Academic publications

Permanent URI for this collectionhttps://hdl.handle.net/20.500.11951/16

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Adherence to Self-care Practices among Diabetes Mellitus Patients at a Tertiary Hospital in Eastern Uganda
(International Scientific Indexing, 2023-06-30) Kiruyi, Samuel; Mukooza, Edward Kibikyo; Higenyi, Emmanuel; Rajab, Kalidi; Walusimbi, David; Ansiima, Sheila; Kitutu, Freddy Eric
Adherence to self-care practices among diabetes mellitus patients is vital in achieving optimal glycemic control and delaying the progression of the disease complications. There is limited information regarding diabetes self-care among diabetic patients in Eastern Uganda, where the disease is most prevalent. The aim of this study was to determine the level of adherence to diabetes mellitus self-care practices and the associated factors among adult diabetic outpatients at a tertiary hospital in Eastern Uganda. A cross-sectional study was conducted at Mbale Regional Referral Hospital in Eastern Uganda between September and October 2020, on a sample of 156 diabetic patients recruited through systematic random sampling. A structured questionnaire was used to collect data through self-report. Descriptive and Logistic regression analyses were conducted using STATA version 15.0, and a 5% level of significance. Most of the study participants were female (63.8%) with an average age of 52.3 years (SD 13.8). The prevalence of adherence to self-care was 36.5%. The factors associated with adherence to self-care were good diabetes knowledge (AOR=2.5; 95% CI= 1.2-5.3, p = 0.016), and high self-efficacy (AOR=3.9; 95% CI= 1.8 – 8.7, p = 0.001). Less than half of the patients attending the diabetic clinic at Mbale Regional Referral Hospital in Eastern Uganda adhere to self-care practices. Patients ought to receive comprehensive, consistent, and contextualized diabetes education to enrich their knowledge, as well as a boost of their self-efficacy through interventions like counseling, positive feedback, role models, and peer education.
Drug and Therapeutics Committee Structure and Roles in Hospitals: A Scoping Review
(International Scientific Indexing, 2023-12-29) Kiruyi, Samuel; Nagadya, Catherine; Walusimbi, David; Mukooza, Edward Kibikyo; Higenyi, Emmanuel; Rajab, Kalidi
Drug and Therapeutics Committees (DTCs) have been identified and promoted as a fundamental model in advancing the rational management and use of essential medicines and health supplies in hospitals since the 1970s. However, there is still a scarcity of comprehensive literature on their current structure and actual roles performed in various countries. We conducted a scoping review using the Pubmed and ResearchGate databases and included eligible articles published between 2010 and 2023, to assess the structure and roles performed by hospital DTCs. The database search yielded 47 potential records, but only seven of these were eligible for inclusion. Studies included were from both highincome and low- and middle-income countries. The structure of DTCs is generally similar across these countries, with minor contextual variations. All DTCs are heterogeneous in composition and contain both medical and non-medical staff. The DTC leadership comprises a chairperson who is usually a senior clinician, and a secretary who is usually a pharmacist. The majority of the DTCs have at least one sub-committee, and antimicrobial stewardship is the most common. The DTCs still perform their customary roles, although their role scope is expanding. In some countries, the DTCs have taken on additional roles due to the evolving medicines management and use problems, and technologies. There is however still a dearth of recent primary data on the structure and roles of DTCs in many countries. We recommend more primary research to understand the status of DTCs in various countries and to provide more insights into the existence and functionality of the DTC sub-committees.
