Browsing by Author "Abaasa Andrew M."

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    Assessment of quality of care among in-patients with postpartum haemorrhage and severe pre-eclampsia at st. Francis hospital nsambya: a criteria-based audit
    (BioMed Central Ltd, 2017-01-13) Lumala Alfred ; Sekweyama Peter ; Abaasa Andrew M.; Lwanga Humphrey ; Byaruhanga Romano
    Background: The maternal mortality ratio of Uganda is still high and the leading causes of maternal mortality are postpartum haemorrhage (PPH), severe pre-eclampsia and eclampsia. Criteria-based audit (CBA) is a way of improving quality of care that has not been commonly used in low income countries. This study aimed at finding out the quality of care provided to patients with these conditions and to find out if the implementation of recommendations from the audit cycle resulted in improvement in quality of care. Methods: This study was a CBA following a time series study design. It was done in St. Francis Hospital Nsambya and it involved assessment of adherence to standards of care for PPH, severe pre-eclampsia and eclampsia. An initial audit was done for 3 consecutive months, then findings were presented to health workers and recommendations made; we implemented the recommendations in a subsequent month and this comprised three interventions namely continuing medical education (CME), drills and displaying guidelines; a re-audit was done in the proceeding 3 consecutive months and analysis compared adherence rates of the initial audit with those of the re-audit. Results: Pearson Chi-Square test revealed that the adherence rates of 7 out of 10 standards of care for severe pre-eclampsia/eclampsia were statistically significantly higher in the re-audit than in the initial audit; also, the adherence rates of 3 out of 4 standards of care for PPH were statistically significantly higher in the re-audit than in the initial audit. Conclusion: The giving of feedback on quality of care and the implementation of recommendations made during the CBA including CME, drills and displaying guidelines was associated with improvements in the quality of care for patients with PPH, severe pre-eclampsia and eclampsia
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    Participation in Clinical Research Could Modify Background Risk for Trial Outcome Measures
    (2014) Ndibazza Juliet; Abaasa Andrew M.; Asiki Gershim; Levin Jonathan; Bahemuka Ubaldo; Ruzagira Eugene; Kibengo Freddie M.; Mulondo Jerry; Price Matthew A.; Fast Pat; Kamali Anatoli
    Data on HIV incidence and retention are needed to inform study design of efficacy trials. However, the selection criteria and interventions during an actual clinical trial could reduce HIV incidence and thus affect the statistical power. Weinvestigated the effect of inclusion and participation in a simulated vaccine efficacy trial (SiVET) on HIV and pregnancy incidence in a fisherfolk cohort in SW Uganda. High-risk vounteers aged 18–49 years from fishing communities 30-40 km from the MRC/UVRI research centre were recruited in HIV open cohort. High risk was defined as history of multiple sex partners, unprotected sex, STI presence and absence from home for ‡ 2 days in the preceding 3 months. Consenting volunteers with at least 3 months of follow-up, no contraindications for hepatitis B vaccine and willing to use contraception were administered a licensed Hepatitis B vaccine at 0, 1 and 6 months to mimic a candidate vaccine. The cohort was followed quarterly for a year. HIV incidence, pregnancy and retention rates were compared. Results: Of 853 (55% men) individuals screened from Jan 2012-Feb 2014, 575 (60% men, mean age 28) were enrolled into the open cohort, 282 (73% men) of whom enrolled into the SiVET between July, 2012-Feb 2013. In both groups there was reduction of risky behaviours, (p < 0.05). A total of 13 HIV incident cases occurred in 93.0 PYO [brackets 95% CI]; incidence 13.9/100 PYO [8.1-24.1] and 10 cases in 311.6 PYO; incidence 3.2 [1.7-6.0] in the open cohort and SiVET respectively. A total of 26 pregnancies were observed in 42.7 Women Years of Observation(WYO); incidence 60.9 [41.5-89.5], and 4 pregnancies (71.4WYO); incidence 5.6 [2.1-14.8] in the open cohort and SiVET respectively.