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    The role of self medication in rural areas
    ( 1969) Bowry, D. R.
    The subject matter has been studied firstly with a view to showing whether the people living in the Defined Area of Kasangati Health Centre are treating themselves by traditional or customary methods (taboos and native medicines), or by the modern ways as practised at the Health Centre at Kasangati. Secondly, it was hoped to discover how much people prefer to attend the outpatient dispensary of the Health Centre, or to buy their basic drugs from the village shopping centre at Kasangati or Gayaza for self medication. Thirdly, it was hoped to learn something of the incentives behind the practice of self medication - was it a cost incentive, as the shops were nearer to the homes, or was it a form of malingering, by attendance at overcrowded dispensaries resulting in the loss of working time, or was it something wholly different ? Fourthly, it was hoped to discover whether patients preferred the new to the old ways in prevention and cure, and fifthly, whether there was any interest in the simplest possible subjects of public health importance, e.g. teaching on nutrition to prevent kwashiorkor or the importance of breast feeding to avoid marasmus, maternity and child health services in the avoidance of childhood infections, and so on. The study has shown the usefulness of the health centre in every respect. The people like the use of modern (allopathic) treatment. The gentry follow the instructions given to them about their health problems, for example, nutrition, inmunisation, and sanitation, consequently it is found that the people living in the Area are healthy, cleaner and cautious about their health problems. In short the Health Centre services should be extended as the finances of the government concerned allow.
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    Some observations on birth weights and nutritional changes during pregnancy
    ( 1969) Watts, Theresa E.E.
    It has been the impression of the author while conducting antenatal examinations in various parts of East Africa that many women experience very little weight again compared with the recognised standards from the ‘western’ countries. Several publications have shown that the birth weights of African babies are generally lower than the birth weights of European babies. It would be a great help to be able to predict low birth weight babies in the ante-natal clinic as these babies are at greater risk. No study has yet been published concerning weight changes in pregnancy in East Africa and so the present study was undertaken to determine the weight gain and nutritional status in pregnancy and see if this could be related to the birth weight of the baby.
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    Primary schools' survey: (Kyadondo County, West Buganda, Uganda)
    ( 1973) Ogoye, Omondi Ojure
    Some work has already been done on school health in Uganda. But with the quick pace in scientific research in this field, it’s necessary that field surveys be carried out to focus our attention on the most common problems facing this group of school age children. A field survey was undertaken to review health problems of primary school children in Kyadondo County. The aims were: 1. Evaluation of general health of the children including their immunization status. 2. Inspection of the school facilities for water supply, meals, first aid and sanitation. 3. Evaluation of how health education was carried out. 4. The survey was to be coupled with a BCG immunization campaign
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    Malnutrition and intestinal worm infestation in rural Kigezi
    (Makerere University, 1973) Kakitahi, J. T.
    A prevalence study was done on a sample of 169 pre-school children in a rural area in Kigezi, about 3½ miles from Kabale. The objective was to find whether there was an association between malnutrition and intestinal worm infestation. Both clinical and anthropometric measurements were used to determine the nutritional status of the sample. Stoll’s Method was used in stool examination. High prevalences of malnutrition and parasite rates were found, but there was no statistically significant association between malnutrition and parasite rates. A follow up study on weight of some of these children showed a gain in weight three months after de-worming. This weight gain was statistically significant
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    Malnutrition and intestinal worm infestation in rural Kigezi
    ( 1973) Kakitahi, J. T.
    A prevalence study was done on a sample of 169 pre-school children in a rural area in Kigezi, about 3½ miles from Kabale. The objective was to find whether there was an association between malnutrition and intestinal worm infestation. Both clinical and anthropometric measurements were used to determine the nutritional status of the sample. Stoll’s Method was used in stool examination. High prevalences of malnutrition and parasite rates were found, but there was no statistically significant association between malnutrition and parasite rates. A follow up study on weight of some of these children showed a gain in weight three months after de-worming. This weight gain was statistically significant
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    The epidemiology of tetanus in Busoga
    ( 1975-02) Musoke, G. M.