BRCA1 Protein Expression in Epithelial Ovarian Cancer and Associated Clinicopathological Factors in Uganda
(Wiley, 2024-10-21) Okecha, Tonny; Abila, Derrick B.; Nabbale, Dorothy L.; Katongole, Fauz; Yahaya, James Joseph; Lukande Robert; Kalungi, Sam; Nalwoga, Hawa
BRCA1 gene dysfunction seen in epithelial ovarian carcinomas often results from germline mutations, somatic mutations, and promoter methylation. Identi0cation of tumors with loss of BRCA1 protein expression has shown to have therapeutic and prognostic implications. *e aim of this study was to determine the expression of BRCA1 protein in epithelial ovarian cancer (EOC) and the associated clinicopathological characteristics. This was a cross-sectional laboratory-based study that used para5n-embedded tissue blocks of patients histologically diagnosed with EOC from January 2010 to August 2018. Tissue sections were stained with hematoxylin and eosin (H&E) for histological con0rmation and with immunohistochemistry (IHC) using a mouse-derived monoclonal antibody MS110 for BRCA1 protein expression. *e association between BRCA1 protein expression and independent variables was determined using Pearson’s Chi-square test. A total of 104 tissue blocks from patients with EOC were included in the study with a mean age of 48.7 ± 12.8 years. Serous tumors were the most common which comprised 74.0% (77/104) of all the tumors and majority of them 75.3% (58/77) were high grade. Loss of expression of BRCA1 protein expression was found in 33.7% (33/98) of all the cases. *ere was no statistically signi0cant association between BRCA1 expression and age of patients, tumor grade, and histological subtype. There is a high expression of altered BRCA1 expression in tissues of EOC. Although it has not shown association with age of patients, histology types, and tumor grade, further studies need to assess its inCuence of the survival of cancer patients with EOC.
Prevalence and risk factors associated with hypopharyngo-esophageal foreign bodies impaction: a cross-sectional study
(Wiley, 2025-03-18) Kabazzi, Edrisa; Namwagala, Justine; Alunga, John R .; Byaruhanga, Richard; Okecha, Tonny; Yahaya, James Joseph
Ingestion of foreign bodies (FBs) is an emergency condition which may be associated with challenges for their removal. We aimed to assess the prevalence and factors associated with hypopharyngo-esophageal foreign bodies (HP-EFBs) impaction. A cross-sectional study was conducted at Mulago national referral hospital in Uganda from August 2018 to May 2019. The study consisted of 150 patients aged 6 months to 49 years with suspicion of HP-EFBs impaction. Binary logistic regression analysis was applied to determine factors associated with HP-EFBs. Statistical significance was set at P < 0.05. The median age of the patients was 7.1 (4.3–16.4) years, and males accounted for the majority (64%, n = 96) of the patients. Clinically, majority (62.0%, n = 93) of the patients had dysphagia. The prevalence of HP-EFBs was (33.3%, n = 50). Majority (76.0%, n = 38) of the FBs were coins. Being aged ≤5 years (aOR = 1.47, 95% CI = 2.18–3.39, P = 0.043), being a child attending school (aOR = 2.03, 95% CI = 1.56–4.92, P = 0.037), and being under caretakers aged ≤25 years (aOR = 6.83, 95% CI = 1.88–24.79), P = 0.003) were associated with increased risk of HP-EFBs impaction. This study has shown increased risk of HP-EFBs impaction particularly in male children and those attending school. Also, patients who were under younger caretakers had increased odds of HP-EFBs impaction. There is a need for caretakers and teachers at school to provide emphasis for children to always have precaution to avoid impaction of FBs.
