Research Papers and Publications

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The 14 Cost of Commercial Motorcycle Accidents in Uganda
(Taylor & Francis, 2017-04-21) Sebaggala, Richard; Matovu, Fred; Ayebale, Dan; Kisenyi, Vincent; Katusiimeh, Messarck
Understanding the cost of the road traffic accidents (RTAs) has been of interest to many scholars and policy makers for a long time. In Uganda like many developing countries in Africa, injuries due to motorcycle accidents represent a major but often neglected emerging public health problem and contribute significantly to the overall road traffic injuries. This research study therefore explored the costs of motorcycle accidents and the pain, grief and sufferings of the motorcycle accident victims using a multi-method approach. Unlike many studies on cost of accidents which use the traditional human capital approach, this study in addition to the human capital approach, applied the Willingness-to-pay (WTP) approach to estimate the cost of motorcycle accidents. WTP method was used to estimate the value that boda boda riders would pay for reducing the risk of loss of life based on Contingent Valuation (CV) method. We extend the analysis to also explore the key coping mechanisms adopted by the Boda- boda riders amidst the challenges the riders face when they suffer motorcycle accidents. The data were obtained from multiple sources, including a survey of 1600 boda boda cyclists in Kawempe and Central divisions in Kampala City, interviews with accident victims and their immediate family members, traffic police records, hospitals and national statistics on selected economic aggregates. The results show that motorcycle accidents are associated with huge economic and non-economic burden borne by the accident victims and the society as a whole. The study established that it costs approximately 7 million shillings (or 2800 USD) to treat a boda boda accident victim who is severely injured. Based on annual police statistics on motorcycle accidents for 2012; the Ugandan economy losses more than UGX 3 billion (1.2m USD) value of output due to days away from productive work as result of severe injuries and death. Likewise, the cost of motorcycle repairs amounted to UGX 350 million (140,000 USD). The study also estimated the value of preventing motorcycle accidents. The estimates show that on average boda boda riders are willing to pay Ug Shs 222,550 (89 USD) a year for a reduction in mortality risks associated with motorcycle accidents that translate into UGX 4.45 billion (US$1.78m), the value of statistical life (VOSL). Overall, the combined economic burden of the motorycle accidents (repairs, medical costs, lost output and imputed cost of pain grief and suffering) were estimated to be approximately US$ 3.6 million annually. This cost is about 0.02% of Uganda’s GDP in 2013. The key policy implication of the study is that reducing motorcycle causalities and fatalities will reduce social and economic sufferings of victims, unlock growth and free resources for more productive use. The findings provide the cost-benefit analysis of any investment in areas that will promote the prevention, treatment, care and management of motorcycle accidents in Uganda.
A Framework for Adopting ICT-Based Services Among Coffee Farmers in Uganda: Case Study of Bugisu Subregion in Bugisu
(Springer, 2024-06-04) Moses Obulei; Emmanuel Eilu; Joseph Mutemere
While information and communication technology (ICT)-based services would help address most of the challenges faced by the coffee farmers and improve coffee production in Bugisu region, there are several challenges that hinder the adoption and use of ICT-based services among coffee farmers in Bugisu region. This study, therefore, assessed the technological challenges associated with the adoption of ICT-based services among coffee farmers in Bugisu region and examined the technological, organizational, and environmental factors that facilitate the successful adoption of ICT among coffee farmers in Bugisu subregion in Bugisu. Twenty-three participants including coffee farmers, extension workers, and Bugisu cooperative union leaders were involved in the study. Both interview and focus group discussions were utilized for data collection. The study used content analysis to determine the presence of certain words, themes, or concepts from the field data. The study found out that lack of electricity, inadequate ICT infrastructure, high cost of ICT software and hardware, and high ICT illiteracy rates were some of the challenges faced by coffee farmers in Bugisu region. This chapter, therefore, presents a TOE framework for successful adoption of ICT among coffee farmers in Bugisu subregion in Bugisu.
