Hoima Hospital

<title>Abstract</title> <bold>Background</bold> : Globally, about 26% of women experience maternal near miss (MNM) events during pregnancy or childbirth. MNM events are a crucial indicator for evaluating maternal health services and achieving SDG3 which aims to reduce maternal mortality. The study aimed to determine the predictors of MNM among postnatal mothers at Hoima Regional Referral Hospital. <bold>Methodology:</bold> Study design was cross sectional with a quantitative research approach. Using Cochran’s (1977) formula for sample size computation 289 respondents were assessed and sociodemographic, obstetric and other health related data collected from August to September 2025. Statistical analysis involved chi squares, and logistic regressions through SPSS version 27. P values &lt; 0.05 were considered significant. Ethical approval was obtained from the research ethics committee of Uganda Martyrs University. Other ethical principles like informed consent, anonymity were accordingly upheld. <bold>Results</bold> : Of the assessed mothers, 113/289 (39.1%) were near miss. Underlying causes of maternal near miss were obstetric hemorrhage 54/113 (47.8%), pregnancy‑related infections 30/113 (26.5%), hypertensive disorders 15/113 (13.3%) and other conditions 14/113 (12.3%). Modifiable factors that significantly predicted maternal near miss included having four or fewer ANC visits during pregnancy (AOR = 2.01, [CI: 1.11-3.98], p = 0.047), whereas non modifiable factors that significantly predicted maternal near miss included severe post-partum hemorrhage (AOR = 18.95, [CI: 5.26-68.21], p &lt; 0.001), severe pre-eclampsia (AOR = 4.32, [CI: 3.33-5.57], p &lt; 0.001), sepsis AOR = 5.28, [CI: 7.45-12.22], p = &lt; 0.001) and delivery from the hospital (AOR = 0.23, [CI: 0.08-0.71], p = 0.010). <bold>Conclusion</bold> : The result highlights critical need for targeted intervention to address these leading causes, improve referral system and enhance care for high-risk mothers to eventually reduce the incidence of MNM.

Abstract Background Single Incision Total Laparoscopic Hysterectomy (SITLH) is a modified version of the Conventional Total Laparoscopic Hysterectomy (CTLH). The newer technique requires advanced skills with special trocars. This may partly explain the rareness of the technique in low-income countries where the special trocars may be lacking due to them being expensive. There is no documented hysterectomy performed using the SITLH technique in Africa. We present two cases of hysterectomies successfully performed using this advanced technique, by a single surgical team led by Dr John Bosco Spire Kiggundu, at Henrob laparoscopy hospital, Kampala, Uganda, using improvised conventional laparoscopic trocars. Case series We present two cases of a 48-year old, Para 2+0, black African with symptomatic uterine fibroids and a 47-year-old para 4+0, black African with endometriosis; Enzian classification P-0 O-0/0 T-2/2 A-1 B-2/0 C-0 FA. These were successfully managed using the SITLH technique by a single surgical team led by Dr John Bosco Spire Kiggundu, at Henrob Laparoscopy Hospital, using improvised conventional laparoscopic trocars. Conclusion Though the single incision total laparoscopic hysterectomy technique requires special trocars, it is still possible to be performed using improvised conventional laparoscopic trocars in low-resource setting. These two cases demonstrate the ability and innovativeness of the surgical team, to use the limited available resources and successfully perform a task that would actually demand advanced special equipment.

Abstract Background In Tanzania, unmet need for family planning (FP) presents a major challenge for preventing unintended pregnancies and their associated maternal and child health morbidities. Understanding factors associated with unmet need for FP is critical for effective policy formulation and improving maternal and child health outcomes. Therefore, this study aimed to determine the prevalence and associated factors of unmet need for FP among women in sexual unions in Tanzania. Methods An analytical cross-sectional study was conducted using secondary data from the 2022 TDHS. A generalized logistic regression model was used to determine factors associated with unmet need for FP. Odds ratio and 95% confidence Intervals (CI) were computed to estimate the strength and magnitude of association. Statistical significance was set at p &lt; 0.05. Results The prevalence of unmet need for family planning was 20.7% (95%CI: 18.9–22.6). For the factors, women aged 25–34 years (AOR = 0.47, 95%CI: 0.35–0.63) and those aged 35–49 years (AOR = 0.37, 95%CI: 0.25–0.54) had lower odds of unmet need for FP than their counterparts. Women who were working had lower odds of unmet need for FP compared to their counterparts (AOR = 0.71, 95%CI: 0.56–0.87). The increase in the number of children was associated with a higher likelihood of unmet need for FP (AOR = 1.30, 95%CI: 1.22–1.38). Women with a history of pregnancy termination were 26% less likely to have unmet need for FP than their counterparts (AOR = 0.74, 95%CI: 0.53–0.97). Conclusion The established findings of this study indicate that factors such as age, parity, and employment status significantly influence the likelihood of unmet need, with younger and non-working women often facing greater challenges. Addressing this public health challenge necessitates a concerted and targeted approach, focusing on enhancing the accessibility and quality of family planning services, particularly for rural and younger populations.

