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ItemPerceptions and experiences of Mulago School of Nursing and Midwifery students about preceptorship(Makerere University, 2024)Preceptorship is a widely used teaching strategy by different nursing institutions in clinical education. Preceptorship provides students and novice nurses and midwives with reality-based knowledge, transferring theoretical knowledge into practical knowledge alongside acquiring skills, confidence, and professional socialization. Two individuals are involved in a professional relationship; an experienced staff member teaches an inexperienced student to acquire professional knowledge and skills. Objective: The study objective was to explore the perceptions and experiences of Mulago School of Nursing and Midwifery students about preceptorship. A qualitative, exploratory study design, was used to collect data among Mulago School of Nursing and Midwifery students in their final year of study. Six focus group discussions were conducted. Transcribed data were analyzed using a deductive thematic approach. Four themes emerged from students' perceptions, revealing four key themes—including communication, contribution, competence, and confidence. Students reported that effective communication with preceptors, clear instructions, and constructive feedback were crucial for success. The data highlights the importance of communication, active engagement, skill development, and growing confidence in their roles. Additionally, three themes emerged from students' preceptorship experiences: collaboration, confidence, and competence with seven sub-themes. Students reported that collaboration emphasized teamwork, confidence developed through support from preceptors, and competence evolved through the practical application of classroom knowledge. These findings highlight the importance of preceptorship programs for students’ comprehensive professional growth. The study comprehensively summarizes students' perceptions and experiences in preceptorship programs. The results indicate that students found preceptorship beneficial in enhancing their communication skills, sense of contribution, competence, and confidence. These positive aspects highlight the program's role in fostering student development and professional readiness. However, students also expressed concerns, particularly the need for more consistent and effective supervision by preceptors. These findings suggest that while preceptorship programs are valuable, there is room for improvement in supervision efforts. The implications for curriculum development and training strategies are significant, pointing towards necessary enhancements to support student learning and professional growth.
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ItemStakeholders’ Perspectives Towards Pharmacy Based Delivery of Injectable Pre-Exposure Prophylaxis to Key Populations, Adolescent Girls And Young Women in Kampala, Uganda(Makerere University, 2026-01-12)Background: In Uganda, key populations (KP) and adolescent girls and young women (AGYW) (15–24 years) face high HIV incidence, with 5,900 infections in 2023. Oral PrEP is hindered by adherence, stigma, and access. Long-acting injectable PrEP (LAI-PrEP) offers an alternative, and pharmacies could serve as decentralized delivery points. Methodology: A mixed-methods study in Kampala surveyed 119 AGYW, 119 KP, 150 pharmacy staff, and 9 key informants (KI). Pharmacy readiness was assessed with Proctor framework, factors with consolidated framework for implementation research (CFIR), KI data thematically analysed, and quantitative data analysed in STATA 14. Results: Category 1 (KP and AGYW): Among the 238 AGYW and KP (77.7% female), 33.5% (77/230) reported no condom use in the past month, 88.4% (199/225) had ≥2 partners, and 27.7% (64/230) knew their partner’s HIV status. PrEP Knowledge and Awareness: PrEP knowledge was 79.8% (186/233), mainly from health workers (81.2%; 151/186). Awareness was reported as oral only in 90.5% (172/190) of participants, LAI only in 1.6% (3/190), and both oral and LAI in 7.9% (15/190). PrEP use willingness: Willingness to use PrEP was 79.2% (183/231), with 65.6% (120/183) preferring LAI-PrEP; 85.3% (102/120) favoured lenacapavir over cabotegravir. KP were more willing than AGYW (PR=10.32, 95% CI: 5.656–18.824, p<0.001), and HIV status-aware participants were more willing (PR=2.26, 95% CI: 1.04–4.94, p=0.039). Over half (54.3%; 115/212) were willing to receive LAI-PrEP at pharmacies, citing accessibility (57.7%) and fast service (31.5%). About 49.8% (112/225) believed pharmacies could administer it, and 65.9% (151/229) were willing to pay (<$1: 34.5%; $1-$2: 31.8%; $2-$14: 31.8%). Category 2 (Pharmacy staff): Pharmacy staff (n=150): mean age 27, 59.3% male, 79.7% diploma holders. Two (1.3%) routinely administered injections. Most (90.0%; 135) had customers ask about PrEP, mainly oral (89.7%; 122/136). While 60.7% (85/140) had PrEP training, 99.3% were willing to train in both forms. Pharmacy readiness: Mean acceptability, appropriateness and feasibility scores were 3.9, 3.9, and 3.8 (out of 5). Recommended preparations included staff training/education (29.1%), policy changes (17.5%), and infrastructure (7.8%). Category 3 (Key Informants): Qualitative findings showed benefits of better access, less stigma, and service integration. Challenges were staffing gaps, lack of infrastructure, unclear policies, and stigma. Enablers were training, policy changes, and health system linkages. Conclusion: Pharmacy-based LAI-PrEP delivery is feasible and acceptable for KP and AGYW in Kampala. Willingness to receive LAI-PrEP from pharmacies was high, especially among KP, driven by access and privacy. Pharmacies demonstrated moderate–high readiness despite limited injection experience. Stakeholders supported the model, citing policy, training, infrastructure, and financing as key requirements for implementation.