A Framework for Enhancing the Adoption of E-Tax Services in Tanzania
(International Journal of ICT Research in Africa and the Middle East, 2019-12) Daniel Deogratus; Gilbert Maiga; Emmanuel Eilu
Domestic revenue collection through taxation is still below its potential in many developing countries. There have been concerted efforts to improve domestic revenue mobilization in many developing countries using ICT. However, since the use of ICT in taxation in developing countries is still relatively a new phenomenon, models and frameworks that can best guide the adoption of an e-tax service in a developing country context are lacking. Therefore, in this article, the authors investigated requirements for enhancing e-tax service adoption in a typical developing country like Tanzania. Requirements for enhancing e-tax service adoption were first elicited through literature review and validated using questionnaires and an interview guide. The requirements for enhancing e-tax adoption were used to extend TOE framework developed by Tornatzky and Fleischer in 1990. This article, therefore, presents a model that supports electronic tax services adoption in a typical developing country like Tanzania
A Framework for Enhancing the Influence of Evaluation in the Implementation of the African Peer Review Mechanism
(2024-01) Martin Kizito
This study analyses the implementation of the African Peer Review Mechanism (APRM), as a governance evaluation framework mandated by Article 5(2) of the African Union (AU) Constitutive Act of 2000. It aimed at generating a framework for enhancing the APRM, and in turn positively influence public policy outcomes in AU member states. The study was in response to increasing calls for empirical field studies especially about African home-grown initiatives, to guide stakeholders on how evaluation inputs translate into activities and consequently policy outcomes. In contributing to the decolonising agenda, in policy evaluation knowledge, it argues that APRM, is a Made in Africa Evaluation (MAE), but adopts a Eurocentric rational and outcome oriented approach to evaluation. This mismatch, in light of the limited attention given to the implementation process of peer review, has resulted into concerns of emerging patterns of evaluation under-use, misuse and non-use or inaction. This trend may result into an evaluation crisis, affecting the sustainability of the APRM as a catalyst to the realisation of the AU Agenda 2063. Using a mechanism-based approach, this thesis aims at bridging the knowledge gap by empirically drawing on qualitative data collected from 35 purposively selected participants. Through interviews and a focus group discussion (FGD), it established the perceptions of APRM stakeholders, about the impact of the first and second-generation peer reviews (2005-2018) as well as the refugee policy framework as a reported best practice. The findings were analysed inductively using ATLAS.ti 08 qualitative software and they reveal that the APRM first National Plan of Action (NPoA) was among the 23 core studies that directly informed the formulation of Uganda’s initial National Development Plan (NDPI). Nevertheless, APRM influence is declining to show casing best practices, with increasing symbolic use but also mis-use of APRM recommendations. This is attributed to inadequate financial and technical capacity inputs, lack of a well-domesticated legal framework supporting APRM activities, stakeholders without a well-established culture of evaluations and a political context that allows selective use of evaluations in policies. In the proposed framework, the study recommends inclusive participation in evaluation input, activities aligned with government plans; institutionalising government wide reporting on NPoA implementation and establish a well-domesticated legal framework.
A Model for Improving Social Media Tax Compliance in Uganda
(Springer Nature Switzerland AG 2024, 2024-06-04) Emmanuel Eilu; Joseph Mutemere; Peter Wanda; Justus Byamukama; Peter Kamya
When the social media tax was introduced in Uganda in June 2018, a case was filed in the Constitutional Court seeking the nullification of the tax. A campaign hashtag “#ThisTaxMustGo” was created against the tax. Social media users began using Virtual Private Network (VPN) Apps installed on their smartphones to evade the tax. One year after its introduction, the Uganda Revenue Authority (URA) acknowledged that the social media tax was among the worst-performing tax categories for 2018/19. Only UGX 49.5 billion was collected in 2019, against the projected UGX 284 billion, hence a 17.4% performance. URA observed that there was a need for a deeper study of social media tax to find ways of improving its compliance. This chapter surveyed the social media tax compliance levels and investigated ways of improving compliance with the social media tax among the taxpayers in Uganda. A survey was conducted in Mbale municipality, where a total of 381 closed-ended questions with ordered choices were given out within the municipality, and 325 were filled out and returned for analysis. Statistical Package for the Social Science (SPSS) and Excel were used to analyse quantitative data. The results of the survey revealed that 40% of social media users did not pay the social media tax whenever they wanted to access social media, while 58% of those who did not pay the tax used VPN to evade the social media tax. About 67% said the social media tax was very high, while 75% said the tax was unfair and 68% said the introduction of the social media tax was an attempt to reduce freedom of expression. This chapter presents a modified model for improving social media tax compliance in Uganda. It is hoped that this model may be of great use to the Uganda Revenue Authority and other revenue bodies in developing countries seeking to improve tax compliance.