    During a brief period of 4 weeks in October 1974, a study was conducted about factors associated with the high frequency of TETANUS in Busoga previously reported from analysis of Jinja Hospital records. 36 cases of tetanus admitted in 4 Hospitals due to tetanus in this period were interviewed and followed up in their homes where possible. 289 mothers who delivered in the 4 Hospitals were also interviewed about their antenatal care. The number of cases of tetanus previously admitted to these Hospitals over specified periods was also unveiled by the Hospital records. And all Immunization returns against tetanus from the whole province were analysed. Results showed that the disease morbidity and mortality was higher than the average for other parts of Uganda and comparable developing countries, but the other features characteristic of tetanus i.e. affecting mainly the people in the low socio-economic status especially those involved in cultivation exist as in the rest of the world. And that low education plus lack of basic personal hygiene as illustrated by the high rate of jigger sores as well as other forms of sepsis as predesposing factors to the development of the disease were causing a big problem. The province however, proved to have a good distribution of health units and the staffing position was good compared to the rest of the country and the population especially in the group of expectant mothers is well motivated to utilize these health services. The present immunization programmes, however are not covering a good proportion of the population at risk of catching tetanus.
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    Risks to tuberculosis among freshers in Makerere University Kampala 1970-1974
    ( 1975-03) Ajayi-Obe, O.
    Tuberculosis has been known to physicians and laymen or centuries. It was mentioned by the posts in their writings. It is now known that tuberculosis is a world wide disease. A conservative estimate of the problem by the WHO experts noted: A pool of 10-15 million infectious cases 2-3 million new cases each year 1-2 million deaths (17) In the introduction to the eighth report (1964) of the WHO Expert Committee on Tuberculosis, the disease is conceded “to be the most important specific communicable disease in the world as a whole, and its control should receive priority and emphasis both by WHO and Governments.” (18) Dr. Candau, then Director General of the WHO adding the Committee noted a rapidly increasing gap between the developed and the developing countries in the incidence of tuberculosis. He said he believed that the unsatisfactory position in tuberculosis was largely due to the inadequate application of the existing knowledge. It is well recognized that tracing and treating all individuals with active tuberculosis is one of the methods of eradicating this disease; hence the need to evaluate our methods of this ‘tracing’ in the Tuberculosis Control. (5)
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    Malaria indices in children from the urban and peri-urban areas of Kampala
    ( 1977-02) Juxon-Smith, Eugene A.
    Malaria in man is the term given to the acute or chronic infections commonly caused by four species of protozoa parasites belonging to genus plasmodium. Malaria is characterized by fever which tends to be paroxysmal, by anaemia and splenomegaly and often by symptoms resulting from lesions of particular organisms. In the past the names given to acute fevers varied widely amongst countries and even ethnic groups due to the misconception (e.g. malaria – “bad air”, paludisme – “coming from the mashes”) of the true causation of the disease. The concept and term of “malaria” are relatively of late origin. Torti (1658-1741) who first distinguished malaria from other fevers through their property of being cured by cinchoma bark does not employ any simple term in his famous work “Therapeutic Specialis” first published in 1712.
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    A retrospective study of mental illnesses among Makerere University students over the period 1965-1974
    ( 1977-03) Mujabi, J.F.B
    The necessary data for this study was extracted from the student case notes in the student sick bay of Makerere University, the Registrar’s Office of Makerere Main Hall building and from the individual halls of residence. In the ten year period investigated (1965 – 1974 inclusive) 457 psychiatric cases were collected and the disease pattern and distribution by sex, age, faculty, East African territories, halls of residence, diagnosis, predisposing factors, and for Uganda, distribution by tribe, were tabulated, analysed and discussed. One important point that must be borne in mind when comparing those results with those of other authors is that this study, the denominator used is the total student population in the University for each year. Where necessary, this population has been broken down to faculty sizes, territorial sizes etc. This was done because sick bay attendance returns were not complete for the whole period under investigation.
