in Gulu Hospital over a period of two years (January 2008 to December 2009) using a prepared proforma designed to capture physical injuries admitted. Only patients that met the inclusion criteria for domestic injuries were registered. Informed consent and ethical approval was obtained from the committee of the Hospital. Results: Of 1880 patients registered with trauma, 454 were due to domestic violence (24.1%) and was the commonest form of physical trauma and mainly occurred in December and June and were lowest in February and March. Its frequency of occurrence was followed by boda boda injuries (21.4%). The majority of victims were females (73.6%) with a female to male ratio of 2.84:1.0 Conclusion: Domestic violence was commonest cause of trauma in Gulu Hospital. More females were affected than males. December and June had the highest incidence. It is a public health problem in the region which drains hospital resources.Item Developing a Rational Policy on Plagiarism for Institutions of Higher Education: A Case of Gulu University(EAST AFRICAN NATURE & SCIENCE ORGANIZATION, 2025) Ongaya, Kizito; Alidri , Agatha; Onen, Walter Yagos; Odongkara, Beatrice; Okumu, CharlesGlobally, plagiarism is a pervasive issue in institutions of higher education, posing challenges to academic integrity and ethical standards. Developing a policy on plagiarism is crucial for maintaining the quality and credibility of academic work within these institutions. The purpose of this paper is to discuss the development of a rational policy on plagiarism. The following are the objectives; to benchmark requirements for anti-plagiarism; to model process of procurement and detection of plagiarism process in public universities in Uganda; to examine how the challenges of Inter-Repository Plagiarism was addressed at Gulu University. The study reviewed existing literature on plagiarism policies in higher education institutions worldwide. The findings were that universities have varying views on levels of plagiarism with some policies allowing as high as 30% plagiarism level in scholarly work. Most of the peer-reviewed journals demand much lower allowable levels of plagiarism to encourage originality and sustainable adherence to copyright and intellectual property policies.Item Cultural beliefs and practices on perinatal death: a qualitative study among the Lango community in Northern Uganda(Springer Nature, 2023-04-03) Arach, Anna Agnes Ojok; Nakasujja, Noeline; Rujumba, Joseph; Mukunya, David; Odongkara, Beatrice; Musaba, Milton W.; Napyo, Agnes; Tumwine, James K.; Nankabirwa, Victoria; Ndeezi, Grace; Kiguli, JulietBackground Perinatal death has profound psychosocial effects on women and their families. Sociocultural con texts influence the burden, rituals and bereaved’s support. Little is known about cultural beliefs and practices related to perinatal death. This study explored the cultural perspectives of the Lango community on perinatal death. Methods This study utilised a focused ethnographic design anchored on a symbolic interactionist framework to understand the meanings attached to beliefs and practices on stillbirth or neonatal death among the Lango community in Lira District, Northern Uganda. Participants were sampled purposively for FGD while key informants were identified through snowballing technique. Data were audio recorded in Lango, transcribed, and later translated, a codebook was developed and data entered into Atlas. ti version 8.4.26 and then coded. It was analysed both deduc tively and inductively into themes. Results Stillbirth and early neonatal death both attract similar rituals as would an older child. Burial is not rushed and is attended by family members and close friends. Stillbirths and children that die before naming are buried with out names. Bereaved families are comforted and encouraged about future pregnancies. Currently, Lango associates the deaths to biomedical explanations such as teenage pregnancies, inadequate pregnancy care, health system chal lenges and poor health-seeking behaviour, unlike previously when they were attributed to consequences of unaccep table social behaviours, superstitious beliefs and witchcraft. Antenatal care and health facility childbirths are currently preferred over traditional practices for good pregnancy outcomes. Conclusion Stillbirth or early neonatal death is viewed as the death of a child, different from other settings. Thus, ritu als are performed to honour, create memory, and maintain the connection with deceased babies. Bereaved parents are supported. Health care workers need to provide culturally sensitive support to parents after perinatal loss. The prevailing beliefs of perinatal death cause in terms of biomedical explanations consistent with known determinants and preference for health facility care for prevention creates an opportunity for improving perinatal health. Keywords Culture, Perspectives, Beliefs, Practices, Stillbirth, Perinatal death, UgandaItem Clinical evidence and recommendation on the use of Type-2 Diabetes Mellitus drugs in Lactation(PMX, 2027) Richardson, Katherine; Kiptoo, Joshua; Odongkara, Beatrice Mpora; Ojara, Francis Williams; Waitt, CatrionaItem Challenges and opportunities with providing genetic testing and counseling for mucopolysaccharidosis type II in Kenya(Springer Nature, 2025-11-04) Wainaina Mungai, Lucy N.; Njeru, Charles; Njoroge, Allan; Maina, Michuki; Ilovi , Syokau; Nduati, Ruth W.; Wamalwa, Dalton; Odongkara, Beatrice; Miller, Danny E.Background Limited or absent