A Multi-national Validity Analysis of the Personal Report of Communication Apprehension (PRCA-24)
(Routledge, 2019) Croucher, Stephen M.; Kelly, Stephanie; Rahmani, Diyako; Jackson, Kelsea; Lando, Agnes; Galy-Badenas, Flora; Agnes, Lando; Chibita, Monica; Nyiranasbimana, Venantie; Turdubaeva, Elira; Eskiçorapçı, Nadirabegim; Condon, Shawn Michael; Stanalieva, Gulzada; Orunbekov, Bakyt
Methodological issues abound when conducting cross-cultural research. In this manuscript we discuss three methodological issues present in many cross-cultural communication studies: lack of geographic diversity, reliability, and validity. To explore these issues the Personal Report of Communication Apprehension (PRCA-24) is assessed. The PRCA-24 serves as an exemplar of a US-designed and -validated measure frequently used outside the US without tests of validity or measurement invariance. In fact, since 1990 less than 10 studies have reported validity results, often citing fit issues. The PRCA-24 was administered to respondents from 11 countries and failed to yield acceptable fit statistics in all samples, showing poor construct validity. Implications for cross-cultural research are discussed, with particular emphasis on recommendations for increased cross-cultural methodological rigor.
A Multi-national Validity Analysis of the Self Perceived Communication Competence Scale
(Routledge, 2020) Croucher, Stephen M.; Kelly, Stephanie; Rahmani, Diyako; Burkey, Mark; Subanaliev, Talgat; Galy-Badenas, Flora; Lando, Agnes Lucy; Chibita, Monica; Nyiranasbimana, Venantie; Turdubaeva, Elira; Eskiçorapçı, Nadirabegim; Jackson, Kelsea
The self-perceived communication competence (SPCC) measure has been used in over 50 published studies since 2000. McCroskey and McCroskey (1988. Self-report as an approach to measuring communication competence. Communication Research Reports, 5, 108–113. doi: 10.1080/08824098809359810) developed the measure to be used within the US college/university classroom. Despite its intended use, the measure is frequently used outside of the US and outside of the college/university setting without tests of measurement invariance. In fact, only four studies have performed tests of internal consistency on the measure since 2000, and each has found poor fit. Therefore, the purpose of this study was to assess the utility of the measure outside of its intended population. The measure was utilized to survey respondents from 12 countries and failed to yield acceptable fit statistics in all samples, showing poor evidence of construct validity.
A National Framework for Sustainability of Health Knowledge Translation Initiatives in Uganda
(Uganda Country Node of the Regional East African Community Health Policy Initiative, 2014-05-26) Robert Basaza; Alison Annet Kinengyere; Nelson Sewankambo
This report is intended to inform the deliberations of those engaged in developing policies on sustainability of health knowledge translation initiatives policies as well as other stakeholders with an interest in such policy decisions. It summarizes the best available evidence regarding the design and implementation of policies on how to advance sustainability of health knowledge translation initiatives policies in Uganda’s [mainstream] health system. The purpose of the report is not to prescribe or proscribe specific options or implementation strategies. Instead, the report allows stakeholders to consider the available evidence about the likely impacts of the different options systematically and transparently.