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    Factors associated with absenteeism at Kakira Sugar Works (non-plantation workers)
    ( 1978-03) Rubinga, E. P. R. K.
    In this paper, literature on subject of absenteeism in industrialized countries was reviewed briefly, and a passing commentary made on what the pattern of absenteeism in Uganda was likely to be. A short history of the company was given together with the social amenities provided by the company for the workers. The set up of Kakira Sugar Works hospital was also outlined. The population studied in total comprised of 1808 people, and all were non-plantation workers. Estimates of the characteristics of this population were determined by studying a sample of 100 people selected from the 1808 people, by stratification followed by systematic sampling. The study lasted 28 days (1st October 1977 to 28th October 1977) and during this period, there were 245 absentees giving 268 spells in all. All the absentees were interviewed to determine the factors that were associated with absenteeism. The results showed 1034 days as total number of days of absence belonging to all the spells, a severity rate of absenteeism of 0.57 days per person, average duration per spell of 3.9 days, a standard deviation of 7.14 days, a median of 44 days, and a range of 44 days (45 and 1 being the two extreme values). 2.2% of the total man-days were lost through absenteeism, and this cost the company Ug.Shs.16,323.80 for the period of four weeks. Initial day of absence showed a peak, on Mondays, and a subsidiary peak on Saturdays. This pattern was more sociological than medical. Frequency of absenteeism was found to be significantly more among workers getting 650/= or less, and less among workers getting 651/= and above. It was also found that workers living far from the factory were significantly more frequently absent than those living in the company camps. This was explained as possibly due to transport problems for the workers who lived outside the camps. It was also found that there was a significant association between frequency of absenteeism and means of travel. Workers who lived far from the factory had to depend on public transport or personal cars, both of which were unreliable. However, workers who walked to the factory did not show any significantly higher rate of absenteeism than the control group because such workers lived in the company camps and so had no transport problems. No significant rate of absenteeism compared to the control group, was found to be associated with age, ethnic groups, marital status, family size, sex, religion, education or duration on the job. Personal sickness and injury, sickness and/or death of a family member, social problems, transport problems, alcoholism as reasons given for absence contributed 32.8%, 36.3%, l7.5%, 10.4%, 3% of all the spells, respectively. As possible solutions to the problems of absenteeism, the following were recommended: - A better equipped hospital, free ration to workers to supplement their income, revision of salaries, more houses to be constructed for accommodation of those workers who lived far from the place of work. Also loss of Sunday for every employee who absented himself during the course of the week whether it had been certified or not should be abolished, as this demoralized the workers. Better toilet facilities within the factory, destruction of breeding areas for mosquitoes, and shield type protectors and/or goggles for welders and foundry workers were also recommended, since typhoid which is a disease associated with poor sanitation, malaria fever and damage to the eyes due to intense radiant energy, respectively, were some of the causes of absenteeism.
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    Characteristics of acceptors of Planned Parenthood at Mbale Family Planning Clinic
    ( 1979) Yossa, G. P.
    The Concept of Planned Parenthood:- Definition and Synonyms:- A common misconception by the layman is to regard Planned Parenthood as a method of stopping to produce anymore children. In Public Health parlance, this has a dual connotation and has to do with:- i. The spacing and timing of pregnancy and the control of ones fertility so that the desired number of children is got. ii. This also includes the management of sub/infertility especially if such occurs before the attainment of the desired number of children, along with the related social and psychological problems. (Rosa 1971). Hence the primary aim of Planned Parenthood is to have a child born to parents, who is well planned for, to enable healthy growth and development and at the same time with the mother maintaining a sound state of health, which ultimately means the production of a healthy community.
