Browsing by Author "Kaleebu, Pontiano"
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Item Predictors of Loss to Follow up Among Patients With Type 2 Diabetes Mellitus Attending a Private Not For Profit Urban Diabetes Clinic in Uganda – A Descriptive Retrospective Study(BMC, 2019-08-23) Tino, Salome; Wekesa, Clara; Kamacooko, Onesmus; Makhoba, Anthony; Mwebaze, Raymond; Bengo, Samuel; Nabwato, Rose; Kigongo, Aisha; Ddumba, Edward; Mayanja, N. Billy; Kaleebu, Pontiano; Newton, Rob; Nyerinda, MoffatBackground: Although the prevalence of type 2 diabetes mellitus is increasing in Uganda, data on loss to follow up (LTFU) of patients in care is scanty. We aimed to estimate proportions of patients LTFU and document associated factors among patients attending a private not for profit urban diabetes clinic in Uganda. Methods: We conducted a descriptive retrospective study between March and May 2017. We reviewed 1818 out-patient medical records of adults diagnosed with type 2 diabetes mellitus registered between July 2003 and September 2016 at St. Francis Hospital - Nsambya Diabetes clinic in Uganda. Data was extracted on: patients’ registration dates, demographics, socioeconomic status, smoking, glycaemic control, type of treatment, diabetes mellitus complications and last follow-up clinic visit. LTFU was defined as missing collecting medication for six months or more from the date of last clinic visit, excluding situations of death or referral to another clinic. We used Kaplan-Meier technique to estimate time to defaulting medical care after initial registration, log-rank test to test the significance of observed differences between groups. Cox proportional hazards regression model was used to determine predictors of patients’ LTFU rates in hazard ratios (HRs). Results: Between July 2003 and September 2016, one thousand eight hundred eighteen patients with type 2 diabetes mellitus were followed for 4847.1 person-years. Majority of patients were female 1066/1818 (59%) and 1317/1818 (72%) had poor glycaemic control. Over the 13 years, 1690/1818 (93%) patients were LTFU, giving a LTFU rate of 34.9 patients per 100 person-years (95%CI: 33.2–36.6). LTFU was significantly higher among males, younger patients (< 45 years), smokers, patients on dual therapy, lower socioeconomic status, and those with diabetes complications like neuropathy and nephropathy. Conclusion: We found high proportions of patients LTFU in this diabetes clinic which warrants intervention studies targeting the identified risk factors and strengthening follow up of patientsItem Prevalence and Factors Associated with Overweight and Obesity Among Patients with Type 2 Diabetes Mellitus in Uganda—A Descriptive Retrospective Study(BMJ Publishing Group , British Med Assoc House, Tavistock Square, London, England, Wc1h 9jr, 2020) Tino, Salome; Mayanja, Billy N; Mubiru, Michael Charles; Eling, Emmanuel; Ddumba, Edward; Kaleebu, Pontiano; Nyirenda, MoffatObjectives To assess the prevalence and risk factors of overweight and obesity among type 2 diabetes mellitus (T2DM) patients in Uganda. Design Retrospective chart review. Setting This study was conducted in the outpatient’s T2DM clinic in St. Francis Hospital—Nsambya, Uganda between March and May 2017. Participants Type 2 diabetes patients registered in the diabetes clinic between July 2003 and September 2016. Outcome measures Overweight and obesity defined as body mass index (kg/m2) of 25.0–29.9 and obesity as 30.0 or higher. Results Of 1275T2DM patients, the median age was 54 (IQR: 44–65) years, 770 (60.40%) were females, 887 (69.6%) had hypertension, 385 (28%) had controlled glycaemia, 349 (27%) were obese, while 455 (36%) were overweight. Overweight/obesity were lower among men (OR: 0.45, 95%CI: 0.340 to 0.593, p≤0.001) and among patients aged ≥65 years (OR: 0.52, 95%CI: 0.350 to 0.770, p=0.001); patients who rarely ate fruits and vegetables (OR: 0.66, 95% CI: 0.475 to 0.921, p=0.014) but higher among patients of middle (OR: 1.83, 95%CI: 1.320 to 2.550, p≤0.001) and upper (OR: 2.10, 95%CI: 1.450 to 2.990, p≤0.001) socioeconomic status; on dual therapy (OR: 2.17, 95%CI: 1.024 to 4.604, p=0.043); with peripheral neuropathy (OR: 1.40, 95% CI: 1.039 to 1.834, p=0.026) and hypertension (OR: 1.70, 95% CI: 1.264 to 2.293, p≤0.001). Conclusions Overweight and obesity are high among T2DM patients in this population and may contribute significantly to poor outcomes