Abstract Background The introduction of HIV self-test (HIVST) kits offered a significant advancement in fighting HIV/AIDS, particularly for vulnerable populations. Despite its potential, self-testing uptake varies. In Tanzania, where HIV prevalence among women remains a concern, this study aimed to identify the socio-demographic and behavioural predictors of self-testing for effective prevention. Methods We conducted a cross-sectional analysis using data from the 2022 Tanzania Demographic and Health Survey. Data management and analysis were performed using Stata 18.5. Given the survey’s complex design, a multilevel mixed-effect logistic regression model was used to identify predictors of HIVST kit use, with results presented as adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Statistical significance was set at p &lt; 0.05. Results The prevalence of HIVST kit usage among women of reproductive age in Tanzania was 3.2% (95% CI: 2.8–3.7%). Individual-level factors associated with a higher likelihood of HIV self-test kit use included age, 25–34 (AOR = 1.93, 95%CI: 1.43–2.60) and 35–49 (AOR = 1.60, 95%CI:1.43–2.26), secondary/higher education (AOR = 2.77, 95%CI: 1.57–4.85), belonging to the rich wealth quintile (AOR = 2.69, 95%CI: 1.52–4.77), internet use (AOR = 3.04, 95%CI: 2.04–4.52), awareness of sexually transmitted infections (STIs) (AOR = 2.03, 95%CI: 1.21–3.42), and one or higher number of sexual partners. At the community level, geographical zone was associated with increased odds of use, while living in a high-poverty community (AOR = 0.52, 95%CI: 0.30–0.89) was associated with a lower likelihood of HIV self-test kit use. Conclusion This study reveals a low uptake of HIVST kits among women of reproductive age in Tanzania, highlighting the influence of both individual-level factors, such as age, education, wealth, internet access, STI awareness, and sexual behaviours, as well as community-level factors like geographical zone and community poverty. These findings underscore the importance of considering both individual characteristics and the broader community context when designing targeted interventions to promote HIVST kits.

Introduction: For the effective control of the COVID-19 pandemic, the development and use of vaccines was a global target. Since March 2021, Uganda publicized and implemented COVID-19 vaccination activities. Reports from other parts of the world indicate mixed results in relation to willingness to receive the vaccine and little information is available from rural settings. We assessed the willingness to receive the COVID-19 vaccine and associated factors among adult residents in Hoima District, Western Uganda. Methods: A cross-sectional study that employed concurrent mixed-methods comprising a survey and key informant interviews. The study was conducted between January and April 2022, among residents of Hoima District, Uganda. We used multi-stage sampling to randomly select 379 adult participants from 13 systematically sampled villages in two rural sub-counties in Hoima District. We also interviewed 8 purposively selected key informants who were health workers at Hoima Regional Referral Hospital (HRRH), where vaccination was being conducted. We used descriptive statistics and then conducted multivariable-modified Poisson regression to generate adjusted prevalence ratios (adj.PRs) and confidence intervals (CIs) for the quantitative data, while a thematic approach was used for qualitative data analysis. Results: More than three quarters 79 % (301/379) of the participants were willing to receive the COVID-19 vaccination.Willingness to receive COVID-19 vaccination was significantly higher among participants with tertiary level of education (adj.PR=1.26, 95% CI: 1.12-1.47); those who received information about COVID-19 vaccination from healthcare workers (adj.PR=1.37, 95% CI: 1.21-1.64); and those who resided within five Kilometers from a vaccination site (adj.PR=1.22, 95% CI: 1.18-1.37). Perceived fear of losing libido among men and infertility among women was a major concern across the interviews. Conclusion. Willingness to receive COVID-19 vaccination was high in rural settings but safety concerns were the main barrier. Strategies to improve COVID-19 vaccination programs, in such settings, may focus on health education messages through local radio stations to counter fears of reproduction and misconceptions about the vaccine.

Abstract Background Contraceptive use is fundamental to achieving Sustainable Development Goal 3.7. Given the low prevalence of modern contraceptive use, understanding socioeconomic and area-based inequality in the use of modern contraceptives is essential to address disparities among adolescent girls and young women (AGYW) in Tanzania. Therefore, this study examined the socioeconomic and area-based inequalities in modern contraceptive use among AGYW in Tanzania. Methods This study employed a cross-sectional analysis of the 2022 Tanzania Demographic and Health Survey (TDHS) data. A weighted sample of 3,724 sexually active AGYW was included in the study. We used the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software for data analysis. Modern contraceptive use was disaggregated using five equity stratifiers (age, economic status, education, residence, and geographical zones). Data were analyzed through four summary measures (Difference (D), Population Attributable Risk (PAR), Ratio (R), and Population Attributable Fraction (PAF)) to assess inequality. To measure statistical significance, point estimates were constructed using a 95% Uncertainty Interval (UI). Results Our findings revealed significant socio-economic, educational, geographic, and age-related disparities in modern contraceptive use. Women in wealth quintile (PAF: 11.08% [95% UI: 10.98–11.18], D: 13.43 [95% CI: 13.37–13.49], educated (PAR: 3.22 [95% UI: 2.35–4.09], R: 1.87 [95% UI: 1.86–1.87]), those in rural areas (PAF: 14.83% [95% CI: 14.76–14.90], R: 1.24 [95% UI: 1.24–1.24]), older age group (PAF:16.46% (95% CI: 16.43–16.50], PAR: 4.93 [95% CI: 3.93–5.93], R: 1.73 (95% CI: 1.73–1.73]) had a higher chance of modern contraceptives use than their counterparts. Conclusion This study provides compelling evidence of persistent inequalities in modern contraceptive use among AGYW in Tanzania, shaped by socioeconomic status, educational attainment, age, and geographic residence. A multi-dimensional and equity-focused reproductive health policy and programs, emphasizing empowerment through education, youth-friendly services, financial accessibility, and culturally sensitive community engagement, would be essential in addressing inequalities among AGYW in Tanzania.

Umbilical cord knots are very rare cases. As opposed to single loop knots, double-and more loop knots are extremely rare. When they occur, adverse outcomes become inevitable in most cases. We present this rare case diagnosed coincidentally on cesarean section at term with good fetal outcome.

Typhoid gangrenous cholecystitis is uncommon and can be managed by subtotal cholecystectomy with nonclosure of the cystic duct if that is required for patient safety.