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ItemThe role of oxidative stress response in modulating fluconazole resistance in cryptococcus clinical isolates.(Makerere University., 2025)Introduction; Fluconazole-resistant Cryptococcus neoformans has emerged as a significant public health concern, complicating the management and treatment of cryptococcal infections. Resistance to fluconazole is associated with increased rates of treatment failure, relapse, and mortality. Resistant strains have been reported globally, with varying prevalence rates. Objectives This study aimed to asses the role of oxidative stress resistance in modulating fluconazole resistance using cryptococcal isolates. Methods A laboratory-based experimental study was conducted at the Makerere University Microbiology Laboratory. Twenty Cryptococcus species isolates were analysed for tolerance to hydrogen peroxide (H2O2) and fluconazole resistance. Minimum inhibitory concentrations (MICs) were determined before and after oxidative stress exposure. Data were analyzed using STATA to calculate the proportion of H2O2- and fluconazole-resistant isolates. Results At lower H2O2 concentrations, most isolates-maintained growth, though responses varied at higher doses. C. gattii showed increased MICs under oxidative stress compared to non-stressed conditions. C. neoformans exhibited a heterogeneous response to fluconazole following H2O2 exposure. Oxidative stress sensitized some isolates to fluconazole, although several remained resistant. Conclusion Resistance patterns in Cryptococcus isolates are influenced by oxidative stress and are highly heterogeneous. These findings highlight the complexity of antifungal resistance and the need for individualized resistance profiling. Recommendations Routine resistance profiling should be incorporated into clinical management of cryptococcal infections. • Combination antifungal therapy using agents with diverse mechanisms of action should be considered for patients with resistant species. Further research is needed to understand the molecular basis of oxidative stress-induced sensitivity and resistance. Fluconazole resistant Cryptococcus neoformans has emerged as a significant public health concern, posing challenges in the management and treatment of Cryptococcal infections. This abstract provides a comprehensive overview of the epidemiology, mechanism of resistance, clinical implications and therapeutic strategies associated with fluconazole resistant Cryptococcus neoformans. fluconazole resistant Cryptococcus neoformans strains have been reported worldwide, with varying prevalence rates. The clinical implications of fluconazole resistance include increased rates of treatment failure, relapse and mortality. To address the challenges due to fluconazole resistance, alternative treatment approaches have been explored. combination therapy, employing multiple antifungal agents with different mechanisms of action. This study determined the resistance pattern of Cryptococcus isolates with and without external oxidative stress. In a laboratory-based experiment study, we analysed 20 Cryptococcus species isolates at the Makerere University Microbiology laboratory. We determined their tolerance levels to hydrogen peroxide and assessed for their resistance partners before and after exposure to hydrogen peroxide. Data was analysed to determine the proportion of H2O2 and fluconazole resistant isolates were calculated using STATA. At lower doses of H2O2, most isolates-maintained growth although there was a heterogeneity response at higher concentrations. The MIC values for C. gattii were higher in stressed compared with non-stressed conditions. While in C. neoformans, there was a heterogenous response to Fluconazole post-oxidative stress exposure. We observed that oxidative stress sensitizes cryptococcus isolates to fluconazole though there were a number of isolates that remined resistant after exposure. This study demonstrates that the resistance patterns of Cryptococcus isolates are oxidative stress dependant and heterogenous in nature. The results highlight the heterogenous resistance nature of Cryptococcus isolates underpinning the need for cases to case analysis of resistance profiles.
