Journal Article

Permanent URI for this collectionhttp://hdl.handle.net/20.500.12280/2899

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Building Research Capacity in Africa: Equity and Global Health Collaborations
(Public Library Science, 1160 Battery Street, Ste 100, San Francisco, Usa, Ca, 94111, 2014) Chu, Kathryn M; Jayaraman, Sudha; Kyamanywa, Patrick; Ntakiyiruta, Georges
Global health has increased the number of high-income country (HIC) investigators conducting research in low- and middle-income countries (LMICs). N Partnerships with local collaborators rather than extractive research are needed. N LMICs have to take an active role in leading or directing these research collaborations in order to maximize the benefits and minimize the harm of inherently inequitable relationships. N This essay explores lessons from effective and equitable relationships that exist between African countries and HICs.
The Desired Rwandan Health Care Provider: Development and Delivery of Undergraduate Social and Community Medicine Training
(Taylor & Francis Inc , 530 Walnut Street, Ste 850, Philadelphia, USA, PA, 19106, 2015) Flinkenflögel, Maaike; Cubaka, Vincent Kalumire; Schriver, Michael; Kyamanywa, Patrick; Muhumuza, Ibra; Kallestrup, Per; Cotton, Phil
What works well in primary care education in your locality, region or country? • The new undergraduate social and community medicine training (iSOCO) in Rwanda focuses on crosscutting skills, knowledge and attitudes in primary health care delivery. What challenges have you faced? • Challenges faced include programme sustainability (PHC), large student group teaching, limited resources and students being unfamiliar with the new online teaching platform with unstable internet accessibility. How have you addressed them? • The iSOCO development and teaching team was motivated to work with the limited resources available and to develop an innovative training with available resources. Strong focus of the Ministry of Health on PHC, the need of the College of Medicine and Health Sciences to become more socially accountable and long-term commitment of external partners increased the programme sustainability. What is the generalisable learning? • When students are exposed to the principles of PHC and social and community medicine early in the medical education, it is more likely they will become patient-centred and community-oriented health care providers who are good communicators, collaborators, managers, scholars, health advocates and professionals, as described in the ‘desired Rwandan health care. provider
Developing research potential and building partnerships: a report of the fundamentals of surgical research course at the College of Surgeons of East, Central, and Southern Africa
(Academic Press Inc Elsevier Science , 525 B St, Ste 1900, San Diego, USA, CA, 92101-4495, 2021) Long, Kristin L; Galukande, Moses; Kyamanywa, Patrick; Tarpley, Margaret J; Dodgion, Christopher
Background Approximately a decade after the inaugural Fundamentals of Surgical Research Course (FSRC) at the West African College of Surgeons meeting (2008), the Association for Academic Surgery expanded the course offering to the annual meeting of the College of Surgeons of East, Central and Southern Africa (COSECSA). After the second annual offering of the course in 2019, participants were surveyed to assess the impact of the course. Methods A survey was distributed to the attendees of the 2019 second COSECSA FSRC course, held in December 2019 in Kampala, Uganda. Approximately 80 people attended at least a portion of the full-day course. Forty-nine participants completed the voluntary survey questionnaire distributed to assess each session of the course at course completion. Results Ten different countries were represented among the attendees. Of the 49 evaluations, 35 respondents were male and six were female. Eight respondents did not identify a gender. Surgical residents comprised 19 of the 49 attendees, and one of the 49 attendees was a medical student. Thirty-five respondents indicated that their views of surgical research had changed after attending the course. Conclusions The second annual FSRC at COSECSA confirmed significant interest in building research skills and partnerships in sub-Saharan Africa. A wide variety of learners attended the course, and a majority of the sessions received overwhelmingly positive feedback. Multiple conference attendees expressed interest in serving as faculty for the course moving forward, highlighting a viable path for sustainability as the Association for Academic Surgery develops an international research education platform.
Effect of rural trauma team development on outcomes of motorcycle related injuries: a protocol for a multi-center cluster randomized controlled clinical trial (The MOTOR trial)
(medRxiv preprint, 2023-12-09) Lule, Herman; Mugerwa, Micheal A.; SSebuufu, Robinson; Kyamanywa, Patrick; Bärnighausen, Till; Posti, Jussi P.; Wilson, Michael Lowery
Injury is a global health concern whose mortality disproportionately impact low-income countries. Compelling evidence from high-income countries show that rural trauma team development courses (RTTDC) increase clinicians’ knowledge. There is a dearth of evidence from controlled clinical trials to demonstrate the effect of RTTDC on process and patient outcomes. We document a protocol for a multi-center cluster randomized controlled clinical trial which aims to examine the impact of RTTDC on process and patient outcomes of motorcycle-related injuries. This will be a two-armed parallel multiple period cluster randomized controlled clinical trial in Uganda, where rural trauma team development training is not routinely conducted. We shall recruit regional referral hospitals and include road traffic injured patients, interns, medical trainees, and road traffic law enforcement professionals who serve as trauma care frontliners. Three hospitals will be cluster randomized to RTTDC (intervention group) and the remaining three to standard care (control group). The primary outcomes will be prehospital interval from accident scene to arrival at emergency department, and referral-exit interval from the time the referral decision is made to hospital exist in hours as a measure of process improvement. The secondary outcomes will be all cause mortality, and morbidity of neurological, and orthopedic injuries based on the Glasgow outcome scale and trauma outcome measure scores respectively at 90-days post injury. All outcomes will be measured as final values. We shall compare baseline characteristics and outcomes both at individual, and at cluster level as intervention versus control group. We shall use the mixed effects regression models in Stata 15.0 to report any absolute or relative differences along with 95% CIs. We shall perform subgroup analyses to control for confounding due to injury mechanisms and severity. In parallel to the trial, we shall establish a motorcycle trauma outcome registry (MOTOR) in consultation with community traffic police. Our results could inform the design, implementation, and scalability of future rural trauma teams and education programs.
