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ItemAssessment of preconception folic acid use and associated factors among pregnant women in Wakiso district, Uganda: a facility based cross-sectional study(Makerere University, 2025)Background: Obstetric guidelines recommend women of childbearing potential to use Folic Acid (FA) three months prior conception. Preconception FA supplementation provides adequate serum FA levels necessary for prevention of up to 72% of Neural Tube Defects (NTDs). However, majority of pregnancies in low and middle-income countries are unplanned resulting in failure to use FA as recommended. There is limited data on use of FA during the preconception period in Uganda. This study assessed preconception FA use and associated factors among pregnant women attending antenatal care (ANC) in Wakiso district. Methods: A facility based cross-sectional study was conducted from 1st June 2025 to 31st August 2025 among 943 pregnant women 15-49 years attending their first antenatal care visit at four healthcare facilities in Wakiso district (Wakiso HCIV, Kajjansi HCIV, Kasangati HCIV and Ndejje HCIV). Pregnant women were then requested to voluntarily provide written Informed consent. A structured questionnaire was used to assess use of FA prior to conception. Descriptive and Firth-logit regression analyses were performed using Stata® version 14 to characterize factors associated with preconception FA use. Analysis was stratified by pregnancy planning status. Results: The overall uptake of preconception FA use was 3% (28/943) (95% CI: 2.0-4.3%). The uptake of preconception FA use among women with planned pregnancies was 3.5% (22/631) (95% CI: 2.2-5.2) which was not statistically different from women with unplanned pregnancies [1.9% (6/312) (95% CI: 0.7-4.1)]. The mean age of study participants was 25 years (SD 5.2) with 58.4% (551/943) of the respondents attending their first ANC visit in their second trimester. Awareness about preconception FA use was 52.9% (499/943). Muslim women were more likely to use FA during the preconception period, AOR 4.05 [95% CI: 1.06 - 15.52], P value 0.041. Health workers (P=0.014) and social media (P=0.049) were significant sources of knowledge about FA. Women who were aware of the recommended start period for using FA were more likely to take FA during the preconception period (P= 0.003). Conclusion: This study found a low uptake of FA during the preconception period by Women of Reproductive Age (WRA). Lack of awareness about FA was the primary barrier for non-users. Current FA uptake is insufficient to address Uganda’s NTD burden and current health education and policy are insufficient to prevent the high burden of NTDs in Uganda. MOH needs urgent, multi-channel health education campaigns through mass media and health workers to emphasize the necessity of starting FA supplementation three months before pregnancy. Further biochemical studies to quantify actual serum FA levels among WRA and explore deeper insights into the complex behavioural determinants and socio-cultural barriers underlying the low FA uptake in Uganda is urgently needed.
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ItemAssessment of Monitoring and Evaluation Practices in Management of Laboratory Reagent Stock Outs in Selected Regional Referral Hospitals in Uganda. A Concurrent Mixed Methods Study.(Makerere University., 2026-04-30)Background: Laboratory reagents are essential for accurate diagnosis and efficient healthcare delivery, yet Uganda’s referral hospitals frequently experience stockouts. These shortages delay diagnosis, compromise treatment decisions, increase healthcare costs, and reduce the overall quality of patient care. Aim: This study evaluated monitoring and evaluation(M&E) practices for managing stock out of laboratory reagents, facilitators and barriers to their application at Entebbe and Mbale regional referral hospitals. Methods: This study is a concurrent mixed-methods study. Data on stock out of laboratory reagents was collected from the stock cards and Order /Requisition forms, Electronic afya(E-AFYA) system in the laboratory using a checklist. Additional data was collected through key informant interviews of laboratory staff in Mbale and Entebbe regional referral hospitals. The interviews were audio recorded and data analyzed using thematic manual coding. Quantitative data was summarized in frequencies and inferential analysis was conducted using chi-square tests. Results: A total of 171 reagents experienced 848 stockout episodes from 2023–2025, with Entebbe RRH recording 66 reagents and 369 episodes, and Mbale RRH 105 reagents and 479 episodes. Entebbe had more frequent stockouts, while Mbale had fewer but longer episodes. Stockouts were most common in Immunology/Serology (37.6%) and Biochemistry (26.5%). The overall mean stockout duration was 26.7 days (SD: 39.3); Entebbe averaged 19.5 days (SD: 35.2) and Mbale 35.9 days (SD: 42.2). A Chi-square tests (p < 0.05) showed significant differences in stockouts between the two hospitals for Microbiology/Parasitology and Immunology/Serology, but not for Hematology and Biochemistry. Qualitative findings indicated that stock monitoring tools, electronic inventory systems, supervision, audits, and reporting mechanisms were in place in both hospitals but were applied inconsistently. Mbale achieved full implementation of the Electronic afya (E-AFYA) system in May 2025, with earlier records maintained manually, while Entebbe had relatively more organized documentation; nevertheless, both facilities demonstrated data quality challenges, including incomplete stock cards, missing records, and inconsistent requisition forms. Use of M&E data for decision-making and accountability was limited. Facilitators included leadership support, availability of digital tools, and inter-facility redistribution of reagents, whereas barriers included staff shortages, weak data-use culture, and irregular supervision. Conclusion: Strengthening M&E systems including better data quality, reporting, supervision, staff capacity, and digital tools will enhance stockout management and ensure sustained reagent availability.