A Secondary Analysis to Determine Variations of Dental Arch Measurements With Age and Gender Among Ugandans
(BMC, 2015) Hilda Okori; Pricilla S. Apolot; Erisa Mwaka; Gerald Tumusiime; William Buwembo; Ian G. Munabi
Background: Dental arch dimensions are useful in dental practice and in forensic odontology. Local data is essential because ethnic differences exist in dental arch dimensions. In the Ugandan population no studies had been done on dental arch dimensions. The objective of the current study was to determine the variations in dental arch dimensions with age and gender in a sample of dental casts from the Ugandan population. Method: This was a secondary analysis of dental casts previously prepared using mandibular and maxillary arch impressions of 220 children (85 boys and 135 girls) aged 12–17 years recruited from schools in Kampala, Uganda. Dental arch dimensions for the maxilla and mandibular casts were taken using a digital vernier calliper. The data was analysed using the means based independent samples t test to obtain the descriptive statistics with regression analy- sis being used to obtain the regression coefficients and constants using STATA 12. Results: The overall maxillary dimensions were significantly smaller in females than males by 1.50 mm (95 % CI −2.91 to −0.09, P = 0.04), controlling for age group. The overall dimensions of the mandible were also smaller in younger participants, though this was not statistically significant. Conclusion: From this study we observed significant differences in arch dimensions between males and females that are of forensic value for this population. There is need for more study of the differences in arch dimensions with age using a larger and more age diverse study population. Keywords: Dental arch, Dimensions, Age, Anatomy, Forensic odontology, Gender
A Socio-History of the Media and Participation in Uganda
(Routledge, 2007) Chibita, Monica; Fourie, Peter, J.
This article is based on research done for a doctoral thesis titled Indigenous language programming and citizen participation in Ugandan broadcasting: An exploratory study (Chibita, 2006). The purpose of the thesis was to investigate and show the importance of first-language media for the participation of citizens in democratic processes. The thesis covered a wide range of topics including linguistic perspectives on language and participation, the history, structure and operation of the media in Uganda, the regulatory environment for linguistic diversity in Uganda's broadcast media, debates about indigenous language broadcasting in Uganda, and policy recommenda tions. In this article, the emphasis is on one of the topics dealt with in the thesis, namely key political, economic and cultural factors in Uganda's history and how these factors, including the right to the use of indigenous languages, have had an important impact on citizens' capacity to participate in public debate through the media (especially broadcasting). It is argued that the opportunities for Ugandans to participate in their governance through critiquing and making an input in government policy have been limited by a number of factors. These include bad colonial and postcolonial policies on the media and language, poverty, low levels of education, and lack of basic access to the means of participation. They have also been limited by governments which have proscribed freedom of expression and association by varying means and to different degrees since the early twentieth century.
ABC for people with HIV: responses to sexual behavior recommendations among people receiving antiretroviral therapy in Jinja, Uganda
(Routledge Taylor & Francis Group, 2011-03-09) Allen, Caroline; Mbonye, Martin; Seeley, Janet; Birungi, Josephine; Wolff, Brent; Coutinho, Alex; Jaffar, Shabbar
People living with HIV who are taking antiretroviral therapy (ART) are increasingly involved in ‘positive prevention’ initiatives. These are generally oriented to promoting abstinence, ‘being faithful’ (partner reduction) and condom use (ABC). We conducted a longitudinal qualitative study with people living with HIV using ART, who were provided with adherence education and counselling support by a Ugandan nongovernmental organisation, The AIDS Support Organisation (TASO). Forty people were selected sequentially as they started ART, stratified by sex, ART delivery mode (clinic- or home-based) and HIV progression stage (early or advanced) and interviewed at enrolment and at 3, 6, 18 and 30 months. At initiation of ART, participants agreed to follow TASO’s positive-living recommendations. Initially poor health prevented sexual activity. As health improved, participants prioritised resuming economic production and support for their children. With further improvements, sexual desire resurfaced and people in relationships cemented these via sex. The findings highlight the limitations of HIV prevention based on medical care/personal counselling. As ART leads to health improvements, social norms, economic needs and sexual desires increasingly influence sexual behaviour. Positive prevention interventions need to seek to modify normative and economic influences on sexual behaviour, as well as to provide alternatives to condoms.
