Browsing by Author "Sikakulya, Franck K"

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The double burden of Ebola and COVID-19 viral infections and the readiness for safe surgical care provision in Uganda and the Eastern Democratic Republic of the Congo: an online cross-sectional survey
(Research Square, 2021) Sikakulya, Franck K; Ssebuufu, Robinson; Longombe, Albert Ahuka Ona; Okedi, Francis; Kalongo, Michel; Valimungighe, Moise Muhindo; Furaha, Nzanzu Blaise Pascal; Vahwere, Bienfait Mumbere; Mambo, Simon Binezero; Mulumba, Yusuf; Muyisa, Muhindo Muhasa; Sonia, Fatuma Djuma; Sekabira, John; Fualal, Jane; Kyamanywa, Patrick
Objective: This study aimed at highlighting the extent to which Uganda and the Eastern DR Congo are ready for safe surgical care provision during the double burden of Ebola and COVID-19. Methods: An online cross-sectional study was conducted in selected National, Regional Referral and General Hospital facilities of Uganda and in the Eastern part of D.R. Congo from 1st August 2020 to 30 October 2020. Data was analysed using Stata version 14.2. Results: A participation rate of 37.5% for both countries (72/192). The mean bed capacity of participating health facilities (HF) was 184 in Eastern DR. Congo and 274 in Uganda with an average surgical ward bed capacity of 22.3% (41/184) of the beds in the DR. Congo and 20.4% (56/274) in Uganda. The mean number of operating rooms was 2 and 3 in Eastern DR. Congo and Uganda respectively. Nine hospitals (12.5%) reported being able to test for Ebola and 25 (34.7%) being able to test for COVID-19. Only 7 (9.7%) hospitals reported having a specific operating room for suspect or confirmed cases of Ebola or COVID-19. Provision of appropriate Personal Protection Equipment to personnel were reported to be available in 60 (83.3%) hospitals. The mean of readiness score for provision of surgical care was 7.8/16 (SD: 2.3) or 60% in both countries with no statistical significance in multiple linear regression analysis (p>0.05). Conclusion: The majority of participating hospitals in both countries had a low level of readiness to provide safe surgical care due to lack of supplies to limit the exposure of Healthcare workers (HCW) to Ebola and Covid-19 viral infections, and poor funding. Governments and non-governmental organizations should work together to enhance health facility supplies and readiness for safe surgical provision in resourcelimited settings.
Health facilities’ readiness for safe surgical care provision in Uganda and the Eastern Democratic Republic of Congo during Ebola and COVID-19 era
(BMC , Campus, 4 Crinan St, London, England, N1 9XW, 2021) Sikakulya, Franck K; Ssebuufu, Robinson; Longombe, Albert Ahoha Ona; Okedi, X Francis; Ilumbulumbu, Michel Kalongo; Valimungighe, Moise Muhindo; Furaha, Nzanzu Blaise Pascal; Vahwere, Bienfait Mumbere; Mambo, Simon Binezero; Mulumba, Yusuf; Muyisa, Anderson Muhindo Muhasa; Sonia, Fatuma Djuma; Sekabira, John; Fualal, Jane O; Kyamanywa, Patrick
Objective This study aimed to assess health facilities’ readiness to provide safe surgical care during Ebola and COVID-19 era in Uganda and in the Eastern DR Congo. Methods A cross-sectional study was conducted in selected national, regional referral and general hospital facilities in Uganda and in the eastern part of DR Congo from 1st August 2020 to 30th October 2020. Data was analysed using Stata version 15. Results The participation rate was of 37.5 % (72/192) for both countries. None of the hospitals fulfilled the readiness criteria for safe surgical care provision in both countries. The mean bed capacity of participating health facilities (HF) was 184 in Eastern DR Congo and 274 in Uganda with an average surgical ward bed capacity of 22.3 % (41/184) and 20.4 % (56/274) respectively. The mean number of operating rooms was 2 and 3 in Eastern DR Congo and Uganda respectively. Nine hospitals (12.5 %) reported being able to test for Ebola and 25 (34.7 %) being able to test for COVID-19. Postponing of elective surgeries was reported by 10 (13.9) participating hospitals. Only 7 (9.7 %) hospitals reported having a specific operating room for suspect or confirmed cases of Ebola or COVID-19. Appropriate Personal Protection Equipment (PPE) was reported to be available in 60 (83.3 %) hospitals. Most of the staff had appropriate training on donning and doffing of PPE 40 (55.6 %). Specific teams and protocols for safe surgical care provision were reported to be present in 61 (84.7 %) and 56 (77.8 %) respectively in Uganda and Eastern DR Congo participating hospitals. Conclusions The lack of readiness to provide safe surgical care during Ebola and COVID-19 era across the participating hospitals in both countries indicate a need for strategies to enhance health facility supplies and readiness for safe surgical provision in resource-limited settings.