Prognostic Factors for Overall Survival of Patients with Prostate Cancer in Kyadondo County, Uganda
(Hindawi, 2020-01-27) Yahaya, James Joseph; Okecha, Tonny; Odida, Michael; Wabinga, Henry
Prostate cancer is the second most common cancer among men globally. A few studies that have been done in Uganda on survival of patients with prostate cancer indicate that, the overall survival of patients with prostate cancer in Uganda is poor. The aim of this study was to determine the 3-year overall survival rate of a cohort of patients with prostate cancer residing in Kyadondo County who were diagnosed from 2012 to 2014. The secondary objective was to correlate the overall survival with the clinicopathological prognostic factors. Materials and Methods. This was a retrospective cohort study which involved 136 patients who were diagnosed histologically with prostate cancer at the department of pathology between 2012 and 2014. The cases were registered at the Kampala cancer registry and followed up to 31st December 2017. Data analysis was done using STATA version 12.0. The Kaplan-Meir curves were used for analysis of the 3-year overall survival rate. Hazard ratio (HR) and Log-rank test at 95% confidence interval under Cox-regression model were used to evaluate the effect of the covariates on the 3-year overall survival rate. < 0.05 was considered statistically significant. Results. More than half of the cases, 55.9% ( = 76) had Gleason score >8. Most of the patients, 67.7% ( = 92) had advanced disease at diagnosis. The 3-year overall survival rate was 67.6% with median survival of 36.5 months and range of 0–65 months. Clinical stage of the patients (HR = 1.65, = 0.039), Gleason score (HR = 1.88, = 0.008 ), and lymphovascular invasion (HR = 0.37, = 0.002) were the independent predictors of the 3-year overall survival rate in this study. Conclusion. The 3-year overall survival of prostate cancer patients in Uganda is poor. Most of the patients with are diagnosed with advanced clinical stages (stage III and IV). The Gleason score, clinical stage and lymphovascular invasion can powerfully predict independently the overall survival of patients with prostate cancer. This implies that the Gleason score, clinical stage and lymphovascular invasion may be used to predict the overall survival of patients with prostate cancer even prior prostatectomy.
Malignant Mixed Mullerian Tumor: A Case Report About a Uterine Tumor’s Case
(Elsevier, 2022-05-20) Morgan, Emanuel D; Okecha, Tonny; Yahaya, James J.; Othieno, Emmanuel
Introduction: Malignant mixed Mullerian tumor (MMMT) is an exceedingly rare and aggressive tumor which occurs predominantly in postmenopausal women though it has been reported rarely in premenopausal women. Case presentation: A 54-year old nulliparous postmenopausal female presented with a 3-month history of vaginal bleeding, mild lower abdominal pain and weight loss. Ultrasound revealed markedly enlarged uterus with a hyper-echoic solid and cystic mass and a right adnexal complex mass. Total abdominal hysterectomy and bilateral salpingioopherectomy were done. Histopathological features were consistent with MMMT. The patient is currently stable after 6 cycles of adjuvant chemotherapy which consisted of paclitaxel and carboplatin. Clinical discussion: MMMT of the uterus is rare, high-grade neoplasms comprising only 1–2% of uterine cancers and 3–5% of all uterine malignancies. This tumor may arise in the ovaries, fallopian tubes and vagina. Histologically, MMMT is a biphasic tumor composed of both epithelial (carcinoma) elements and mesenchymal (sarcoma) elements; though, which component is responsible for the tumor’s aggressive biological behavior remains undetermined. Conclusion: MMMT is a rare and aggressive tumor which is commonly seen in postmenopausal women with high rate of recurrence therefore, Radical surgery and close follow-up is mandatory since the role of chemoradiotherapy remains unclear in the management of patients with this tumor. Both stage of the tumor and myometrial invasion are considered as potential prognostic factors.
Role Conflict and Burnout among Administrators in Higher Institutions of Education in Uganda
(East African Nature and Science Organisation, 2023-10-16) Faith Mbabazi; Wilson Eduan; Mary Kagoire Ocheng
The purpose of this study was to find out the relationship between role conflict and burnout among administrators in higher education institutions in Uganda. There have been a number of studies on academicians in universities, but not much research has been done on administrators, especially in Uganda. The respondents included midlevel administrators such as deans, directors, heads of department, heads of sections, academic registrars, librarians, directors of services and human resource officers. This was a survey research design carried out on administrators in universities. The questionnaire, which was a combination of role conflict questions and Maslach burnout inventory, was administered to the administrators who had been randomly selected from universities. The findings indicated that role conflict was not a predictor of burnout dimensions of emotional exhaustion, cynicism and professional efficacy; however, coupled with demographics, the results changed, and there was a positive significant relationship, especially with age on emotional exhaustion. It was recommended that university top administrators should be interested in the mental state of their staff because, as earlier noted, emotional exhaustion was the most significant burnout dimension predicted by role conflicts
Head Teacher’s Support Role on the Quality of Inclusive Education in Secondary Schools in Iganga District
(Advances in Social Sciences and Management, 2023-12) Lastone Balyaino; Muweesi Charles; Mary Kagoire Ochieng; Isabirye Christopher; Faith Mbabazi Musinguzi