Feasibility of rural trauma team development amongst medical trainees and traffic law enforcement professionals in a low-income country: a prospective multi-centre study of interrupted time series of interventional training
(Research Square Preprints, 2023-10-05) Lule, Herman; Mugerwa, Michael; SSebuufu, Robinson; Kyamanywa, Patrick; Jussi, Posti. P; Wilson, Michael Lowery
Research shows that trauma team formation could potentially improve effectiveness of injury care in rural settings. The aim of this study was to determine the feasibility of the use of rural medical trainees and road traffic law enforcement professionals in the formation of rural trauma teams in Uganda. Multi-center interrupted time series of interventional rural health professions education, using the American College of Surgeons’ 4th edition of rural trauma team development course model. Trauma related multiple choice questions (MCQs) were administered pre-and post-training between September 2019- August 2023. Acceptability of the training for promulgation to other rural regions and its relevance to participants’ work needs were evaluated on 5- and 3-point Likert scales respectively. The median MCQ scores (IQR) were compared before and after training at 95% CI, regarding p < 0.05 as statistically significant. Triangulation with open-ended questions was obtained. Time series regression models were applied to test for autocorrelation in performance using Stata 15.0. Ethical approval was obtained from Uganda National Council for Science and Technology (Ref: SS 5082). A total of 500 participants including: 66 (13.2%) traffic police officers, 30 (6.0%) intern doctors, 140 (28.0%) fifth year and 264 (52.8%) third-year medical students were trained. The overall median pre- and post-test scores were 60%, IQR (50–65) and 80%, IQR (70–85) respectively. Overall, the mean difference between pre- and post-test scores was statistically significant (z = 16.7%, P|z|=<0.0001). Most participants strongly agreed to promulgation 389 (77.8%), relevance to their educational 405 (81.0%), and work needs 399 (79.8%). All the course elements scored above 76.0% as being very relevant. This study demonstrates that rural trauma team development training had a positive effect on the test scores of course participants. The training is feasible, highly acceptable and regarded as relevant amongst medical trainees and traffic law enforcement professionals who provide first-aid to trauma patients in resource-limited settings. The findings could inform the design of future trauma teams in rural communities.
Rural trauma team development training amongst medical trainees and traffic law enforcement professionals in a low-income country: a protocol for a prospective multicenter interrupted time series
(National Library of Medicine - PubMed Central, 2024-02-08) Lule, Herman; Mugerwa, Michael; SSebuufu, Robinson; Kyamanywa, Patrick; Posti, Jussi P; Wilson, Michael L
Road traffic injuries and their resulting mortality disproportionately affect rural communities in low-middle-income countries (LMICs) due to limited human and infrastructural resources for postcrash care. Evidence from high-income countries show that trauma team development training could improve the efficiency, care, and outcome of injuries. A paucity of studies have evaluated the feasibility and applicability of this concept in resource constrained settings. The aim of this study protocol is to establish the feasibility of rural trauma team development and training in a cohort of medical trainees and traffic law enforcement professionals in Uganda. Muticenter interrupted time series of prospective interventional trainings, using the rural trauma team development course (RTTDC) model of the American College of Surgeons. A team of surgeon consultants will execute the training. A prospective cohort of participants will complete a before and after training validated trauma related multiple choice questionnaire during September 2019-November 2023. The difference in mean prepost training percentage multiple choice questionnaire scores will be compared using ANOVA-test at 95% CI. Time series regression models will be used to test for autocorrelations in performance. Acceptability and relevance of the training will be assessed using 3 and 5-point-Likert scales. All analyses will be performed using Stata 15.0. Ethical approval was obtained from Research and Ethics Committee of Mbarara University of Science and Technology (Ref: MUREC 1/7, 05/05-19) and Uganda National Council for Science and Technology (Ref: SS 5082). Retrospective registration was accomplished with Research Registry (UIN: researchregistry9490).
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.
Why Evidence Based Approaches are Urgently Needed in Africa
(Elsevier Gmbh , Hackerbrucke 6, Munich, Germany, 80335, 2014) Forland, Frode; Rehfuess, Eve; Klatser, Paul; Kyamanywa, Patrick; Mayanja-Kizza, Harriet
HIV/AIDS, malaria, tuberculosis and other infectious diseases are still major causes of mortality and morbidity in Sub-Saharan Africa (SSA). However, chronic noncommunicable diseases (NCDs) like ischemic heart disease and diabetes mellitus are also on the rise [1](Lozano et al., 2012). This double burden is equally apparent when examining the leading risks to health, which are dominated by//traditionalrr risk factors, such as childhood underweight, household air pollution from solid fuel use and poor water, sanitation and hygiene, as well as//modernrr life-style associated risk factors, such as physical inactivity and smoking [2](Lim et al., 2012). Addressing this substantial burden requires a combination of effective curative, rehabilitative

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