Browsing by Author "Vahwere, Bienfait Mumbere"

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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.
Local anesthesia versus saddle block for open hemorrhoidectomy: cost-analysis from a randomized, double blind controlled trial
(BMC Springer Nature, 2023-11-22) Sikakulya, Franck Katembo; Ssebuufu, Robinson; Okedi, Francis Xaviour; Baluku, Moris; Lule, Herman; Kiyaka, Sonye Magugu; Muhumuza, Joshua; Molen, Selamo Fabrice; Bassara, Godefroy Nyenke; Waziri, Musa Abbas; Kithinji, Stephen Mbae; Mugisho Munyerenkana, Leocadie; Kagenderezo, Byamungu Pahari; Munihire, Jeannot Baanitse; Vahwere, Bienfait Mumbere; Kiswezi, Ahmed; Kyamanywa, Patrick
Despite the benefits attributed to the use of local anesthesia (LA) for open hemorrhoidectomy (OH) in developed countries, this technique is still not considered as the first line technique in low-income countries such as Uganda; therefore, we aimed at comparing the cost of OH under LA versus Saddle block among patients with 3rd or 4th degree hemorrhoids. This trial was conducted from December 2021 to May 2022 among patients with primary uncomplicated 3rd or 4th degree hemorrhoids. The operating time, and direct costs in (US$) including medical and non-medical were recorded. We analysed the cost in the two groups (local anesthesia versus saddle block) using SPSS version 23.0. Findings of fifty-eight patients were analysed including 29 participants per group. There was a significant difference in operating time and cost among the two groups (p<0.05). The mean operating time was 15.52±5.34(SD) minutes versus 33.72±11.54 min for OH under LA and SB respectively. The mean cost of OH under LA was 57.42±8.90 US$ compared to 63.38±12.77US$ in SB group. The use of local anesthesia for OH was found to have less operating time with high-cost effectiveness. Being affordable, local anesthesia can help to increase the turnover of patients who would otherwise wait for the availability of anesthesia provider. Policy makers should emphasize its applicability in low-income settings to help in the achievement of 2030 global surgery goals.
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.