The study investigated the Head Teacher’s support Role in the Quality of Inclusive Education in Secondary Schools in the Iganga District. It examined the head teacher’s mandates in the realization of quality inclusive education in selected secondary schools. Explicitly, the study determined the influence of the head teacher's support role on the quality of inclusive education in secondary schools. This study adopted a cross-sectional survey design, drawing on quantitative and qualitative research approaches with a sample size of 83 respondents. Interview guides and questionnaires were used for data collection. SPSS software version 23 was used with a focus on descriptive statistics. The verbatim method was used for qualitative data. The study revealed that there was a moderate positive or constructive significant correlation between the head teacher's support role and achievement of quality inclusive education in selected secondary Schools (r=.514** p < 0.05). The study established that putting in place continuous professional development workshops, welfare, giving support supervision and provision of teaching aids, while other factors or issues remain constant, is most likely to better the process of inclusive education quality in secondary school. Conclusively the study revealed that the Head teacher's planning, support and motivation cannot work in isolation in the attainment of quality inclusive education. Monetary and nonmonetary ways greatly influence the quality of inclusive education. Also, the study recommends head teachers make relevant plans and increase support and motivation to uplift secondary schools' quality of inclusive education.
Records Management Practices and School Management Decisions in Selected Secondary Schools in Kibuku District, Eastern Uganda
(East African Nature and Science Organisation, 2025-06-16) Kataike, Rita; Turyahabwe, Remigio; Owomugisha, Evelyn; Mbabazi, Faith
The study examined the effect of records management practices on school management decisions in selected secondary schools in Kibuku District, Eastern Uganda. The objectives of the study included: i) to establish the effect of records management practices on academic decisions, and ii) to examine the effect of records management practices on administrative decisions in selected secondary schools. A cross-sectional survey design was used to guide this study. The study involved 113 respondents. These were purposively and simply randomly selected. The questionnaires, interview guide and focus group discussion helped in collecting the data. Quantitative data was analyzed by use of frequencies and percentages as well as SPSS, whereas, qualitative data was analyzed using thematic content analysis. The study findings revealed that records management practices have a significant effect on academic decisions in selected secondary schools in the Kibuku District (r=.686**, p=0.001). The study also revealed that records management practices have a significant effect on administrative decisions in selected secondary schools in Kibuku district (r=.342**, p=0.001). The study concluded that records management practices in administrative and financial decisions had the highest significant positive relationship on the school management decisions in secondary schools. It was concluded that records management practices play a key role in the management of academic institutions, so they should be handled seriously. The study recommended that records management practices should be improved through the introduction of computerized formats such as e-payment of fees, and digitized systems to check teachers’ lass attendance. In the same way, secondary schools should draft a records management policy to govern and regulate the management of students' academic records.
Experiences of Mid-Level Administrators in Ugandan Universities: A Study of Multiple Role Conflicts
(East African Nature and Science Organisation, 2025-06-20) Faith Mbabazi; Wilson Eduan; Mary Kagoire Ocheng; Stella Amero Eduan
This qualitative study explores the experiences of mid-level administrators in Ugandan public universities, focusing on role conflicts arising from their multiple responsibilities. Grounded in Role Conflict Theory, the research explores time-based, strain-based, and behaviour-based conflicts among 20 administrators at Makerere and Kyambogo Universities. The study was guided by the following research questions: What are the strain-based experiences of mid-level administrators regarding their workload? How do time-based constraints affect their workplace responsibilities? What behavioural challenges arise when executing multiple roles? This qualitative study adopted a constructivist approach, focusing on participants' lived experiences (Creswell, 2014). It targeted mid-level administrators (e.g., deans, bursars, heads of sections, etc.) due to their multifaceted roles. Twenty participants were purposively selected for their expertise. Data were collected via semi-structured interviews, conducted face-to-face and online during the COVID-19 lockdown. Interviews were audio-recorded, with brief notes for follow-up. Pseudonyms ensured confidentiality. Thematic analysis categorized data into time-based, strain-based, and behavior-based themes, aligned with Role Conflict Theory. Findings reveal that extended work hours, heavy workloads, and challenges in switching roles lead to stress, burnout, and work-life imbalances. Gender, marital status, and age influence these experiences, with female and younger administrators reporting higher strain. The study recommends enhanced training and resource support to mitigate role conflicts. Implications for university administration and future research are discussed.
