Mildmay Uganda

Background: Vitamin A supplementation coverage has been inconsistent, as only slightly more than half of children aged 6–59 months receive the supplement. This study aimed to assess the determinants of Uptake of Vitamin A supplements among children aged 6 to 59 months attending Kirumandagi Health Centre II, Luweero district. Methodology: A descriptive cross-sectional study design employing quantitative methods was used to collect data among caregivers of children aged 6 to 59 Months attending Kirumandagi Health Centre II. Data collection was done within a period of 4 days by a convenience sampling technique using researcher-administered questionnaires, and data were analyzed using the Microsoft Excel (2019) program. Findings were presented in the form of tables, graphs, and pie-charts. Results: Out of 40 participants: (62.5%) were aged between 29 and 39 years, and (50%) of the respondents had attained secondary education. With caregiver-related factors (50%), the respondents did not know the benefits of Vitamin A for children, (65%) family needs made it hard to take their children, (75%) forgot, and (50%) families did not support them in taking their children for Vitamin A supplementation. Health facility–related determinants showed that (62%) reported inadequate staffing level, (70%) Vitamin A supplements were not always available at the health Centre and (65%) stated that health workers did not explain during Vitamin A visits. Conclusion: Forgetfulness, poor family support, and limited awareness were major barriers to the uptake of Vitamin A supplements. Many caregivers lacked knowledge about the benefits of Vitamin A, and some had mixed beliefs about its importance. Recommendation: The health facility management should improve health worker communication by encouraging brief but effective health education during child health visits. They should conduct regular community sensitization sessions to improve caregiver knowledge and awareness.

Background: Awareness about diabetes is an important component in the prevention, early detection, and effective management of the disease. Therefore, this study aims to assess the level of awareness about diabetes among adults attending services at Entebbe Grade B Hospital in Wakiso District. Methodology: Quantitative data were collected using structured questionnaires with closed-ended questions from adults attending services at Entebbe Grade B Hospital in Wakiso District. The completed questionnaires were checked for completeness, coded, and entered into Microsoft Excel for analysis. Data were analyzed using descriptive statistics such as frequencies and percentages. Results: All 35 (100%) participants had heard about diabetes. Common complications of poorly managed diabetes included poor vision/sight 7 (20%), delay in wound healing 5 (14%), and severe headache 23 (66%), with no participants having experienced none. 33 (94%) of the participants believed that stress and poor sleep could affect their blood sugar levels, whereas only 2 (6%) did not believe it. Conclusion: Adults attending services at Entebbe Grade B Hospital in Wakiso District were generally aware of diabetes since all participants had heard about the disease. Recommendation: Healthcare workers at Entebbe Grade B Hospital should strengthen patient health education on diabetes causes, risk factors, complications, and management. Regular awareness programs should be conducted to improve patients’ understanding of the disease.

Background The study aimed to identify the individual factors influencing the work-life balance of nurses and midwives at Mukono Church of Uganda Hospital. Methodology A descriptive cross-sectional study was conducted among 32 nurses and midwives at Mukono Church of Uganda Hospital using purposive sampling. Data were collected via self-administered questionnaires, both electronic and face-to-face, covering demographic, individual, and health facility-related factors affecting work-life balance. Data were analyzed using descriptive statistics in Excel and thematic analysis for interviews. Validity and reliability were ensured through expert review and a pilot study. Ethical approval, informed consent, and confidentiality were strictly maintained throughout the study. Results Among the 32 respondents, most were aged 25–34 years (42.7%) and female (68.7%). The majority were married (53.1%) with 1–2 dependents (43.7%) and had 6–10 years of work experience (34.4%). Midwives represented 53.1% of the sample, while nurses represented 46.9%. Regarding work-life balance, 40.6% reported being unable to balance work and family duties at all, whereas 9.4% balanced easily. Emotional effects sometimes influenced work-life management for 37.5%, while 15.6% reported no effect. Fatigue due to work and family demands affected 31.3% strongly, and 21.9% were neutral. Most respondents (40.6%) had limited personal time, 28.1% rarely had time, and 21.9% had no personal time. Family support was not supportive for 43.7%, somewhat supportive for 28.1%, and very supportive for 21.9% of respondents. Conclusion Nurses and midwives at Mukono COU Hospital struggle with work-life balance due to heavy workloads, fatigue, limited personal time, and insufficient support. Recommendation Hospitals should improve staffing, shift management, and support systems, while staff should seek family support and practice self-care to enhance work-life balance.

