School of Bio-Medical Sciences (Bio-Medical) Collections

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Now showing 1 - 5 of 426
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    Health workers’ perceptions of the quality of print IEC materials for Cancer patient education at the Uganda Cancer Institute
    (Makerere University, 2025) Katumba, Andrew
    Background: Print Information, Education, and Communication (IEC) materials serve as invaluable resources in cancer patient education in low-resource settings, providing patients with information, educational content, and communication tools to support their journey through diagnosis, treatment, and survivorship. However, challenges such as language barriers, literacy levels, cultural sensitivities, and material accessibility may limit their effectiveness. Objectives: This study aimed to determine the perceptions of health workers regarding the quality of Print Information, Education, and Communication (IEC) materials and to assess their quality using the Patient Education Materials Assessment Tool for Print Materials (PEMAT-P). Methods: This was a multiple methods study design that employed qualitative and quantitative methods of data collection and analysis. It was carried out among Health workers and IEC materials used in cancer patient education at the Uganda Cancer Institute. Qualitative data was collected through in-depth interviews using an interview guide. The data was transcribed, coded into themes and analysed using thematic analysis. The Patient Education Materials Assessment Tool (PEMAT-P) for print materials was utilized to collect and analyze data on the quality of the Print IEC materials. Results: Interviews with 20 health workers revealed that while IEC materials are valued as important educational aids, their impact is hindered by limited language options, predominantly English and Luganda, excluding many patients from diverse linguistic backgrounds. Low literacy levels further reduced patient engagement with the text-heavy materials. Cultural and religious beliefs affected acceptance, with some images and recommendations causing discomfort or rejection. Inconsistent availability, outdated content, and poor placement also compromised usage. The PEMAT-P evaluation showed high Understandability scores between 59–94% (81% Avg.) but lower Actionability scores between 20–100% (59% Avg.), indicating a lack of practical guidance for patients. More than half (71%, n=10) of the materials met the AHRQ threshold of ≥70% for Understandability while more than half (64%, n=9) of the materials scored below this threshold in Actionability. Conclusion and recommendations: Health workers perceived Print IEC materials as valuable tools for standardizing information and supporting patient education, but their utility was diminished by limited accessibility, language and literacy barriers, cultural and religious mismatches, and outdated content. The materials were effective in conveying knowledge but less effective in empowering patients to translate that knowledge into actionable health decisions. Efforts should be made to improve accessibility, ensure language and literacy appropriateness, align content with cultural and religious contexts, and regularly update materials to maximize their effectiveness. The materials should be redesigned to not only convey information clearly but also provide practical guidance that enables patients to take specific health actions.
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    MAGEA12 expression, prognostic significance, and Antigenicity in invasive Ductal carcinoma breast cancer
    (Makerere University, 2025) Nabukeera, Kevin Cissy
    Background: The heterogeneity of breast cancer (BC) significantly influences treatment, creating a need for new therapies effective across molecular subtypes. Invasive Ductal Carcinoma (IDC), the most common and aggressive form of BC, often exhibits resistance to conventional therapies. Melanoma Associated Antigen 12 (MAGEA12), frequently associated with aggressive cancers such as IDC, is a promising immunotherapy target. Identifying its putative epitopes may facilitate peptide vaccine and novel immunotherapy design against IDC. Methods: We used 4 transcriptomics datasets (the three MAGEA12 mRNA splice variants, 576 IDC cases from TCGA, 40 BC cell lines SRA samples, and 10,000 CDR3β TCR sequences) to identify MAGE12 peptides that can be exploited for immunotherapy in IDC. Differential expression analysis was done with DESeq2, survival associations with Cox models, peptide-MHC binding with NetMHCpan 4.1a, and TCR-pMHC interactions with pMTnet. Results: MAGEA12 was significantly overexpressed across all BC subtypes (adj p-value< 0.05) compared to normal tissue, with highest levels in non-luminal (Basal, HER2+) and second to MAGEA1 in luminal (A & B) subtypes. Its expression correlated with poor survival in Luminal A patients (ρ = 0.0189). From 15,759 predicted peptides, 690 bound strongly to 64 genotyped MHC I alleles, forming 2,710 stable, high-affinity TCR-pMHC complexes with CDR3β TCR sequences. Conclusion: These findings reveal novel immunogenic MAGEA12-derived peptides capable of forming strong TCR-pMHC interactions, supporting MAGEA12 as a promising target for antigen-based immunotherapy in IDC. We provide a prioritized repertoire of peptides for experimental validation and development of MAGEA12-directed cancer vaccines and immune interventions.