Head Teachers’ Team Leadership Practices’ Influence on Financial Performance in Church of Uganda Founded Secondary Schools in Namirembe Diocese
(East African Journal of Education Studies, 2024-10) Tumuhimbise, M. Jasper; Muweesi, Charles; Buluma, Alfred; Mbabazi, Faith; Ochenge, Kagoire Mary; Eryenyu, Charles; Kitayimbwa, M. John; Wanyana, Mercy
The influence of Head Teachers’ team leadership practices on financial performance is highly acknowledged. The paper aims to highlight the challenges of head teachers’ team practices and advance insights on how they can be overcome to enhance financial performance. The methodology employed was a mixed-methods approach. Quantitative data was gathered through questionnaires assessing perceptions of the above metrics. Qualitative data was collected through documentary review of reports and interviews to explore the underlying mechanisms through which the variables above interrelate. The total number of respondents were 326 sampled from eight out of twenty-three schools. Quantitative analysis revealed that it has a coefficient of 0.52 and a value of 0.004 which indicates a strong correlation and statistically significant relationship between effective team leadership and financial health. This indicated that a team leader yielded better cash flow management, alignment with financial objectives, and overall sustainability. Qualitative insights supported the above crucial role that head teachers’ have in engaging teams of CFSs in shaping financial decision-making processes. The study concludes by emphasizing the need to foster team cohesion, positive financial culture and ensuring the long-term sustainability of CFSs. Recommendations include strengthening leadership development programs that are not available currently in Church of Uganda. Further, to enhance team dynamics and aligning leadership practices with organizational goals to optimize financial performance in these settings. Keywords: Leadership, Team, Finance Performance, Church Founded School.
Techniques Used by Teachers in Teaching Literacy and Numeracy in Selected Primary Schools in Kongwa District, Tanzania
(Paradigm Academic Press, 2024-01) Zilpa Graceford Masenje; Charles Muweesi; Mary Kagoire Ochieng; Tendo Shira Namagerob; Faith Mbabazi Musinguzi
The study investigated techniques used by teachers in the teaching of literacy and numeracy in selected Primary Schools in Kongwa District. It examined the factors that contribute to pupils’ inadequate literacy and numeracy skills. A cross-sectional survey research design, with a sample size (N=95) was used. Simple Random Sampling and Census Inquiry techniques were adopted. Quantitative data were analyzed using SPSS and the Qualitative data were analyzed using the verbatim method. The study findings suggested that there were literacy and numeracy issues in these particular Primary Schools since most of the Teachers lacked the skills needed to impart these abilities the majority of the Teachers never used the brainstorming technique, and others never used cooperative learning to teach literacy and numeracy. Likewise, few of these teachers’ use playing games as a technique for teaching literacy and numeracy. The study concluded that the majority of the teachers never used brainstorming, cooperative learning, and the use of play games as techniques to deliver lessons to learners. The study recommends retraining Teachers, employing teachers who have qualifications and cooperative teaching.