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    Quality of health care in Mukono District
    ( 1997) Ocom, Felix
    There is no reliable information on the quality of care offered in health units in Mukono District. This study was therefore carried out to provide the DHT with information for targeting improvements in quality of care. The study objectives were to, i) assess patient satisfaction with quality of care provided in health units in Mukono District, ii) assess the quality of the process of health care delivery. In health units in Mukono District, iii) assess health care provider prescribing behavior using treatment of malaria in children under five years as a proxy indicator, and iv) determine factors that influence delivery of quality health care among health care providers in Mukono District. A descriptive cross sectional study was done. A stratified sample of eighteen health units was selected. Three hundred and eighty seven patients were interviewed to assess satisfaction with the quality of health care. To assess the process of health care delivery, 18 health care providers were observed attending to three sick under five year old children each. Health care provider prescribing behavior was assessed retrospectively by a review of records of malaria treatment in children under five years old. Three hundred and eighty four records of previous six months were reviewed. Factors affecting delivery of quality care by health care providers was assessed by use of key informant interviews. The results on patient satisfaction revealed that 15.5% (601387) of patient respondents were completely satisfied with the overall quality of care provided in the health units. Eighty percent (31 11387) were satisfied, 4% (141387) were dissatisfied and 0.5% (21387) were completely dissatisfied. The quality of the process of care was assessed using a scoring system. At a cut off mark of 60% of the expected total score, only 35.2% of the children were managed adequately. This study also found that on average, 3.2 drugs were dispensed to each child with malaria and 41.8% received antibiotics. Eighty five percent received an injection and only 48.3% were treated according to NSTG. The key informants thought that factors that contribute to quality health care were availability of drugs and equipment, adequate staffing with trained personnel, regular effective support supervision, and motivation of health care providers. From the findings of this study, it may be concluded that patients are generally satisfied with the quality of health care provided in the health units of Mukono District. However technical competence of health care providers does not reach required standards. It is therefore recommended that the DHT of Mukono District focus training of health care providers on clinical case management of common childhood illnesses and rational drug use
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    Quality of health care in Mukono District
    ( 1997) Ocom, Felix
    There is no reliable information on the quality of care offered in health units in Mukono District. This study was therefore carried out to provide the DHT with information for targeting improvements in quality of care. The study objectives were to, i) assess patient satisfaction with quality of care provided in health units in Mukono District, ii) assess the quality of the process of health care delivery in health units in Mukono District, iii) assess health care provider prescribing behavior using treatment of malaria in children under five years as a proxy indicator, and iv) determine factors that influence delivery of quality health care among health care providers in Mukono District. A descriptive cross sectional study was done. A stratified sample of eighteen health units was selected. Three hundred and eighty seven patients were interviewed to assess satisfaction with the quality of health care. To assess the process of health care delivery, 18 health care providers were observed attending to three sick under five year old children each. Health care provider prescribing behavior was assessed retrospectively by a review of records of malaria treatment in children under five years old. Three hundred and eighty four records of previous six months were reviewed. Factors affecting delivery of quality care by health care providers was assessed by use of key informant interviews. The results on patient satisfaction revealed that 15.5% (60/387) of patient respondents were completely satisfied with the overall quality of care provided in the health units. Eighty percent (311/387) were satisfied, 4% (14/387) were dissatisfied and 0.5% (2/387) were completely dissatisfied. The quality of the process of care was assessed using a scoring system. At a cut off mark of 60% of the expected total score, only 35.2% of the children were managed adequately. This study also found that on average, 3.2 drugs were dispensed to each child with malaria and 41.8% received antibiotics. Eighty five percent received an injection and only 48.3% were treated according to NSTG. The key informants thought that factors that contribute to quality health care were availability of drugs and equipment, adequate staffing with trained personnel, regular effective support supervision, and motivation of health care providers. From the findings of this study, it may be concluded that patients are generally satisfied with the quality of health care provided in the health units of Mukono District. However technical competence of health care providers does not reach required standards. It is therefore recommended that the DHT of Mukono District focus training of health care providers on clinical case management of common childhood illnesses and rational drug use.