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ItemTrends of childhood vaccination in Wakiso District(Makerere University, 2026)Introduction: While immunization remains one of the most successful interventions in public health, the coverage has flattened over the last decade. And so many children don’t get a single vaccine dose and while others take vaccine doses partially. Objectives Main objective: To evaluate the trends of childhood vaccination in Wakiso district in order to improve the childhood vaccination services in the district. Specific objectives 1. To determine the trend of childhood vaccination drop-out rates for DPT 1 to DPT3, MR 1 to 2, to PCV3 and HPV1 to HPV2 between October 2021 and September 2022. 2. To establish the trend of childhood vaccination coverage in Wakiso district between October 2021 and September 2022. Methods: It was a cross-sectional study. All records of children who received at least one dose of the childhood vaccines were used in the study from October 2021 to September 2022. Results: The drop-out rates were very high especially for Measles Rubella vaccine and Human Papilloma Vaccine. The vaccination coverage was very low with Measles Rubella vaccine and Human Papilloma Virus vaccine coverage taking the lowest position. Conclusions & Recommendations: There should be strategies that decrease vaccination drop-out and increase vaccination coverage.
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ItemEvaluation of the tuberculosis surveillance system in Wakiso District(Makerere University, 2026)Introduction: TB (Tuberculosis) has been a serious problem in Uganda and a lot of effort has been put in place to fight it and this led to creation of the TB surveillance system in Uganda. TB was introduced in Uganda following the implementation of the Millennium Development Goals and the Sustainable Development Goals (SDGs) to reduce the prevalence of TB to acceptable levels. TB surveillance was introduced in Wakiso District in the year 2015 but since then there has been no evaluation carried out to establish its existence thus creating a need for this study to be done. Objectives The main objective for this study was: to evaluate the TB surveillance system in Wakiso district and in so doing, generate information that will help the District Health Team improve the implementation of the system. The specific objectives were: to determine the Total TB cases registered (all cases, all forms) from October 2021 to June 2022 and to determine the TB case notification rate for new and relapse TB cases for all forms per 100,000 populations from October 2021 to June 2022. Methods: The study was a cross-sectional study. The data was collected through the review of patients’ archived records. Raw data was then entered into Microsoft Excel and later exported to SPSS for further processing. Results: There was an overall increase in the number of TB cases and also there was a low notification rate for the TB although it was increasing at a slow pace. . Conclusions & Recommendations: The study thus recommend the government and its partners to put aside more funding targeted to the strengthening the TB surveillance system in Uganda with main focus on Wakiso district so as to minimize the morbidity and mortality caused by TB.
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ItemThe utilisation of cytopathology technique at Makerere University Pathology Laboratory, Kampala, Central Uganda(Makerere University, 2026)Abstract Background: Cytopathology plays a central role in the early detection and management of benign and malignant conditions. Makerere University Pathology Laboratory (MUPL) provides diagnostic cytopathology services for patients from across Uganda. This retrospective study assessed the utilisation of cytopathology technique and evaluated predictors of malignancy from 2015 to 2019. Methods: A total of 400 archived cytopathology records were reviewed. Data on patient demographics, specimen type, and diagnostic outcome were extracted. Descriptive, bivariate, and multivariate analyses were performed using SPSS version 25. Chi-square tests and independent t-tests explored associations, while binary logistic regression identified independent predictors of malignancy. Significance was set at p < 0.05. Results: Of the 400 cases, the mean age was 44.2 ± 13.7 years; 68.5% were female. Cervical (31.0%) and breast (27.5%) specimens predominated. The overall malignancy rate was 24.5%. A significant association was found between specimen type and malignancy (χ² = 23.7, p < 0.001). Multivariate analysis revealed that increasing age (AOR = 1.05; 95% CI: 1.02–1.08; p = 0.002) and breast specimens (AOR = 2.94; 95% CI: 1.31–6.58; p = 0.008) were independent predictors of malignancy. Conclusion: Cytopathology utilisation at MUPL has increased, with high diagnostic yield in breast and cervical lesions. Continuous investment in cytopathology infrastructure, training, and quality assurance is essential to enhance diagnostic accuracy and improve patient outcomes.