Knowledge, Attitude, and Self-reported Practice Toward Measures for Prevention of the Spread of COVID-19 Among Ugandans: A Nationwide Online Cross-sectional Survey
(Frontiers Media SA , Avenue Du Tribunal Federal 34, Lausanne, Switzerland, Ch-1015, 2020) Ssebuufu, Robinson; Sikakulya, Franck K; Mambo, Simon Binezero; Wasingya, Lucien; Nganza, Sifa K; Bwaga, Ibrahim; Kyamanywa, Patrick
Background: The world is facing the Coronavirus pandemic, which is highly infectious. Several measures have been put in place to prevent its spread among the population. However, for these preventive measures to be effective, the population requires appropriate and sufficient knowledge, attitude, and practices. Thus, a survey to assess knowledge, attitude, and self-reported practice toward measures for prevention of the spread of COVID-19 was conducted among Ugandans. Methods: This was a cross-sectional study conducted among during the lockdown in Uganda. An online structured questionnaire was used, applying a snowballing sampling approach for recruitment of participants 18 years and above and residing in Uganda. Data collection was done from 6th to 15th April 2020, during which 1,763 people participated. We analyzed all data using STATA 14.2, applying appropriate statistical tests. Results: Out of 1,763 participants, 80% were highly knowledgeable. For attitude, 72.4% reported following recommendations given by the Ministry of health to prevent the spread of COVID-19; 89.0% were worried about contracting COVID-19 and 73.3% agreed that COVID-19 can be cured and 99.3% reported good practice toward measures to prevent the spread of COVID-19. According to ordered logistic regression, health workers were 6 times more knowledgeable [aOR:6 (3.51–10.09), p < 0.001] followed by teachers [aOR:5.2 (2.6–10.32), p < 0.001]; students [aOR:3.2 (1.96–5.33), p < 0.001]. On the contrary, the drivers, business entrepreneurs, and security personnel had less knowledge. Conclusion: The results show that the participating Ugandans were knowledgeable and had a positive attitude and good practices. However, there is still a gap in knowledge among drivers, business entrepreneurs, and security personnel. Therefore, there is a need to mobilize the country’s population to have the same degree of knowledge, which will have an impact on the attitude and practices toward prevention of the spread of COVID-19.
Malnutrition Amongst HIV Adult Patients in Selected Hospitals of Bushenyi District in Southwestern Uganda
(Makerere Univ, Coll Health Sciences,Sch Med , Po Box 7072, Kampala, Uganda, 00000, 2020) Ssebuufu, Robinson; Sikakulya, Franck K; Mambo, Simon Binezero; Wasingya, Lucien; Nganza, Sifa K; Bwaga, Ibrahim; Kyamanywa, Patrick
Background: Malnutrition is an important clinical outcome amongst HIV patients in developing countries and in Uganda, there is scarcity of information on its prevalence and risk factors amongst HIV adult patients. Methods: A cross-sectional study amongst 253 HIV patients in Bushenyi district assessed their nutritional status using the body mass index (BMI) and mid-upper arm circumference (MUAC), and a questionnaire was used to identify major risk factors. Results: The mean age of the study participants was 38.74 ± 0.80 yrs, while females and males were 52.2% and 47.8% respectively. Prevalence of malnutrition was 10.28% (95% CI: 6.82 – 14.69) in the study. Major socio-economic factors associated with malnutrition were being female, unemployed, dependent and with many family members. Patients with op- portunistic infections, low adherence to HAART, and stage of HIV/AIDS had a higher risk of malnutrition. Discussion: In rural communities, a majority of malnourished patients are elderly and these were identified as priority groups for HIV outreach campaigns. The current policy of prioritizing children and women is outdated due to changing disease dynamics, thus showing a need to revise extension service provision in rural communities. Conclusion: Malnutrition is a threat in HIV adult patients in rural communities of Uganda.