Abundance, distribution and effects of temperature and humidity on arthropod fauna in different rice ecosystems in Uganda
(Journal of Entomology and Zoology Studies, 2017) Kizito, Elizabeth B.; Masika, Fred Bwayo; Masanza, Michael; Aluana, Goncalves; Barrigossi, Jose Alexandre Freitas
The study on abundance, distribution and effects of temperature and humidity on arthropod fauna was conducted in smallholder rice farming areas in three agro ecological zones of Lake Victoria basin, Northern moist farmlands and Western Savannah grasslands in Uganda. Arthropods were collected using a standard sweep net and a total of 17 orders representing 13,272 arthropods were recorded from the three agro – ecological zones during the study. Most arthropod fauna were collected in Bugiri, Lira and Kasese respectively. The most abundant orders throughout the survey included Homoptera, Coleoptera, Hemiptera, Diptera, Hymenoptera and Orthoptera. While the least abundant included Dermaptera, Zoraptera, Phasmatoda, Mantodae, Embioptera and Neuroptera. All orders except Embioptera, Mantodae, Neuroptera and Phasmatoda were collected in all the three agro ecological zones. The orders Diptera (p = 0.0282), Hymenoptera (p = 0.0051), Lepidoptera (p = 0.0149), Odonata (p = 0.0356) showed a significant difference in abundance in the three agro – ecological zones. Temperature and humidity had a significant effect on the arthropod population for example Aranea showed a positive correlation in their abundance with increase in temperature in all the agro – ecologies
Access to improved sanitation facilities in low-income informal settlements of East African cities
(2015-03-05) Okurut, Kenan; Kulabako, R. N.; Adogo, J. M.; Chenoweth, J.; Pedley, S.; Tsinda, A.; Charles, K.
Throughout Africa, the population in urban areas is increasing rapidly beyond the capacity and the resources of the cities to accommodate the people. In Sub-Saharan Africa, the majority of urban dwellers live in informal settlements served by inadequate sanitation facilities. These areas present unique challenges to the provision of sanitation, and there is inadequate information on access to improved facilities. This paper reports findings of a study undertaken in low-income informal settlements using mixed methods to assess access to sanitation and identify the barriers to household improved sanitation facilities. Although more than half (59.7%) of the respondents reported using sanitation facilities that are included in the JMP definition of improved sanitation, a high proportion of these facilities did not provide “ access to basic sanitation” and less than 5% of all the respondents did not report issues related to sustainable access to basic sanitation. The findings highlight the urgent need to develop a more specific and strategic interventions for each low-income informal settlement, to upscale the sustainable access and use of improved sanitation in urban centres.
The Accreditation Process and Challenges of Private Religious Based Universities in Uganda
(International Journal of Pedagogical Innovations, 2013) Otto, Francis; Musinguzi, Benon
The quantitative growth in Ugandan higher education subsector has created many challenges including a drop in quality in education delivery. Today, there are 34 universities in Uganda (up from 26 in 2006) with over 185,000 students (up from 137,190), representing an overall growth rate of more than 15% in the last 5 years. Given this rapid expansion of higher education, some form of regulation is necessary to assure quality. Ugandan government established the National Council for Higher Education (NCHE) as a regulatory agency to set standards and regulations to ensure that all public and private tertiary education institutions in Uganda create, sustain and improve the relevance and quality of higher education for all qualified Ugandans and to meet the local, national and global higher education challenges of the 21st century. In addition to sustaining and improving the relevance and quality of higher education, these religious based universities have a special mission of evangelism and discipleship and view all admissions and appointments as opportunities for ministry and service. This however, may not go well with the peer assessors and the Accrediting Agencies. Currently there are more than six recognised faith based universities in Uganda. Out of the seven fully accredited universities in Uganda, five are faith based and only two are secular. There are different views about the philosophies of these faith-based universities. Some people seem to suggest that they pay more attention to evangelism and discipleship than in provision of higher education. While others view this type of institutions as a very good model to provide good morals and education that can transform the society in a positive way. At the same time, the regulatory framework in the country must provide for an all-inclusive environment for all to participate in higher education which may pose a big challenge to these faith based institutions. This article therefore, discusses the accreditation process in Uganda and challenges of private religious based Universities in Uganda in regards to accreditation.
