Publications by authors named "Ian G Munabi"

17 Publications

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Specialty career preferences among final year medical students at Makerere University College of health sciences, Uganda: a mixed methods study.

BMC Med Educ 2021 Apr 16;21(1):215. Epub 2021 Apr 16.

Department of Pediatrics, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.

Background: Uganda has an imbalanced distribution of the health workforce, which may be influenced by the specialty career preferences of medical students. In spite of this, there is inadequate literature concerning the factors influencing specialty career preferences. We aimed to determine the specialty career preferences and the factors influencing the preferences among fifth year medical students in the School of Medicine, Makerere University College of Health Sciences (MakCHS).

Methods: A sequential explanatory mixed methods study design with a descriptive cross-sectional study followed by a qualitative study was used. A total of 135 final year medical students in MakCHS were recruited using consecutive sampling. Self-administered questionnaires and three focus group discussions were conducted. Quantitative data was analysed in STATA version 13 (StataCorp, College Station, Tx, USA) using descriptive statistics, chi-square tests and logistic regression. Qualitative data was analysed in NVIVO version 12 (QRS International, Cambridge, MA) using content analysis.

Results: Of 135 students 91 (67.4%) were male and their median age was 24 years (IQR: 24, 26). As a first choice, the most preferred specialty career was obstetrics and gynecology (34/135, 25.2%), followed by surgery (27/135, 20.0%), pediatrics (18/135, 13.3%) and internal medicine (17/135, 12.6%). Non-established specialties such as anesthesia and Ear Nose and Throat (ENT) were not selected as a first choice by any student. Female students had 63% less odds of selecting surgical related specialties compared to males (aOR = 0.37, 95%CI: 0.17-0.84). The focus group discussions highlighted controlled lifestyle, assurance of a good life through better financial remuneration and inspirational specialists as facilitators for specialty preference. Bad experience during the clinical rotations, lack of career guidance plus perceived poor and miserable specialists were highlighted as barriers to specialty preference.

Conclusion: Obstetrics and Gynecology, Surgery, Pediatrics and Internal Medicine are well-established disciplines, which were dominantly preferred. Females were less likely to select surgical disciplines as a career choice. Therefore, there is a need to implement or establish career guidance and mentorship programs to attract students to the neglected disciplines.
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http://dx.doi.org/10.1186/s12909-021-02630-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8052684PMC
April 2021

The role of medical equipment in the spread of nosocomial infections: a cross-sectional study in four tertiary public health facilities in Uganda.

BMC Public Health 2020 Oct 16;20(1):1561. Epub 2020 Oct 16.

Department of Microbiology, School of Biomedical Sciences, Makerere University college of Health Sciences, Kampala, Uganda.

Background: With many medical equipment in hospitals coming in direct contact with healthcare workers, patients, technicians, cleaners and sometimes care givers, it is important to pay close attention to their capacity in harboring potentially harmful pathogens. The goal of this study was to assess the role that medical equipment may potentially play in hospital acquired infections in four public health facilities in Uganda.

Methods: A cross-sectional study was conducted from December 2017 to January 2018 in four public health facilities in Uganda. Each piece of equipment from the neonatal department, imaging department or operating theatre were swabbed at three distinct points: a location in contact with the patient, a location in contact with the user, and a remote location unlikely to be contacted by either the patient or the user. The swabs were analyzed for bacterial growth using standard microbiological methods. Seventeen bacterial isolates were randomly selected and tested for susceptibility/resistance to common antibiotics. The data collected analyzed in STATA version 14.

Results: A total of 192 locations on 65 equipment were swabbed, with 60.4% of these locations testing positive (116/192). Nearly nine of ten equipment (57/65) tested positive for contamination in at least one location, and two out of three equipment (67.7%) tested positive in two or more locations. Of the 116 contaminated locations 52.6% were positive for Bacillus Species, 14.7% were positive for coagulase negative staphylococcus, 12.9% (15/116) were positive for E. coli, while all other bacterial species had a pooled prevalence of 19.8%. Interestingly, 55% of the remote locations were contaminated compared to 66% of the user contacted locations and 60% of the patient contacted locations. Further, 5/17 samples were resistant to at least three of the classes of antibiotics tested including penicillin, glycylcycline, tetracycline, trimethoprim sulfamethoxazole and urinary anti-infectives.