of T2DM. Therefore, strategies to address this problem are urgently needed.Item Uganda’s experience in Ebola virus disease outbreak preparedness, 2018–2019(BMC, 2020) Aceng, Jane Ruth; Ario, Alex R.; Muruta, Allan N.; Makumbi, Issa; Nanyunja, Miriam; Komakech, Innocent; Bakainaga, Andrew N.; Talisuna, Ambrose O.; Mwesigye, Collins; Mpairwe, Allan M.; Tusiime, Jayne B.; Lali, William Z.; Katushabe, Edson; Ocom, Felix; Kaggwa, Mugagga; Bongomin, Bodo; Kasule, Hafisa; Mwoga, Joseph N.; Sensasi, Benjamin; Mwebembezi, Edmund; Katureebe, Charles; Sentumbwe, Olive; Nalwadda, Rita; Mbaka, Paul; Fatunmbi, Bayo S.; Nakiire, Lydia; Lamorde, Mohammed; Walwema, Richard; Kambugu, Andrew; Nanyondo, Judith; Okware, Solome; Ahabwe, Peter B.; Nabukenya, Immaculate; Kayiwa, Joshua; Wetaka, Milton M.; Kyazze, Simon; Kwesiga, Benon; Kadobera, Daniel; Bulage, Lilian; Nanziri, Carol; Monje, Fred; Aliddeki, Dativa M.; Ntono, Vivian; Gonahasa, Doreen; Nabatanzi, Sandra; Nsereko, Godfrey; Nakinsige, Anne; Mabumba, Eldard; Lubwama, Bernard; Sekamatte, Musa; Kibuule, Michael; Muwanguzi, David; Amone, Jackson; Upenytho, George D.; Driwale, Alfred; Seru, Morries; Sebisubi, Fred; Akello, Harriet; Kabanda, Richard; Mutengeki, David K.; Bakyaita, Tabley; Serwanjja, Vivian N.; Okwi, Richard; Okiria, Jude; Ainebyoona, Emmanuel; Opar, Bernard T.; Mimbe, Derrick; Kyabaggu, Denis; Ayebazibwe, Chrisostom; Sentumbwe, Juliet; Mwanja, Moses; Ndumu, Deo B.; Bwogi, Josephine; Balinandi, Stephen; Nyakarahuka, Luke; Tumusiime, Alex; Kyondo, Jackson; Mulei, Sophia; Lutwama, Julius; Kaleebu, Pontiano; Kagirita, Atek; Nabadda, Susan; Oumo, Peter; Lukwago, Robinah; Kasozi, Julius; Masylukov, Oleh; Kyobe, Henry Bosa; Berdaga, Viorica; Lwanga, Miriam; Opio, Joe C.; Matseketse, David; Eyul, James; Oteba, Martin O.; Bukirwa, Hasifa; Bulya, Nulu; Masiira, Ben; Kihembo, Christine; Ohuabunwo, Chima; Antara, Simon N.; Owembabazi, Wilberforce; Okot, Paul B.; Okwera, Josephine; Amoros, Isabelle; Kajja, Victoria; Mukunda, Basnet S.; Sorela, Isabel; Adams, Gregory; Shoemaker, Trevor; Klena, John D.; Taboy, Celine H.; Ward, Sarah E.; Merrill, Rebecca D.; Carter, Rosalind J.; Harris, Julie R.; Banage, Flora; Nsibambi, Thomas; Ojwang, Joseph; Kasule, Juliet N.; Stowell, Dan F.; Brown, Vance R.; Zhu, Bao-Ping; Homsy, Jaco; Nelson, Lisa J.; Tusiime, Patrick K.; Olaro, Charles; Mwebesa, Henry G.; Woldemariam, Yonas TegegnSince the declaration of the 10th Ebola Virus Disease (EVD) outbreak in DRC on 1st Aug 2018, several neighboring countries have been developing and implementing preparedness efforts to prevent EVD cross-border transmission to enable timely detection, investigation, and response in the event of a confirmed EVD outbreak in the country. We describe Uganda’s experience in EVD preparedness. : On 4 August 2018, the Uganda Ministry of Health (MoH) activated the Public Health Emergency Operations Centre (PHEOC) and the National Task Force (NTF) for public health emergencies to plan, guide, and coordinate EVD preparedness in the country. The NTF selected an Incident Management Team (IMT), constituting a National Rapid Response Team (NRRT) that supported activation of the District Task Forces (DTFs) and District Rapid Response Teams (DRRTs) that jointly assessed levels of preparedness in 30 designated high-risk districts representing category 1 (20 districts) and category 2 (10 districts). The MoH, with technical guidance from the World Health Organisation (WHO), led EVD preparedness activities and worked together with other ministries and partner organisations to enhance community-based surveillance systems, develop and disseminate risk communication messages, engage communities, reinforce EVD screening and infection prevention measures at Points of Entry (PoEs) and in high-risk health facilities, construct and equip EVD isolation and treatment units, and establish coordination and procurement mechanisms. As of 31 May 2019, there was no confirmed case of EVD as Uganda has continued to make significant and verifiable progress in EVD preparedness. There is a need to sustain these efforts, not only in EVD preparedness but also across the entire spectrum of a multi-hazard framework. These efforts strengthen country capacity and compel the country to avail resources for preparedness and management of incidents at the source while effectively cutting costs of using a “fire-fighting” approach during public health emergencies.