Expression of Her-2 and Ki-67 in Gastric Cancer Formalin Fixed Paraffin Embedded Tissue Blocks and Their Correlation with Histological Grades at the Uganda Cancer Institute Pathology Laboratory
(Dovepress, 2025-12-15) Wasswa, Hassan; Birungi, Abraham; Amadile, Lawrence; Kasadha, Richard; Nabaasa, Saphurah; Ninsiima, Jolly Lydia; Okecha, Tonny; Ssedyabane, Frank; Atwine, Raymond; Tibenderana, Lauben
Background: Her-2/neu, the human epidermal growth factor receptor-2, is an oncogene reported to be excessively expressed in gastric cancer. This over-expression is a criteria for treatment with trastuzumab. An antigen linked to nuclear proliferation is Ki-67, and the level of gastric cancer aggression is reflected in its expression. Objective: To determine the expression of Her-2 and Ki-67 in gastric cancer formalin-fixed paraffin-embedded (FFPE) tissue blocks and their correlation with histological grades at the Uganda Cancer Institute pathology laboratory, with each block representing one gastric cancer case. Methods: A laboratory cross-sectional study was conducted among 75 endoscopic gastric cancer patient cases. Each case was assessed utilizing immunohistochemistry (IHC) for the expression of Her-2 and Ki-67. Spearman correlation coefficient was used to ascertain the expression and its correlation to histological grades. Results: The age range of gastric cancer cases was 26 to 80 years, with a mean age of 54. Poorly differentiated histology (43%) was the most profound. Her-2 over-expression was 20%. High Ki-67 expression was 56%, and the low Ki-67 expression was 7%. Her-2 overexpression correlated significantly with moderate differentiation (rs = 0.336, p = 0.003) and poor differentiation (rs = −0.229, p = 0.048). A significant correlation between moderate differentiation of gastric carcinoma with low intensity of Ki-67 staining was noted (rs = 0.255, p = 0.028). Conclusion: The aggressiveness of gastric cancer may be indicated by the over-expression of Her-2 and a high Ki-67. What This Study Adds: This study provides additional information on the relevance of Her-2 and a high Ki-67 over-expression in diagnosis, prognostic monitoring, and management of gastric cancer in Uganda.
Aids-Related Disseminated Kaposi Sarcoma with Renal Involvement: A Rare Non-Transplant Case Report
(2025-04-01) Omega, Phillip; Musoke Sharrif; Alele David; Okecha, Tonny; Mawanda Anatoli; Mwesigwa, Boaz; Adokorach, Gladys; Lukande Robert; Kalungi Sam
Kaposi’s sarcoma (KS) is a vascular malignancy associated with human herpesvirus 8 (HHV-8). In Africa, the commonest type is the AIDS-associated KS seen in immunocompromised individuals, infected with HIV. Although KS primarily affects the skin and mucosal surfaces, visceral involvement is also well-documented, with the lungs and gastrointestinal tract being the most frequently affected sites. Renal involvement in non-transplant patients remains exceptionally rare. We present a case of a 33-year-old HIV-positive woman with a history of non-adherence to highly active antiretroviral therapy (HAART), who developed disseminated KS involving the oral mucosa, lungs, gastrointestinal tract, liver, and the right kidney. She presented with respiratory distress, generalized lymphadenopathy, and a hyperpigmented sublingual mass. Histopathological examination of the oral lesion confirmed KS, and post-mortem findings revealed extensive tumor infiltration of multiple organs, including the right kidney. This case highlights the aggressive nature of disseminated KS in severely immunocompromised patients and underscores the critical importance of HAART adherence in preventing disease progression. Given the exceptional rarity of non-allograft renal KS, this report adds to the limited literature on its occurrence and emphasizes the need for heightened clinical awareness when evaluating advanced KS cases.