genetic counseling and testing resources in low- and medium-income countries lead to missed or late diagnoses for treatable metabolic conditions with irreversible complications. In some com munities, misunderstanding about the etiology of a genetic condition may lead women whose children are affected to be viewed as a bad omen and become stigmatized or ostracized from their community. Mucopolysaccharidosis type II (MPS II), or Hunter syndrome, is a lysosomal storage disorder in which deficiency or inactivity of the enzyme iduronate-2-sulfatase leads to accumulation of glycosaminoglycans throughout the body. The diagnosis can be made through clinical assessment, enzyme activity analysis, or DNA sequencing. Treatment requires a multidisciplinary approach combining supportive care with disease-modifying therapies, including enzyme replacement therapy where available. Results To understand the incidence and impact of MPS II in Kenya, we sought to provide counseling and genetic testing to individuals and families with suspected MPS II. After pretest counseling, we collected blood from 25 indi viduals to determine iduronate-2-sulfatase levels and sequence the IDS gene. We identified a pathogenic or likely pathogenic variant in 17 of 25 individuals and subsequently identified 18 female carriers in these families. We catalog the genotype of males with MPS II and correlate this with the phenotypic profile of these individuals, the female car rier rate, and mortality within the families. Conclusions This study provides the first summary of genotype–phenotype correlations for MPS II in individu als from Kenya. These findings will allow the development of guidelines to identify individuals who may benefit from early evaluation, especially in those families where there is a risk of MPS II.Item Can an integrated intervention package including peer support increase the proportion of health facility births? A cluster randomised controlled trial in Northern Uganda(BMJ OPEN, 2024-01-29) Nankabirwa, Victoria; Mukunya , David; Ndeezi , Grace; Odongkara, Beatrice; Arach, Agnes A; Achora, Vicentina; Mugenyi, Levi; Sebit, Mohammad Boy; Wandabwa, Julius N; Waako, Paul; Tylleskär, Thorkild; Tumwine, James KObjective To assess the effect of an integrated intervention package compared with routine government health services on the frequency of health facility births. Setting Three subcounties of Lira district in Northern Uganda. Design A cluster randomised controlled trial where a total of 30 clusters were randomised in a ratio of 1:1 to intervention or standard of care. Participants Pregnant women at ≥28 weeks of gestation. Interventions Participants in the intervention arm received an integrated intervention package of peer support, mobile phone messaging and birthing kits during pregnancy while those in the control arm received routine government health services (‘standard of care’). Primary and secondary outcome measures The primary outcome was the proportion of women giving birth at a health facility in the intervention arm compared with the control arm. Secondary outcomes were perinatal and neonatal deaths. Results In 2018–2019, 995 pregnant women were included in 15 intervention clusters and 882 in 15 control clusters. The primary outcome was ascertained for all except one participant who died before childbirth. In the intervention arm, 754/994 participants (76%) gave birth at a health facility compared with 500/882 (57%) in the control arm. Participants in the intervention arm were 35% more likely to give birth at a health facility compared with participants in the control arm, (risk ratio 1.35 (95% CI 1.20 to 1.51)) and (risk difference 0.20 (95% CI 0.13 to 0.27)). Adjusting for baseline differences generated similar results. There was no difference in secondary outcomes (perinatal or neonatal mortality or number of postnatal visits) between arms. Conclusion The intervention was successful in increasing the proportion of facility- based births but did not reduce perinatal or neonatal mortality.Item Assessing a bundle of peer counseling, mobile phonemessages,andmamakitsin promoting timely initiation of and exclusive breastfeeding in Uganda: A cluster randomized controlled study(PLOS ONE, 2025-01-24) Mukunya, David; Tumwine, James K.; Ndeezi, Grace; Musaba, Milton W.; Tongun ,Justin Bruno; Tumuhamye , Josephine; Napyo, Agnes; Amanya, Daphine; Odongkara, Beatrice; Oguttu, Faith; Achora, Vincentina; Tylleskar, Thorkild; Nankabirwa, VictoriaItem A low-cost intervention to promote immediate skin-to-skin contact and improve temperature regulation in Northern Uganda(African Journal of Midwifery and Women’s Health, 2019-03-14) Nissen, Eva; Svensson, Kristin; Mbalinda, Scovia; Brimdyr, Kajsa; Waiswa, Peter; Odongkara, Beatrice Mpora; Hjelmstedt, AnnaBackground Uninterrupted skin-to-skin contact between mothers and newborns during the first hour after birth has been reported to be 2% in Uganda. Aims To investigate if a low-cost intervention targeting the behaviors of hospital staff would increase skin-to-skin contact and to investigate whether skin-to-skin contact stabilised temperature in the newborn. Methods The study had a quasi-experimental, before and after design. The sample included 110 in the pre-intervention group, and 93 in the post-intervention group. Data collection included observations of skin-to-skin contact and temperature measurements. Data were also collected from medical records and interviews. Findings No infants had skin-to-skin contact before the