Conclusion: These results provides strong support for strengthening overall disinfection/sterilization practices around medical equipment use in public health facilities in Uganda. There's also need for further research to make a direct link to the bacterial isolates identified and cases of infections recorded among patients in similar settings.
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http://dx.doi.org/10.1186/s12889-020-09662-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7562759PMC
October 2020

A health care professionals training needs assessment for oncology in Uganda.

Hum Resour Health 2020 09 1;18(1):62. Epub 2020 Sep 1.

Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda.

Background: Cancer incidence and mortality in sub-Saharan Africa are increasing and do account for significant premature death. The expertise of health care providers is critical to downstaging cancer at diagnosis and improving survival in low- and middle-income countries. We set out to determine the training needs of health care providers for a comprehensive oncology services package in selected hospitals in Uganda, in order to inform capacity development intervention to improve cancer outcomes in the East African region.

Methods: This was a cross-sectional survey using the WHO Hennessey-Hicks questionnaire to identify the training needs of health workers involved in cancer care, across 22 hospitals in Uganda. Data were captured in real time using the Open Data Kit platform from which the data was exported to Stata version 15 for analysis using the Wilcoxon signed-rank test and Somers-Delta.

Results: There were 199 respondent health professionals who were predominately female (146/199, 73.37%), with an average age of 38.97 years. There were 158/199 (79.40%) nurses, 24/199 (12.06%) medical doctors and 17/199 (8.54%) allied health professionals. Overall, the research and audit domain had the highest ranking for all the health workers (Somers-D = 0.60). The respondent's level of education had a significant effect on the observed ranking (P value = 0.03). Most of the continuing medical education (CME) topics suggested by the participants were in the clinical task-related category.

Conclusion: The "research and audit" domain was identified as the priority area for training interventions to improve oncology services in Uganda. There are opportunities for addressing the identified training needs with an expanded cancer CME programme content, peer support networks and tailored training for the individual health care provider.
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http://dx.doi.org/10.1186/s12960-020-00506-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465387PMC
September 2020

Effect of an eLearning Intervention on Undergraduate Health Professional Student's General Histology and Embryology Summative Examination Scores.

OAlib 2020 Jun 18;7(6). Epub 2020 Jun 18.

Department of Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda.

Sub-Saharan Africa has the worst global shortage of health professionals. The use of eLearning interventions, that lead to increased interactions according to the Interaction Equivalency theorem, is a potential means of addressing this shortage of health professionals. In this audit we set out to determine the effect of an eLearning general histology and general embryology intervention on student's summative examination scores. The audit compared the written and practical summative examination scores of three sets of student examinations one of which had a five-week eLearning intervention. Two of the examinations were for the same students in one year but different courses while the other two were for students doing the same subject but in different years. In each of the above pair of examinations there was one group from the course that had the eLearning intervention. A Bayesian multilevel regression modelling approach was used to analyse the student scores. The course with the online eLearning intervention had significantly better scores (p-value < 0.01), than the course on a different subject offered at the same time to the same students without the intervention and the same course with students from the previous academic year. On controlling for other factors, the eLearning intervention led to higher examination scores though this was not significant. Student's nationality, sponsorship and program significantly affected the examination scores, controlling for other factors. Overall the students in the course with the online eLearning intervention had significantly better examination scores. The student's nationality, sponsorship and program significantly affect their examination scores. Future, larger and or qualitative studies, are needed to further explore the effect of these factors on student's examination scores.
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http://dx.doi.org/10.4236/oalib.1106230DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7357960PMC
June 2020

Knowledge, attitudes and practices of faculty on mentorship: an exploratory interpretivist study at a sub-Saharan African medical school.

BMC Med Educ 2020 Jun 15;20(1):192. Epub 2020 Jun 15.

School of Medicine, Makerere University, Kampala, Uganda.