Quantitative expression of estrogen, progesterone and human epidermal growth factor receptor-2 and their correlation with immunohistochemistry in breast cancer at Uganda Cancer Institute
(PLOS ONE, 2025-01-03) Wannume, Henry; Niyonzima, Nixon; Kalungi, Sam; Okuni, Julius Boniface; Okecha, Tonny; Kakungulu, Edward; Mpungu, Steven Kiwuwa; Waiswa, Geoffrey; Kadhumbula, Sylvester; Namayanja, Monica; Nabwana, Martin; Orem, Jackson
The detection of Estrogen Receptor (ER), Progesterone Receptor (PR), and Human epidermal growth factor receptor 2 (HER-2) is important for the stratification of breast cancer and the selection of therapeutic modalities. This study aimed to determine the quantitative expression of ER, PR and HER-2 using Immunohistochemistry and their correlation with quantitative baseline Ct values measured using Quantitative Polymerase Chain Reaction (PCR). This study also assessed the use of fresh breast tissue biopsies preserved in RNAlater solution in the quantitative detection of these receptors using PCR technique. The study evaluated 20 matched formalin fixed paraffin embedded and RNAlater preserved samples for ER, PR, and HER-2 using IHC and quantitative PCR technique. One portion of the breast tissue biopsy was fixed immediately in 10% neutral buffered formalin and another was preserved in RNAlater. After the histological confirmation of breast cancer by the H&E technique, formalin fixed paraffin embedded tissues (FFPE)—positive cases were matched with their corresponding RNAlater samples for IHC and qPCR. The extracted RNA was quantified using Nanodrop technology, resulting into complementary DNA. ER and PR using IHC were expressed in 60% (n = 12) of the study samples and were negative in 40% (n = 8) of samples. HER-2 was negative in 70% (n = 14) of study samples, 25% (n = 5) positive, and 5% (n = 1) equivocal. With the quantitative expression of ER, PR, and HER-2 being reported in the IHC triple—negative breast cancer cases. The mean Ct values for the hormonal receptors correlated with what has been previously studied with ER at 19.631, PR at 25.410 and HER-2 at 25.695. There was no statistically significant difference between the mean Ct values of RNAlater and FFPE with their P-values being 0.9919, 0.0896 and < 0.0001 for ER, PR, and HER-2 respectively. P-values; 0.9919 and 0.0896 for ER and PR respectively being greater than 0.05 it’s a borderline significance although HER-2 had a statistical significance. With a concordance in the detection of these breast cancer hormonal receptors, qPCR can be used in our setting considering the delays that may be associated in following the samples through IHC processing.
Bladder extra-gastrointestinal stromal tumor in an elderly patient in Uganda: a case report
(Edorium Journals, 2025-06-14) Okecha, Tonny; Bakenga, Alex; Waiswa, Ali; Mawanda, Anatoli; Nyakato, Veronica; Niyonzima, Nixon
Introduction: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract (GI). They arise from the interstitial cells of Cajal or similar cells. Gastrointestinal stromal tumors that occur primarily outside the GI tract are termed extra-gastrointestinal stromal tumor (EGIST). These tumors are extremely rare and very few cases have been reported to date. Case Report: We report a case of a 75-year-old male who presented with a bladder mass. The patient presented with hematuria and lower urinary tract symptoms of dribbling, straining and incomplete voiding of urine. Pelvic computed tomography scan showed a well-defined homogenous mass in the urinary bladder. The tumor was partially surgically resected, and histology revealed a spindle-shaped tumor that was initially reported as fibrosarcoma. However, a histology review was done and immunohistochemistry staining was positive for CKIT, CD34, and DOG-1. A diagnosis of EGIST was made. There has not been any case of EGIST reported in Uganda to the best of our knowledge. Conclusion: This case highlights the rarity of EGISTs, emphasizing the need for accurate diagnosis through immunohistochemistry and increased awareness for clinical management.
Managing Burnout among Teaching Staff at Private Universities in Uganda A Case Study
(International Journal of Educational Development in Africa, 2022-08-01) Joel Yawe Masagazi
The focus of this study was to examine the causes of burnout among teaching staff and, based on the findings, to suggest a framework to manage burnout among teaching staff at private universities in Uganda. A qualitative research approach with a multiple case study design was adopted in the study. Individual and focus group interviews as well as document analysis aided data collection from 50 lecturers, 40 senior lecturers, 20 faculty deans and five registrars across five chartered private universities in the Central Region in Uganda. Empirical data revealed that burnout was mainly due to institutional causes specifically from their workplaces such as conflicting directives, teaching staff’s need to accomplish tasks by a known deadline, delays in the issuance of teaching staff contracts, job insecurity, teaching staff’s incompetence due to skills gaps, limited teaching staff support, students’ disruptive behaviour, and workload. In a second classification, interpersonal causes such as unresolved family challenges, being overly ambitious, failing to progress academically, financial obligations and limited resources also caused burnout among teaching staff. The recommendations that were made include mandatory workouts to boost morale and mood through continuous aerobic exercises, mandatory rest and repair of the lost resources through a paid annual leave, identification of alternative sources of income to supplement salaries, open communication channels, and employee assistance programmes, among others. The study suggests a framework to manage burnout among teaching staff at private universities in Uganda.