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ItemPrevalence, radiographic patterns, and pathologies associated with impacted third molars among patients 20-39 years old attending selected hospitals in Kampala, Uganda.(Makerere University, 2025-07-12)Background: The most commonly impacted teeth in the oral cavity are the third molars. Different third molar patterns and prevalence are seen in various populations and geographic places. For Uganda, there is little information available.Objective: This study aimed to determine the prevalence, radiographic patterns, and associated pathologies of impacted third molars in selected hospitals in Kampala, Uganda, from January 2019 to May 2024.Materials and methods: A retrospective study was conducted in the dental departments of three selected hospitals: Mulago National Referral Hospital, Makerere University Dental School and Hospital, and the Mengo Hospital Dental Department, all located in Kampala. A total of about 1130 valid radiographic records (orthopantomograms) of patients who attended the selected dental facilities from January 2019 to May 2024 were assessed. The radiographs were assessed by the principal investigator and 2 research assistants placed at each Hospital, who were Dental surgeons using standardised criteria. Data were collected using a checklist that included items to determine demographic variables, patterns of impaction, and associated pathologies. Data were entered and analysed using SPSS software and summarised using descriptive statistics. Chi-square tests were conducted to check for relationships between categorical variables. P values less than 0.05 were considered statistically significant.Results: 350 (31.0%) of the 1130 OPGS showed at least one impacted third molar, with no significant difference between males (m=561; 49.6%) and females (F=570; 50.4%) (P 0.284). Impacted third molars were 3.5 times more likely to occur in the mandible than in the maxilla. The most common angulation of impaction in the mandible was the mesioangular (50.6%), while the most common angulation in the maxilla was the vertical (47.4%). Level A impaction was the most common in the mandible (61.5%) and level B in the maxilla (62.6%). Conclusion: The study reveals a moderately high prevalence of impacted third molars and associated pathologies like caries and periodontal diseases in Kampala. This could influence clinical recommendations and preventive dental care. Targeted oral education and treatment measures are needed to address root causes and improve oral health outcomes. To manage complications, dental facilities should have well-trained professionals, appropriate interventions, and panoramic radiographic services. Supporting accessible and affordable dental services, particularly in rural areas, is crucial to addressing this issue. Keywords: Radiographic patterns, impacted third molars, associated pathologies, panoramic
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ItemA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfilment of the requirements for the award of the Degree of Master of Dentistry in Oral & Maxillofacial Surgery(Makerere University., 2025-07-27)Background: The most commonly impacted teeth in the oral cavity are the third molars. Different third molar patterns and prevalence are seen in various populations and geographic places. For Uganda, there is little information available.Objective: This study aimed to determine the prevalence, radiographic patterns, and associated pathologies of impacted third molars in selected hospitals in Kampala, Uganda, from January 2019 to May 2024. Materials and methods: A retrospective study was conducted in the dental departments of three selected hospitals: Mulago National Referral Hospital, Makerere University Dental School and Hospital, and the Mengo Hospital Dental Department, all located in Kampala. A total of about 1130 valid radiographic records (orthopantomograms) of patients who attended the selected dental facilities from January 2019 to May 2024 were assessed. The radiographs were assessed by the principal investigator and 2 research assistants placed at each Hospital, who were Dental surgeons using standardised criteria. Data were collected using a checklist that included items to determine demographic variables, patterns of impaction, and associated pathologies. Data were entered and analysed using SPSS software and summarised using descriptive statistics. Chi-square tests were conducted to check for relationships between categorical variables. P values less than 0.05 were considered statistically significant.Results: 350 (31.0%) of the 1130 OPGS showed at least one impacted third molar, with no significant difference between males (m=561; 49.6%) and females (F=570; 50.4%) (P 0.284). Impacted third molars were 3.5 times more likely to occur in the mandible than in the maxilla. The most common angulation of impaction in the mandible was the mesioangular (50.6%), while the most common angulation in the maxilla was the vertical (47.4%). Level A impaction was the most common in the mandible (61.5%) and level B in the maxilla (62.6%). Conclusion: The study reveals a moderately high prevalence of impacted third molars and associated pathologies like caries and periodontal diseases in Kampala. This could influence clinical recommendations and preventive dental care. Targeted oral education and treatment measures are needed to address root causes and improve oral health outcomes. To manage complications, dental facilities should have well-trained professionals, appropriate interventions, and panoramic radiographic services. Supporting accessible and affordable dental services, particularly in rural areas, is crucial to addressing this issue. Keywords: Radiographic patterns, impacted third molars, associated pathologies, panoramic