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    Malaria control methods used by the community in peri-urban area (Ndeeba Parish)
    ( 1997) Makanga, Livingstone K.M.
    Malaria threatens 2200 million people worldwide every year. The disease undermines the health and welfare of mainly women and children. Malaria is the leading cause of morbidity and mortality in Uganda. Close to 50% of the population suffers an average of two attacks per year. Currently almost all the anti-malarial activities are in a fragmentary state and grossly uncoordinated. The study was cross-sectional and descriptive, designed to identify malaria control methods used by the community in Ndeeba Parish (a peri-urban area). The general objective was to reduce the incidence and effects of malaria in the Kampala City community. Specific objectives were, to determine mosquito control methods used by the community in Ndeeba; to find out the community’s knowledge and perceptions about malaria in the study area; and to find out health seeking behaviour regarding malaria attack amongst the people in the study population. Data collection involved use of both qualitative and quantitative methods. The multi-stage cluster sampling method was used to sample the study units (households). Qualitative data was collected through Focus group discussions where participants were sampled purposively with guidance of the local leaders. Data analysis was done using a computer (EPI INFO Program) Mosquitoes were found to be a big health problem in Ndeeba parish. This was mentioned in 90% of the respondents. Both qualitative and quantitative results showed that there was a high level of knowledge about the cause of malaria. Forty eight of the respondents showed they knew some traditional methods of mosquito control. Traditional methods that were mentioned included: burning (smoking) of green leaves in 43%, environmental sanitation in 34% and burning (smoldering) of cow dung in 23 %. However these methods were not being used amongst the people as they were mentioned to be inconveniencing because of the smoke and soot that they produce. Mosquito coils were mentioned as the commonest method of mosquito- control being used in Ndeeba in 56% of the respondents. Bednets were indicated to be used in 34% of the cases. While indoor spraying was commonly used in combination with other methods in 10% of the cases. There was an association between education level and the use of a protective method (p value 0.0017). It was mentioned that bednets were used by few people because they were expensive in 75 % of the respondents, and that the bednets were uncomfortable to use. From the results, mosquito screens in the windows were found not to be protective against presence of mosquitoes in the house, Odds ratio 0.6. Similarly screened ventilators were found not be protective against presence of mosquitoes in the house Odds ratio 0.73 . This was attributable to the high mosquito density in the area as indicated by 90% of the respondents. There was poor communal effort in malaria control. Members mentioned that residents were uncooperative in maintaining their compounds. And that people were dumping refuse in the drains which leads to clogging and water stagnation hence increasing the mosquito breeding sites in the area. Members blamed Kampala city council for the failure to provide adequate refuse disposal bins. There should be improved effort in environmental sanitation as to reduce the mosquito breeding sites.
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    Traditional Medicine; Practise and Utilization in an Urban Setting.
