Browsing by Author "Mugwano, Isaac"
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Item Factors associated with severity and anatomical distribution of diabetic foot ulcer in Uganda: a multicenter cross-sectional study(BMC Springer Nature, 2023-03-10) Bienfait Mumbere, Vahwere; Ssebuufu, Robinson; Namatovu, Alice; Kyamanywa, Patrick; Ntulume, Ibrahim; Mugwano, Isaac; Pius, Theophilus; Sikakulya Katembo, Franck; Okedi, Francis Xaviour; Mulumba, Yusuf; Jorge, Soria; Agaba, Gidio; Nasinyama, George WilliamDiabetic foot ulcer (DFU) is a devastating complication of diabetes mellitus (DM) that is associated with increased mortality, morbidity, amputation rate and economic burden. This study aimed at identifying the anatomical distribution and factors associated with severity of DFU in Uganda. This was a multicenter cross-sectional study conducted in seven selected referral hospitals in Uganda. A total of 117 patients with DFU were enrolled in this study between November 2021 and January 2022. Descriptive analysis and modified Poisson regression analysis were performed at 95% confidence interval; factors with p-value<0.2 at bivariate analysis were considered for multivariate analysis. The right foot was affected in 47.9% (n=56) of patients, 44.4% (n=52) had the DFU on the plantar region of the foot and 47.9% (n=56) had an ulcer of >5 cm in diameter. The majority (50.4%, n=59) of patients had one ulcer. 59.8% (n=69) had severe DFU, 61.5% (n=72) were female and 76.9% had uncontrolled blood sugar. The mean age in years was 57.5 (standard deviation 15.2 years). Primary (p=0.011) and secondary (p<0.001) school educational levels, moderate (p=0.003) and severe visual loss (p=0.011), 2 ulcers on one foot (p=0.011), and eating vegetables regularly were protective against developing severe DFU (p=0.03). Severity of DFU was 3.4 and 2.7 times more prevalent in patients with mild and moderate neuropathies (p<0.01), respectively. Also, severity was 1.5 and 2.5 higher in patients with DFU of 5–10 cm (p=0.047) and in those with >10 cm diameter (p=0.002), respectively. Most DFU were located on the right foot and on the plantar region of the foot. The anatomical location was not associated with DFU severity. Neuropathies and ulcers of >5 cm diameter were associated with severe DFU but primary and secondary school education level and eating vegetables were protective. Early management of the precipitating factors is important to reduce the burden of DFU.Item Poor Drug Adherence and Lack of Awareness of Hypertension Among Hypertensive Stroke Patients in Kampala, Uganda: A Cross Sectional Study(SPRINGERNATURE , CAMPUS, 4 CRINAN ST, LONDON, ENGLAND, N1 9XW, 2016-01-02) Mugwano, Isaac; Kaddumukasa, Mark; Mugenyi, Levi; Kayima, James; Ddumba, Edward; Sajatovic, Martha; Sila, Cathy; DeGeorgia, Michael; Katabira, EllyBackground: Raised blood pressure (BP) remains an important risk factor for cardiovascular diseases such as stroke. Adherence to therapeutic recommendations especially antihypertensive drugs is important in BP control. The aim of the study was to assess the stroke risk factors and levels of adherence among hypertensive patients with stroke in Kampala Uganda. Methods: In a cross-sectional study we describe 112 hypertensive subjects with stroke from two Kampala city hospitals. A standardized pre-tested questionnaire was used to collect medical history, clinical details, radiological findings and laboratory data. Results: A total of 112 hypertensive subjects with stroke were enrolled between May 2013 and April 2014. The median ages were 63.5 years (52.5–75.0) for the cases. Seventy percent (78/112) of the study participants had ischemic strokes. Only 17 % were adherent to anti-hypertensive medications. The main cause of non-adherence appears to be lack of knowledge. Conclusions: Poor adherence of anti-hypertensive medications among hypertensive patients remains a big challenge in our setting. This has been attributed to lack of adequate knowledge and cost of the prescribed drugs. There is therefore an urgent need to promptly diagnose and educate hypertensive patients with emphasis on adherence to anti hypertensive drugs.