intervention, whereas the proportion was 54.8% after the intervention. Infants who received skin-to-skin contact (n=51) and infants who did not receive skin-to-skin contact (n=146) increased in temperature; however, infants who received skin-to-skin contact were significantly warmer after 5 minutes and remained so at 60 minutes. Conclusions The intervention increased the practice of skin-to-skin contact, which was found to be safe in regard to temperature stabilisation. Key words: ■ Low‑cost intervention ■ Newborn temperature ■ Observation ■ Skin‑to‑skin contact ■ UgandaItem Age at menarche in relation to nutritional status and critical life events among rural and urban secondary school girls in post-conflict Northern Uganda(BMC Women's Health, 2014-05-09) Odongkara Mpora, Beatrice; Piloya, Thereza; Awor, Sylvia; Ngwiri, Thomas; Laigong, Paul; Mworozi, Edison A; Hochberg, Ze’evBackground: Menarche age is an important indicator of reproductive health of a woman or a community. In industrial societies, age at menarche has been declining over the last 150 years with a secular trend, and similar trends have been reported in some developing countries. Menarche age is affected by genetic and environmental cues, including nutrition. The study was designed to determine the age at menarche and its relation to childhood critical life events and nutritional status in post-conflict northern Uganda. Methods: This was a comparative cross-sectional study of rural and urban secondary school girls in northern Uganda. Structured questionnaires were administered to 274 secondary school girls, aged 12– 18 years to determine the age at menarche in relation to home location, nutritional status, body composition and critical life events. Results: The mean age at menarche was 13.6±1.3 for rural and 13.3±1.4 years for urban dwelling girls (t= −1.996, p=0.047). Among the body composition measures, hip circumference was negatively correlated with the age at menarche (r =−0.109, p=0.036), whereas height, BMI and waist circumference did not correlate with menarche. Paternal (but not maternal) education was associated with earlier menarche (F = 2.959, p = 0.033). Childhood critical life events were not associated with age at menarche. Conclusions: Age at menarche differed among urban and rural dwelling school girls and dependent on current nutritional status, as manifested by the hip circumference. It was not associated with extreme stressful childhood critical life events. Keywords: Menarche age, Nutritional status, Body composition, Stress, UgandaItem Adding video-debriefing to Helping-Babies Breathe training enhanced retention of neonatal resuscitation knowledge and skills among health workers in Uganda: a cluster randomized trial(Taylor & Francis, 2020-06-10) Odongkara, Beatrice; Tylleskär, Thorkild; Pejovic, Nicola; Achora, Vincentina; Mukunya, David; Ndeezi, Grace; Tumwine, James K.; Nankabirwa, VictoriaBackground: Skilled birth attendants must be competent to provide prompt resuscitation to save newborn lives at birth. Both knowledge and skills (competence) decline with time after training but the optimal duration for refresher training among frontline-skilled birth atten dants in low-resource settings is unknown. Objectives: We assessed the effect of an innovative Helping-Babies-Breathe simulation-based teaching method using video-debriefing compared to standard Helping-Babies-Breathe train ing on 1) neonatal resuscitation knowledge and skills attainment and 2) competence reten tion among skilled birth attendants in Northern Uganda. Methods: A total of 26 health facilities with 86 birth attendants were equally randomised to intervention and control arms. The 2nd edition of the American Association of Pediatrics Helping-Babies-Breathe curriculum was used for training and assessment. Knowledge and skills were assessed pre- and post-training, and during follow-up at 6 months. A mixed effects linear regression model for repeated measures was used to assess the short and long-term effects of the intervention on neonatal resuscitation practices while accounting for clustering. Results: Eighty-two (95.3%) skilled birth attendants completed follow-up at 6 months. Approximately 80% of these had no prior Helping-Babies-Breathe training and 75% reported practicing neonatal resuscitation routinely. Standard Helping-Babies-Breathe training with video-debriefing improved knowledge and skills attainment post-training [adjusted mean difference: 5.34; 95% CI: 0.82–10.78] and retention [adjusted mean difference: 2.97; 95% CI: 1.52–4.41] over 6 months post-training compared to standard training after adjusting for confounding and clustering. Factors that reduced knowledge and skills retention among birth attendants were monthly resuscitation of one neonate or more and being in service for more than 5 years. Conclusion: Adding video-debriefing to standard Helping-Babies-Breathe training had an effect on birth attendants’ competence attainment and retention over 6 months in Uganda. However, more research is needed to justify the proposed intervention in this contextItem Incidence and determinants of perinatal mortality among women with obstructed labour in eastern Uganda: a prospective cohort study(Springer Nature, 2021-07-15) Musaba , Milton W.; Ndeezi, Grace; Barageine, Justus K.; Weeks, Andrew D.; Wandabwa, Julius N.; Mukunya, David; Waako, Paul; Odongkara, Beatrice; Arach, Agnes; Mugabe, Kenneth Tulya-muhika; Napyo, Agnes Kasede; 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