Action and Action-Regulation in Entrepreneurship: Evaluating a Student Training for Promoting Entrepreneurship
(Academy of Management Learning & Education, 2015) Gielnik, Michael M.; Frese, Michael; Kahara-Kawuki, Audrey; Katono, Isaac Wasswa; Kyejjusa, Sarah; Munene, John; Ngoma, Muhammed; Namatovu-Dawa, Rebecca; Nansubuga, Florence; Orobia, Laura; Oyugi, Jacob; Sejjaaka, Samuel; Sserwanga, Arthur; Walter, Thomas; Bischoff, Kim Marie; Dlugosch, Thorsten J.
Action plays a central role in entrepreneurship and entrepreneurship education. Based on action regulation theory, we developed an action-based entrepreneurship training. We investigated the question of how the training transmitted its effects on entrepreneurial action and start-up. The training put a particular focus on action insofar as the participants learned action principles and engaged in the start-up of a real business during the training. We evaluated the training’s impact over a 12-month period using a randomized control group design in a developing country (Uganda). As hypothesized, the training had positive effects on action-regulatory factors (entrepreneurial goals, action planning, action knowledge, and entrepreneurial self-efficacy) and the action-regulatory factors predicted entrepreneurial action. Entrepreneurial action and business opportunity identification mediated the effect of the training on new business start-up. Our study shows that an action-based entrepreneurship training promotes entrepreneurial action via action-regulatory mechanisms. Thus, action regulatory mechanisms play an important role in the process that leads to the new business creation.
Adaptation and Coping among East African Immigrants in North America
(2017) Okahaabwa, Gooreka
Immigrants are faced with the challenge of adapting to a culture different from their own. Successful adaptation includes socio-cultural adaptation, psychological adjustment, and coping. This study investigated cross-cultural adaptation and coping among East African immigrants in North America. Participants in this study were 51 individuals of East African origin who were over 20 years of age, residing in North America and recruited through a snowballing procedure. Participants completed the Acculturation Index, Socio-Cultural Adaptation Scale, and Center for Epidemiologic Studies Depression Scale, Ways of Coping Checklist (Revised), and a demographic questionnaire using Survey Monkey. Data analysis utilized SPSS. Independent samples-t- tests and Pearson product-moment correlations were conducted. Results indicated that there was no statistically significant difference in socio-cultural adaptation by: acculturation, coping, and migration with family. Additionally, there was no statistically significant difference in psychological adjustment by acculturation and participation in a faith community. Results revealed a positive correlation between psychological adjustment and socio-cultural adaptation, and a statistically significant difference in socio-cultural adaptation by participation in faith community. Further research into adaptation and coping among East African immigrants is recommended
Addressing ethnicity via biblical studies: a task of African biblical scholarship
(Neotestamentica, 2010) Nyende, Peter
In view of the ethnic crisis in Africa and the complexities of the discipline of Biblical Studies, one wonders how African biblical scholarship could address ethnic issues in Africa through its study of the Bible and its Biblical Studies curriculum. I identify three ways of addressing ethnicity through Biblical Studies which I argue for, make sense of, and distinguish by means of methodology (broadly conceived), and the goals of African biblical
Adherence to Antiretroviral Therapy in Jinja, Uganda: A Six-Year Follow-Up Study
(2013-10-11) Mbonye, Martin; Seeley, Janet; Ssembajja, Fatuma; Birungi, Josephine; Jaffar, Shabbar