    ( 2001) Akol, Zainab
    INTRODUCTION Whereas WHO recommends collaboration with traditional practitioners(TPs) in the provision of health care, in Uganda however there is little documentation on the practice and use of TM. This study examined the practice and use of traditional medicine in an urban setting. Kawempe Division of Kampala city was purposively selected, because Mulago Hospital, Makerere University and the Ministry of Health headquarters are all found in this geographical location. OBJECTIVES The purpose of the study was to investigate the extent and patterns of TM practice and use with a view to draw lessons for possible collaboration in public health practice. Specifically the study, carried out a census of all TPs, described their characteristics and that of their clients. It assessed and described a few procedures used by TPs. It also identified reasons/ factors that lead people to seek care from TPs. METHODOLOGY The study was descriptive cross sectional, deploying both qualitative and quantitative methods. It included a census of all TPs, interviewing all those available at the time of study and a sample of their clients. Observation of procedures used / places of practice, review of available records of practice and focus group discussions for selected members of the community was carried out. RESULTS In this one division of Kampala City 278 TPs were found and were actually being consulted. Four categories of TPs were found, majority (82%) were spiritual herbalists. Others included herbalists (8%), TBAs (6%) and faith healers (4%). Majority of the (70%) were males, 43% Muslims. Their mean age was 42 years (median 38 years) and 56% of them had practiced TM for >10 years. A large number 75% of TPs had no or very low education. Hence in spite of 55% receiving some training meant to improve their performance, only 32% for example kept records. Most TPs (>80%) mainly dealt with non medical conditions. The sample of clients of TM was easily obtained; majority of them were women. They were all from social strata had better education than the TPs they consulted. The reasons for seeking care from TPS were two- fold; cultural belief about disease causation and difficulties in obtaining care from and dissatisfaction with modern medicine (mm). Most (80%) of the observed procedures could not be explained significantly, hygiene was lacking in >50% of them and some procedures were harmful to health e.g. prolonged smoking of pipes with inhalation of herbal fumes. However TPs admitted to have benefitted from their practice materially and in status. CONCLUSION There are many TPs in Kawempe Division. Clients (majority of them women) actually seek care from them mainly for social /psychological problems, because of their belief in spiritual causes of illnesses. TPs therefore mainly dealt with non-medical problems. Some of the treatment procedures used were unhygienic and harmful to the health of clients. Recommendations Government through the MOH should legislate to regulate the practice of tm. IPH should initiate and coordinate more research on tm. Mulago hospital should clearly label the critical pathways, which direct patients to obtain health care services.
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    Factors influencing delayed Diagnosis of Tuberculosis in Mukono District, Uganda.
    ( 2001) Oola, Janet
    Setting This study was carried out in Mukono District situated in the South East of Uganda. TB cases present late for care and the factor influencing these delays were not known in district. Objectives The study aimed at determining the average duration of delays and identifying the factors influencing these delays. Methodology The study was carried out in 11 purposively selected TB diagnostic and treatment units. A proportionate and systematically indentified number of patients (384) were selected from each unit and interview using a pre-tested semi-structured questionnaire. Additional information was also obtained from eight FDGs and 10Klls. Results The geometric mean of the total delay was found to be 107.9 days (median 120 days), with a patient’s delay of 45.15 days (median 60 days) and a health facility’s delay of 24 days( median 23 days). Female were 6 times more likely to have a longer total delay (p=0.013), and 5 times more likely to have a longer patient’s delay than Males (p=0.021). Knowledge of stigmatizing cultural beliefs, perceiving the symptoms initially as mild and perceiving the units as only useful some of the times were associated with a longer total and patient’s delay(p=<0.01). The private units were 2 times more likely to have a longer health facility’s delay than government units (p=0.019). Most patients (67.5%) were aware of the cause, mode of spread and symptoms of TB and most (232, 60.4%) had a positive attitude towards it, whereas the general community had a low level of awareness with a negative attitude, and a lot of stigma attached to tuberculosis. Conclusions The delays were too long. Being a female, perceiving the sickness as mild at its onset, knowledge of stigmatizing cultural beliefs and negative perceptions of the quality of care promoted the late seeking care. Private units took longer to diagnose tuberculosis compared to government units. Patients had adequate knowledge and a positive attitude towards tuberculosis. The general community, however, had low awareness and a negative attitude towards tuberculosis. Recommendations Health education should be emphasized. Health care delivery in existing health units be improved by better management of resources. Continuing medical education should be emphasized with the involvement of workers in private units. Improvement of the economic status of women is a necessity.
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    Prevalence and predictors of substance abuse among students in Secondary Schools in Kabarole District.