Background: Hepatitis B virus (HBV) remains a major global public health concern, causing chronic infections, cirrhosis, and hepatocellular carcinoma despite available vaccines. This study examined the prevalence of hepatitis B virus infection among blood donors at Nakasero blood bank kampala district. Methodology: A cross-sectional study was conducted at Uganda Blood Transfusion Services (UBTS), Nakasero, Kampala District. A total of 150 voluntary blood donors, aged 18–60 years, who consented to participate, were included. Participants were selected using purposive, simple random, and systematic sampling techniques. Data were analyzed using SPSS v20.0, with results presented as frequencies and percentages. Results: The overall HBV prevalence was 15% (23/150), higher among males (8.6%) than females (6.6%). Among 150 donors, 67.3% were male and 32.7% female, with the majority aged 18–25 years (51.3%). The most affected age group was 26–35 years (52%), followed by 18–25 years (29.3%). Key risk factors included alcohol use (58%), multiple sexual partners (54%), dental surgery history (38.6%), and cohabitation with an HBV-positive individual (40.6%). Knowledge about HBV transmission and prevention was moderate, with 54.7% having ever heard of HBV and 64.7% reporting vaccination. Conclusion: HBV remains prevalent among blood donors at Nakasero Blood Bank, with higher rates among males and specific age groups. Behavioral and knowledge-related factors contribute significantly to HBV risk. Recommendations: Routine and mandatory HBV screening for blood donors should be enforced. Public health campaigns to raise awareness about HBV transmission and prevention, along with expanded vaccination coverage, are essential.

Abstract Background : Despite the scale-up of Dolutegravir (DTG)-based regimens in sub-Saharan Africa, limited data exist on the real-world impact of antiretroviral therapy (ART) optimization on viral load suppression (VLS) and safety among children and adolescents. We evaluated regimen transitions, viral load trends, and safety outcomes among children and adolescents in HIV care at Mildmay Uganda Hospital (MUgH). Methods : We conducted a descriptive retrospective cohort study of children and adolescents aged ≤19 years receiving HIV care at MUgH between January 2018 and December 2023. Sociodemographic, clinical, and viral load data were abstracted from registers, patient files, and electronic medical records. Regimen transitions were classified into 11 groups, including Abacavir (ABC)/Zidovudine (AZT) to DTG, DTG to DTG, Efavirenz (EFV) or Nevirapine (NVP) to DTG, EFV or NVP to Protease Inhibitor(PI), EFV or NVP to PI/DTG, and PI to DTG, PI, or PI/DTG. Viral load was classified as suppressed (≤200 copies/mL), low-level viremia (201–999), or high-level viremia (≥1000). Descriptive statistics summarized baseline characteristics and regimen transitions. VLS before (2019) and after optimization (2022) was compared using chi-square tests. Adverse events were classified by Medical Dictionary for Regulatory Activities system organ class. Results : A total of 1,036 participants were included, with mean age 14.4 (±4.1) years; 58.0% were ≥15 years and 52.7% female. Most (94.4%) resided in the Kampala Metropolitan Area and 95.2% initiated ART at MUgH. Following optimization, viral suppression improved across multiple transitions: EFV→DTG (81.3% to 88.0%), PI→DTG (52.3% to 86.1%), ABC/AZT→DTG (65.6% to 90.6%), and NVP→DTG (80.6% to 88.8%). EFV→PI maintained 80.0% suppression, whereas NVP→PI consistently showed 100% high-level viremia. Overall suppression increased from 67.9% to 81.7% (p<0.001). Adverse events were predominantly Respiratory, thoracic and mediastinal disorders (49.2%), asymptomatic presentations (16.5%), and skin disorders (12.2%), with other events occurring at ≤2%. Conclusion: ART optimization at MUgH enhanced viral suppression, particularly with dolutegravir-based regimens, while protease inhibitor transitions showed slower improvement. Persistent viremia and frequent respiratory events highlight the need for vigilant monitoring, adherence evaluation and support, and timely interventions to sustain long-term treatment success among children and adolescents living with HIV.

ABSTRACT Several systematic reviews have been published on psychosocial care interventions (PCIs) in cancer care. However, there are limited systematic reviews and meta-analyses (SRMA) on the effectiveness of PCIs in cancer care for adults patients in low- and-middle income countries (LMICs). This study aimed at synthesizing the available evidence on the effectiveness of PCI in improving the quality of life (QoL) of adult cancer patients in LMICs. We registered the protocol with PROSPERO (ID: CRD4202342156) before conducting this SRMA. Studies published between 2002 and 2023 were searched from MEDLINE, Web of Science, EmBASE and APA PsycINFO. We followed the standard guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Results of the pooled studies were analysed using MedCalc version 10.10 statistical software. Twenty-six intervention studies were included in this SRMA. The Eastern Mediterranean WHO region had the highest number of studies and Africa region had the least. Most studies utilised Cognitive Behavioural therapy-related interventions (38%, n = 10 studies), while Family systems therapy 4% (n = 1) was the least utilised. From the subgroup analyses of the means and standard deviations of domains of QoL in the pooled primary studies, the respective standardized mean differences indicated that the PCIs had a significant positive effect on the physical (0.972: p = 0.002), social (0.884: p = 0.005) and psychological (0.590: p = 0.03) domains of QoL of adult cancer patients. However, some PCIs did not improve the QoL of study participants. Generally, PCIs effectively improved most domains of the QoL of adult cancer patients. However, more research is needed for PCIs that had a negative effect on some domains of the QoL of cancer patients. Lastly, there is need for LMICs to prioritise resources to strengthen the integration of psychosocial care interventions in cancer care to meet the different QoL sub-domains of patients with cancer.