Introduction: We report on the adherence experience of a group of people living with HIV on ART over six years in Uganda. Methods: Between 2005 and 2009, we followed up 41 participants who were also part of a clinical trial comparing home and facility based delivery of ART in Jinja, eastern Uganda. We conducted qualitative in-depth interviews at enrolment, 3, 6, 18 and 30 months to capture experiences with adherence over time. In 2011 we returned to these participants to find out how they were fairing with long term adherence. We managed to retrace 24 participants and interviewed them about their experience. We thematically analysed the data and compared findings over time. Results: Initially there were few barriers to adherence and many followed the adherence guidance closely. By year six, relaxation of these rules was noticeable although self-reported adherence continued to be high. Alcohol consumption was more common than before. Some relatives of the participants who had died claimed that some deaths were a result of alcohol. While participants reported that ART had allowed them to reclaim independence and return to work the changes in work and social routines created new challenges for adherence. Side effects like lipodystrophy were not only causing some stigma but for some tested their faith in the drugs. Many participants reported resumption of sexual lives but apart from those who selected same status partners, disclosure to new partners was minimal.
Adoption of Electronic Fiscal Devices (EFDs) for Value-Added Tax (VAT) Collection in Kenya and Tanzania: A Systematic Review
(The African Journal of Information and Communication, 2018-05) Emmanuel Eilu
Domestic revenue collection through taxation is still below its potential in many Sub-Saharan African countries. In an attempt to boost their tax revenues, many national governments have deployed electronic fiscal devices (EFDs) to improve value-added tax (VAT) collection. However, there is evidence indicating that the deployment of EFDs in some African countries has encountered substantial challenges. Using the systematic review method, the research described in this article investigated challenges encountered in adoption of EFDs in Kenya and Tanzania. The review concludes by modelling recommendations, extracted from seven existing studies, in terms of the technology-organisation-environment (TOE) framework (Tornatzky & Fleisher, 1990). This model is an effort to provide a potential guide for successful EFD adoption in East Africa.
Aetiology and Treatment Outcome of Non-traumatic Small Bowel Perforations at Mbarara Hospital in South-Western Uganda
(BMC, 2012-12) D. Mutiibwa; A. Lopez; G. Tumusiime; D. Riding; A. Diaz
Background: Non-traumatic small bowel perforation (SBP) is the most common form of gastrointestinal perforation in sub-Saharan Africa. Although SBP is a surgical emergency associated with complications, information regarding its aetiology is scanty in Uganda. This study was aimed at determining the aetiology and document treatment outcomes of non-traumatic small bowel perforations in South-western Uganda. Methods: This was a descriptive case series of 87 consenting patients with non-traumatic SBP confirmed atlaparotomy, on the emergency ward of Mbarara University Teaching Hospital. They were enrolled from September 2011 to May 2012. Specimens for blood culture, stool microscopy, HIV testing and tissue biopsies at the site of perforation were collected and analyzed. Patient follow-up was done till discharge. Results: Of the 78 biopsies performed, 66(84.6%) had histological features suggestive of typhoid perforations while 12(15.4%) had features of non-specific inflammation. Salmonella typhi was isolated in 13(15.0%) out of the 87 patients. Isolates were susceptible to Ceftriaxone and Ciprofloxacin. All patients tested HIV negative. Ascaris lumbricoides were seen in two patients. Re-laparotomy was done in four patients with new perforations, two with anastomotic breakdown and two with intra-abdominal abscesses. Wound sepsis was observed in 25(28.7%). Average length of hospital stay was 13 days. Some 10(11.5%) patients died. Conclusions: Most cases of non-traumatic SBP in south western Uganda are associated with Salmonella infection. There is need to enhance laboratory capacity to detect typhoid and preventive measures should be instituted in the general population.

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