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    Characterization of transcriptome diversity of invasive ductal carcinoma tissue from individuals of different ethnicities and ages
    (Makerere University, 2023) Ssegawa, Abdulkarim
    Breast cancer is a heterogeneous disease, and its incidence and prognosis are influenced by various factors including age and ethnicity. Consequently, tumors from individuals of different age groups and ethnicities may exhibit unique molecular fingerprints including transcriptomic profiles. However, while much work has been done to characterize tumors and describe their heterogeneity across epidemiological states, our understanding of their molecular features remains limited. This knowledge is critical and a prerequisite in the quest to fully understand the etiology of the disease and biology of tumors for the prevention, early diagnosis, and improved treatment of cancer. RNA sequencing (RNA-Seq) has emerged as a powerful tool for transcriptome analysis, providing a comprehensive view of gene expression and regulation. Therefore, in this study, we aimed to use RNA-Seq to investigate transcriptome diversity in breast cancer tissue from individuals of different ethnicities and ages. This study aimed to obtain RNA-Sequence sample data of breast cancer tissue from various ethnicities and age groups and perform RNA-Seq to analyze the gene expression profiles. The objectives of this study are to identify differentially expressed genes and pathways associated with breast cancer progression and prognosis and to characterize the transcriptome diversity between breast cancer tissues from individuals of different ethnicities and ages. Additionally, we will explore the potential clinical implications of our findings by investigating the relationship between transcriptome diversity, treatment responses, and survival outcomes. Ultimately, our study aims to provide important insights into the molecular basis of ethnic and age-related differences in breast cancer biology and to identify potential targets for personalized breast cancer management.
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    Treatment outcomes of isoniazid mono-resistant mycobacterium tuberculosis patients in Uganda: a retrospective cross-sectional study from 2017 to 2022
    (Makerere University, 2024-10) Kabugo, Joel
    Globally, isoniazid-resistant, rifampicin-susceptible TB is estimated to occur in 13.1% (95% confidence interval [CI]: 9.9–16.9%) of new cases and 17.4% (95% CI: 0.5–54.0%) of previously treated cases. Current WHO guidelines recommend treatment with Rifampicin (RFP), ethambutol (EMB, E), pyrazinamide (PZA, Z), and levofloxacin (LFX, Q) for 6 months in patients with isoniazid mono-resistant TB (Hr-TB) but the effectiveness and use of other regimens in managing Hr-TB has not been established. There is a need to pay increased attention to the timely identification of Hr-TB patients in order to improve treatment success along with reduction of the risk for further drug resistance development Methodology: Selected isolates were tested for mutations associated with isoniazid resistance. Patient demographic data was obtained from the National TB Reference Laboratory (NTRL) electronic data system and request forms with additional data, such as treatment regimen, adverse effects, and treatment start dates obtained from treatment registers. The main outcome was dichotomized as unsuccessful treatment outcome (failed, died, lost to follow-up and not evaluated) vs successful treatment outcome (cured or completed). The independent variables available (age, sex, regimen used, M. tuberculosis mutation genes for isoniazid specifically InhA and KatG, history of TB, HIV status, and reporting year) were assessed as possible factors in the relationship between Hr-TB and treatment success. Results: A total of 85 isolates from different patients were analyzed in this study. Most of the participants 36(42.4%) turned culture negative at month one upon initiation of treatment. The findings from this study show that the most dominant Mycobacterium tuberculosis mutation occurred in the KatG MUT1 region with a nucleotide change of S315T1 and with inhA MUT2, MUT3A, and 3B region being registered with no mutations in this study. However, the study found that the majority of deaths were among people aged above 36 years 71.4% (5/7 participants). Conclusion: This study revealed delayed culture conversation of beyond 2 months as a significant factor associated with unsuccessful treatment of isoniazid mono-resistant TB and this can be used as a predictor in routine patient management. The study found a higher proportion of mutations known to confer high-level isoniazid drug resistance among patients with isoniazid drug resistance but the treatment outcome across the different mutations never varied. Hr-TB was commonest among the male and also mainly among participants who previously had TB and had been initiated on anti-TB treatment. In this study Majority of the patients had successful treatment outcome.
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    Occurrence of quinolone resistance genes qep, QnrA, QnrB and QnrS in uropathogenic E. coli from female clinical samples at Makerere University College of Health Sciences
    (Makerere University, 2022) Tusabe, Godwin Wenka
    Drug resistant Escherichia coli (E Coli) is the leading cause of community and hospital acquired urinary tract infections affecting approximate 150 million people each year worldwide. Uropathogenic Escherichia coli (UPEC) strains accounts for the main causative agents, this increase in prevalence is attributed to the indiscriminate use of antibiotics. Objectives The purpose of this study is to evaluate the prevalence of quinolone resistant genes qep, qnrA, qnrB and qnrS among Escherichia coli isolates obtained from female patients at the microbiology laboratory Makerere University college of Health Sciences. Two mechanisms of quinolone resistance have been established: 1) alterations in the targets of quinolones and decreasing drug accumulation inside cells through membrane impermeability or an over expression of efflux pump. 2) Mutations in specific domains of qep, qnrS, qnrA and qnrB causing variations in single amino acid of either gyrase or topoisomerase IV leading to resistance to quinolones. Methods and materials The study was a cross sectional study carried out using female samples stored in Makerere university microbiology laboratory and known to have quinolone resistance. From the archived samples, DNA extraction was done, polymerase chain reaction and agarose gel electrophoresis. Outcomes In total, 21 isolates resistant to ciprofloxacin and nalidixic acid. The highest rates of antibiotic resistance were obtained for nalidixic acid (100%), ciprofloxacin (80%). Of the 21 quinoloneresistant strains, 01 (7.1%) isolates harbored qep genes. None of the isolates harboured the qnrA gene, qnrB and qnrS. Conclusion These findings suggest a possible resistance to fluoroquinolone is of high interest for better management of patients and control of antimicrobial resistance in Uganda.