Abstract Background Dolutegravir (DTG)–based antiretroviral therapy (ART) is recommended as first⍰line treatment for people living with HIV (PLHIV) in Uganda. However, data on its safety profile in routine care remain limited. This study actively monitored adverse events (AEs) among PLHIV receiving DTG ⍰based regimens, assessing factors associated with their occurrence. Methods We conducted a prospective cohort study nested within a parent cohort from July 2021 to September 2022 a cross three Ugandan sites (urban, peri ⍰urban, and rural). Adults on DTG/lamivudine/tenofovir (TLD), either transitioning from prior ART regimens or initiated on TLD as first⍰line therapy, were followed for six months. AEs were systematically captured using structured interviews and classified by the Medic al Dictionary for Regulatory Activities (MedDRA) System Organ Class. Univariable and multivariable logistic regression analyses identified predictors of AEs. Results Among 607 participants, 50 (8.0%) reported adverse events (AEs). Neuropsychiatric disorders were most common (2.5%), followed by cardiovascular (1.8%) and reproductive system disorders (1.5%). Other AEs, including gastrointestinal, eye, and skin disorders, were rare (<1%). In multivariable analysis, participants at site □3 and being single had significantly lower odds of AEs (aOR □0.04, 95%□CI□0.00–0.29, p □=□0.002), (a OR□0.45, 95%□CI□0.22–0.92, p □=□0.028). Prior exposure to Zidovudine-based regimens was associate d with increased odds of AEs (aOR □3.33, 95%□CI□1.43–7.75, p □=□0.005). Conclusion DTG⍰based ART regimens demonstrated a favourable safety profile, with AEs occurring infrequently and predominantly in neuropsychiatric, cardiovascular, and reproductive categories. Study site, Marital status and prior Zidovudine exposure were associated with AE risk, emphasizing the need for tailored monitoring, strengthened awareness in AE reporting and standardized pharm acovigilance across facilities.

ABSTRACTThis study examines the impact of decentralization on HIV and Tuberculosis (TB) program performance in rural central Uganda, highlighting the mediating role of decentralized monitoring and accountability (DMA). Decentralization aims to improve service delivery through local governance, yet its effectiveness and underlying mechanisms remain underexplored. A cross‐sectional survey of 145 district leaders overseeing HIV and TB programs across eight districts utilized a structured questionnaire and SPSS Version 27. The reliability of decentralization constructs was verified using Cronbach's alpha, while principal component analysis confirmed their Validity. Five constructs emerged: local resource mobilization (LRM), decentralized strategic resource allocation (DSRA), decentralized collaborative program governance (DCG), decentralized program administration (DPA), and DMA, alongside HIV and TB Program Performance (HPP). Regression and mediation analyses demonstrated that DSRA and DPA significantly enhanced HPP by promoting equitable resource allocation and administrative efficiency. DMA mediated the effects of DSRA, DCG, and DPA on HPP, reinforcing gains through transparency, reporting, and stakeholder oversight. However, LRM showed no significant direct or mediated impact, implying that fiscal autonomy alone may not drive program success. These findings suggest decentralization can strengthen health outcomes when supported by robust local planning, administrative capacity, and continuous monitoring. Policymakers should channel resources into local governance infrastructure, DMA included, to ensure that decentralized frameworks advance HIV and TB service delivery.

IntroductionAs the Coronavirus Disease 2019 (COVID-19) pandemic overwhelmed healthcare systems globally, integrating vaccination into primary health services became essential to expedite immunization efforts, especially in resource-constrained settings. This report explains the multifaceted process of integrating COVID-19 vaccination services at Mildmay Hospital Uganda (MUgH), focusing on the strategies, challenges and outcomes associated with this project.MethodsMUgH, a general hospital in Uganda, implemented COVID-19 vaccination services between March 2021 and December 2022. Using the 7 S framework; Structure, Systems, Shared Values, Skills, Style, Staff, and Strategy, the hospital aligned resources effectively. Structure was strengthened by creating dedicated vaccination areas, optimized Staff through targeted training, and aligned Skills for task-specific roles. Strong Systems ensured streamlined vaccine administration, while strategic Style (management) fostered adaptability. Collaborations with the Wakiso District unit supported Shared Values for public health, and social media was used effectively to counter misinformation and engage the community.ResultsMUgH successfully administered 13,370 of 15,000 available COVID-19 vaccine doses, including 8,906 first doses, 3,568 s doses, and 84 boosters. MUgH’s collaborative approach, reinforced by targeted media engagement and strategic partnerships with local vaccine distributors, secured a steady vaccine supply and built public trust. This demonstrated the value of a resource-efficient and adaptable model in addressing community healthcare needs. Key challenges included labour-intensive shifts, task-shifting among staff, misinformation and hesitancy, occasional vaccine stock-outs, and managing demand from ineligible individuals.ConclusionIntegrating COVID-19 vaccination into MUgH services using the 7 S framework proved effective in enhancing healthcare resilience and public health. This adaptable model offers valuable insights for strengthening health systems and preparing resource-limited settings for future epidemic responses.