    ( 2001) Waiswa, Geoffrey
    INTRODUCTION: A study conducted in secondary schools in Kabarole District to determine the prevalence and factors associated with substance abuse among the students. OBJECTIVES: To establish the magnitude and determine predictors of substance abuse among secondary school students in Kabarole District. METHODOLOGY: The study was a cross sectional survey. A total of 400 students completed the questionnaires. RESULTS: Only 37.8% of the students had ever used at least one substance, and 15.8% used more than one substance. The most common used substances were alcohol 27.3%, cigarette smoking at 21.3%. Mairungi (Khat) 7.3%, and marijuana, 4.0%. Consumption of cocaine and volatile substance was the lowest at 1.5% respectively. The majority of substance abusers were male. The factors associated with substance abuse were older age, male sex, attending special occasions away from school especially at night, excess pocket money at school, experience of depression. The other factors that were also associated with substance use are having a parent or sibling who consumes alcohol, cigarettes, or marijuana, and being violent (fighting). Being sexually active, use of alcohol or marijuana before intercourse, and making a girl pregnant were associated with substance abuse. Multiple substance use increases the likely hood of using other substance as well. The other factors were frequent prayers, participating in club activities, and close monitoring by parents. CONCLUSION: The overall prevalence of substance abuse was low and male students were more likely to be engage in some form of substance abuse. Alcohol consumption, cigarette smoking, Mairungi, Marijuana, and Cocaine and volatile substances were the most commonly abused substances. The factors associated with substance abuse were gender, age, poor parental and sibling role models, multiple substance use, being sexually active, excess pocket money, depression, frequent prayers, club activity, and parental monitoring. RECOMMENDATIONS: The DHT and education Department should design control strategies against substance abuse in primary and secondary schools.
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    Factors influencing the prevalence of Intensinal Helmiths among Pupils in Primary Schools in Troro District- Uganda.
    ( 2001) Mwebesa, Kayamba Tom
    INTRODUCTION: Intestinal helminths continue to be a public health problem in Tororo District affecting many primary school pupils, irrespective of their age and sex. Much of the published information at the national and district levels had centered on prevalence without establishing the factors influencing such a situation. One way of obtaining useful epidemiological data and at a low cost was to carry out a study among pupils in primary schools to establish such factors as no such study had been carried out before. OBJECTIVES OF THE STUDY: The study set out to assess factors influencing the prevalence of intestinal helminthes among pupils in primary schools. Specifically the study established the prevalence and the most common type of soil transmitted intestinal worms, the knowledge of pupils and their mothers / guardians about intestinal worms besides assessing environmental sanitation of the pupil’s homesteads. MATERIALS AND METHODS: A Cross sectional study carried out between April and June 2000, involving 372 pupils who were randomly selected from 22 primary schools in Tororo District. Both quantitative and qualitative techniques were used. Questionnaires were administered and stool specimen examinations (based on the Kato-Katz technique) done to collect quantitative data. This was subsequently analyzed using computer software packages. FGDs were conducted to generate qualitative information which was manually transcribed and analyzed. RESULTS: The general prevalence of intestinal helminths was 59.1% and girls (53.2%) were more affected than boys (46.8%). Hookworm infection was the major problem through of low intensity. Knowledge about intestinal helminths was generally low. Being a child of a peasant, inadequate health education, ingestion of contaminated food/water, the need to wash raw-uncooked foods and the need to wear shoes were significantly associated with the prevalence of intestinal helminthes. CONCLUSIONS AND RECOMMENDATIONS: The general prevalence of intestinal helminthes among pupils in primary school was high. Hookworm infection was the most common and girls were more infected than boys. There was inadequate awareness about the mechanisms of transmission and preventive measures of intestinal helminths. Households had inadequate water supply, both in quantity and quality while human excreta were indiscriminately disposed of. The Directorate of Health Services should institute a chemotherapy-based intestinal helminths program alongside a school health education campaign targeting all pupils in primary schools. Home and environment improvement campaigns should be organized. A supportive policy to promote the wearing of shoes by pupils in primary schools should be developed. Another operational study should be carried out in regard to traditional herbs / medicines that can treat intestinal helminths.