Health Financing and Policies in the Transition to Universal Health Coverage–Uganda as a Spotlight
(SSRN, 2024-05-20) Otieno, Emmanuel; Yaya, Togo; Namyalo, Josephine; Alira, Racheal
The problem of the uninsured has been a major focus of health policy debate for decades all over the World. The call for drastic change in the health sector has never been so urgent today than ever before. Humanity faces enormous crises and health related challenges. Before the pandemic the global economy was staggering and fragile; the consequent recovery has increased inequalities in access to health needs. Consequently, creating societies that may be unproductive and unsustainable. This requires transformative health reforms based on health financing and policy aspects. Yet the sector’s mainstream persists in doing business as usual, with no meaningful impact to global aspirations set out in the 2030 Agenda for Universal Health Coverage. The purpose of this perspective is to lay out a framework for policymakers to think about how policy reforms might fit to context of universal health coverage in low- and middle-income countries. The future of health insurance and the pursuit of innovative health financing approaches that we need to know to achieve implementation of National Health Insurance Scheme in Uganda.
Perinatal Mortality and Its Predictors in Beni City, Democratic Republic of Congo a Cross-sectional Study
(BMC, 2023) Kahiririaa, Mathe Julien; Namyalo, Josephine; Otieno, Emmanuel; Mubarak, Nasur
Background: Globally, perinatal mortality rates have decreased considerably in the last 30 years. However, in sub-Saharan African countries perinatal mortality remains a public health burden. Therefore, this study aimed to determine the Perinatal Mortality Rate and the factors associated with perinatal mortality in Beni City, Northeastern Democratic Republic of Congo. Methods: A hospital-based retrospective cross-sectional study was conducted among 1394 deliveries that were documented in Beni General Referral Hospital from 2 January to May 31, 2022. The study was done in the conflictridden Beni city of the North Kivu Province. Analysis was done using Open Epi and SPSS version 22. Binary and Multivariate logistic regression analyses were performed. Odds ratio with 95% confidence interval was used to measure strength of association. Results: Findings indicate that 60.7% of 1394 participants were below the age of 21 years, and 95.1% (1325) Beni residents. The Perinatal Mortality Rate was 42.3 per 1000 live births. Majority (51) of the postpartum women who experienced perinatal mortality didn`t have a history of perinatal mortality as compared to their counterparts. Multivariable analysis revealed that birth weight (AoR = 0.082, 95% CI 0.014–0.449, p < 0.05) and Apgar score in the 10th minute (AoR = 0.082, 95% CI 0.000- 0.043, p < 0.05) were significantly associated with Perinatal mortality. Conclusion: The high perinatal mortality rate in Beni General Referral Hospital, approximately four in every 100 births remains a disturbing public health concern of which is attributable to low birth weight and Apgar score. This study may help policymakers and healthcare providers to design preventive interventions.
The Paradox of the Ugandan Health Insurance System: Challenges and Opportunities for Health Reform: Challenges and Opportunities for Health Reform
(The Korean Society for Preventive Medicine, 2023-12-12) Otieno, Emmanuel; Namyalo, Josephine
For nearly four decades, Ugandans have experienced a period marked by hope, conflict, and resilience across various aspects of health care reform. The health insurance system in Uganda lacks a legal framework and does not extend benefits to the entire population. In Uganda, community-based health insurance is common among those in the informal sector, while private medical insurance is typically provided to employees by their workplaces and agencies. The National Health Insurance Scheme Bill, introduced in 2019, was passed in 2021. If the President of Uganda gives his assent to the National Health Insurance Bill, it will become a significant policy driving health and universal health coverage. However, this bill is not without its shortcomings. In this perspective, we aim to explore the complex interplay of challenges and opportunities facing Uganda’s health sector

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