Prevalence and factors associated with cancellation and deferment of elective surgical cases at a rural private tertiary hospital in Western Uganda: a cross-sectional study
(African Field Epidemiology Network-Afenet , Po Box 12874, Kampala, Uganda, 00000, 2021) Vahwere, Bienfait Mumbere; Sikakulya, Franck K; Ssebuufu, Robinson; Soria, Jorge; Okedi, X Francis; Abdullah, Shaban; Kyamanywa, Patrick
Introduction: the cancellation of elective surgery is still a worldwide challenge and this is associated with emotional and economical trauma for the patients and their families as well as a decrease in the efficiency of the operating theatre. This study aimed at determining the prevalence and factors associated with cancellation and deferment of elective surgery in a rural private tertiary teaching hospital in Western Uganda. Methods: a crosssectional study design was conducted. Data was collected from 1st July 2019 to 31st December 2019. Patients scheduled for elective surgery and either cancelled or deferred on the actual day of surgery were included in the study. Statistical analysis was done using STATA version 15. Results: four hundred patients were scheduled for elective surgery during the study period, among which 90 (22.5%) were cancelled and 310 (78.5%) had their surgeries as scheduled. The highest cancellation of elective surgical operations was observed in general surgery department with 81% elective cases cancelled or deferred, followed by orthopedic department 10% and gynecology department 9%. The most common reasons for cancellation were patient-related (39%) and health worker-related (35%) factors. Other factors included administrative (17%) and anesthesia related factors (9%). Cancellation was mainly due to lack of finances which accounted for 23.3% of the patients, inadequate patient preparation (16.6%) and unavailability of surgeons (15.5%). Major elective surgeries were cancelled 1.7 times more than minor electives surgeries [adjusted prevalence ratio 1.7 (95%CI: 1.07-2.73) and p-value: 0.024]. Conclusion: cancellation and deferment of elective surgeries is still of a major concern in this private rural tertiary hospital with most of the reasons easily preventable through proper scheduling of patients, improved communication between surgical teams and with patients; and effective utilization of available resources and man power.
Sexual and Reproductive Health Problems Among Ugandan Youth During the COVID-19 Pandemic Lockdown: An Online Cross-sectional Study
(2020) Mambo, Simon Binezero; Sikakulya, Franck K; Ssebuufu, Robinson; Mulumba, Yusuf; Wasswa, Henry; Thompson, Kelly; Rusatira, Jean Christophe; Bhondoekhan, Fiona; Kamyuka, Louis K; Akib, Surat Olabisi; Kirimuhuzya, Claude; Nakawesi, Jane; Kyamanywa, Patrick
Background The COVID-19 pandemic threatens access to sexual and reproductive health services. With global health emergencies, there is often a total reversal of priorities and access to sexual and reproductive health services may become challenging. The aim of this study was to establish the problems related to sexual and reproductive health among Ugandan youths during the COVID-19 lockdown. Methods This was an online cross-sectional study carried out from April 2020 to May 2020 in Uganda. An online questionnaire was used and participants aged 18years to 30 years recruited using the snowballing approach. The statistical analysis was done using STATA version 14.2. Results Out of 724 participants, 203 (28%) reported not having information and/or education concerning sexual and reproductive health (SRH). About a quarter of the participants (26.9%, n=195) reported not having testing and treatment services of sexually transmitted infections available during the lockdown. Lack of transport means was the commonest (68.7%) limiting factor to access to SRH services during the lockdown followed by the long distance from home to SRH facility (55.2%), high cost of services (42.2%) and curfew (39.1%). Sexually transmitted infections were the commonest (40.4%) problem related to SRH during the lockdown followed by unwanted pregnancy (32.4%) and sexual abuse (32.4%). The multivariate regression analysis shows that problems were more prevalent among the co-habiting youth [APR: 2.3 (1.6 - 3.29), p<0.001] followed by unemployed (volunteer or unpaid) [APR: 1.6 (1.03 - 2.64), p: 0.037] than in other participants. Conclusions The ndings of this study show that Ugandan youths have accessing SRH information and services during the COVID-19 lockdown. Cohabiting and unemployed participants were the most affected. Lack of transport means and high cost of services were the major limiting factors to access SRH services among the youths. The ndings call for concerted efforts from the Uganda government and international non-governmental organisations to ensure access and availability of SRH services for Ugandan youths during the COVID-19 lockdown.
Surgery of COVID-19-infected patients in Africa: a scoping
(Annals of African Surgery, 2021) Sikakulya, Franck K; Soria, Jorge; Ssebuufu, Robinson; Kiyaka, Sonye Magugu; Molen, Selamo Fabrice; Kyamanywa, Patrick
Objective: The aim of this scoping review was to highlight the nature and scope of research and publications about surgery in COVID-19-infected patients in Africa in order to inform guidelines applicable in Africa. Methods: We considered peerreviewed and gray literature from PubMed, Google Scholar, and Word Health Organization COVID-19 online databases published from February 1, 2020, to February 28, 2021, about surgery for/in COVID-19- infected patients. The review is reported using the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews. Results: of 530 studies screened, only 11 (2.08%) were found eligible, including 4 cohort studies, 3 cross-sectional studies, 2 letters to the editor, 1 case series, and 1 review. The key emphasis areas by the eligible studies were vaccination, testing prior to surgery, clinical guidelines to reduce complications related to COVID-19 among infected patients, and protection of the surgical team. Conclusion: There is a dearth of studies on surgery in COVID-19-infected patients in Africa. There is an urgent need for more reports and publications from the African experiences so as to inform contextualized guidelines for surgical care in low-resource settings during the COVID-19 pandemic.