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    Assessment of the Implementation of the Health Sub-District Concept in Arua District in Uganda.
    ( 2001-03) Oremo, Robert Ojede
    INTRODUCTION: The implementation of the HSD concept, a strategy under health sector reforms and decentralization had been associated with poor management and delivery of health services in HSDs in Arua District. This was in the context of the expected service delivery output. Sufficient, accurate and objective information about the implementation of the concept of HSD was lacking. METHODOLOGY: A Cross sectional study using qualitative methods of data collection was done in April 2001 to assess the implementation of the concept Data was analyzed using Epi-info computer package and also manually. RESULTS: The staffing requirements for HC IV and CHD of hospitals had been met only for only a few cadres of staff. The construction of both the theatre and the doctor’s house had been completed at only one of the hour HC iv. The HSDs had received from 57.4% to 67.5% of their 2000/01 annual budget. All the HSDs headquarters had carried out planning, outreach services and support supervision. At two of the HC IV, Minor operations and some obstetrics and gynecological procedures had been performed.The key informants reported that the HSD concept was poorly understood. CONCLUSIONS: Although there was under staffing, inadequate infrastructure, financial constraints as well as limited sensitization about the HSD concept, the objectives of creating HSDs had been met to a consideration extent. There was need for more resources and sensitization about the HSD concept. RECOMMENDATIONS: Arua District Authorities should recruit the missing staff, review funding procedures, construct infrastructure and conduct sensitization workshops on HSD concept for health workers and local authorities.
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    Carrier state of streptococcus pneumoniae in the nasopharnyx of Sickle Cell Children in Mulago Hospital - Kampala, Uganda.
    ( 2001-04-13) Augustine, Ssevviri KM ; Kanjumbula, Henry ; Deogratias, Kaddu-Mulindwa H
    Introduction: Invasive pneumococcal disease has been recognised as a serious complication of homozygous sickle cell (SS) disease since the first description of this association (Wollstein & Kriedel, 1928). In Uganda there was also a dearth of Streptococcus pneumoniae as a cause of septicemia (Monica Etima, 2002, personal communication, Nantanda, 2006, Katureebe, unpublished data 2007). No studies in sickle cell children have been done before in Uganda. Objectives: The objective of this present study was to address the rate of nasopharyngeal carriage of Streptococcus pneumoniae inn SS children attending the Sickle Cell Clinic in Kampala, Uganda and the antibiotic sensitivity of the isolated organisms. Design: A descriptive cross-sectional study. Setting: The study site was the Sickle Cell Clinic of Mulago Hospital and Complex. Methods: The patients attended the Sickle Cell Clinic of Mulago University Teaching Hospital and the study was restricted to clinically well subjects with SS aged less than 6 years. Nasopharyngeal samples were taken for culture in all and the parents /guardians were questioned on the use of antibiotics over the 4 proceeding weeks and for the history of pneumococcal immunization. Results: S. pneumoniae was found in 27 (33%) of the study group (Table 1), occurring in 2/23 (9%) of those with recent hospitalization and in 25/58 (43%) of those without (2 = 8.8, p=0.003) where the p-value was obtained with Fisher's Exact test. Two subjects had received pneumococcal immunization and neither carried the organism. Antibiotic usage, usually for persistent coughs, was reported in 64/81 (79%) subjects (Table 2). Antibiotic sensitivity of isolated organism showed all to be penicillin resistant but sensitive to other commonly used antibiotics. Conclusion: The nasopharyngeal carrier rate of S. pneumoniae in SS children aged below 6 years is high in Uganda and penicillin resistance is high among the isolated organisms. Further to that study on the prevalence or incidence of SCD in children in Uganda is recommended as this information is missing.