Background: Mentorship has become a routine part of undergraduate training in health professions education. Although many health professions training institutions have successfully incorporated faculty-student mentorship in their formal training, many others especially in Sub-Saharan Africa have not fully embraced this. Institutionalized mentorship programmes are effective methods of enhancing student learning experiences. Faculty, who are the mentors have an active role to play in driving the mentorship agenda and ensure that students benefit from this important activity. The aim of this study was to explore the knowledge, attitudes and practices of faculty about student mentorship at Makerere University College of Health Sciences.

Methods: It was an exploratory qualitative study using interviewer-administered semi-structured questionnaires. The study participants included faculty at Makerere University College of Health Sciences. Thematic analysis was used to analyse the data using pre-determined themes.

Results: Four themes were identified: 1) Knowledge of mentorship, 2) Attitude towards mentorship, 3) Practice of mentorship and 4) Improving the mentorship process. Majority of the faculty reported being less knowledgeable on mentorship regardless of seniority. The level of knowledge seemed to influence the practice of mentorship. Despite the observed knowledge gap, all faculty demonstrated a positive attitude to participate in mentoring.

Conclusion: Faculty demonstrated a positive attitude towards mentorship despite the knowledge gap of mentorship identified. Continuous faculty development in mentorship as well as using peer mentorship were identified as key in sustaining the mentorship programme.
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http://dx.doi.org/10.1186/s12909-020-02101-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294640PMC
June 2020

Partial Least Squares Structural Equation Path Modelling Determined Predictors of Students Reported Human Cadaver Dissection Activity.

Forensic Med Anat Res 2020 Apr 17;8(2):18-37. Epub 2020 Mar 17.

Department of Anatomy, College of Health Sciences, Makerere University, Kampala, Uganda.

Human cadaver dissection remains a core and preferred method of anatomical instruction at most low- and middle-income health professional training institutions. Dissection, which is both traumatic and stressful, sets the tone of the students' responses to later and or similar stressful learning opportunities like the post-mortems or care for terminally ill patients. Partial least squares structural equation modelling was used to determine the effect of the students': personality, perception of the learning environment, learning approach, and effect of the environment on the student, on undergraduate health professional student's activity in the human cadaver dissection room. This was a secondary analysis of previously collected data from a cross sectional survey of undergraduate health professional students. We found that personality type and perception of the environment had a positive effect on dissection room activity. Approach to learning and being affected by the dissection room experience (impact), had a negative effect on dissection room activity. All the above effects on dissection room activity were not significant. This study showed that personality, perception of the learning environment, learning approach and effect of the environment on the student, had effects on undergraduate health professional student's activity in the human cadaver dissection room. The modelled effects are opportunities for educational interventions aimed at increasing student activity in the dissection room.
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http://dx.doi.org/10.4236/fmar.2020.82003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182346PMC
April 2020

Accuracy of the lower third molar radiographic imaging to estimate age among Ugandan young people.

BMC Res Notes 2019 Oct 11;12(1):652. Epub 2019 Oct 11.

Department of Anatomy, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

Objective: Dental development is a useful method for age estimation. Although third molar eruption is commonly used to estimate age in Uganda, it is reported to be unreliable because of external influences. The more reliable radiographic techniques have inter-ethnic differences but data from sub-Saharan Africa are limited regarding estimating age in young adults. This study, therefore, aimed at determining the accuracy of Demirjian's classification of the lower third molar, a common dental age estimation method, in estimating key ages in a Ugandan population using Ugandan references. Dental records of 1021 Ugandans aged 10-22 years were assigned to two groups; reference and test. The reference data was retrieved from a database of a previous bigger research project.

Results: The overall sample population comprised of 514/1021 (50.3%) males. The mean age was 15.8 (3.6) years. No significant sex differences in dental age were established in the reference sample (520 records). Accuracy values (area under the curve) at the 12-, 14-, 16- and 18-year cut-offs were between 0.83 and 0.90 using the test sample (501 records). The results suggest that Demirjian's classification of the lower third molars is a useful method for age estimation in the young urban Ugandan population in the 10-22-year age-group.
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http://dx.doi.org/10.1186/s13104-019-4686-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788087PMC
October 2019

Epilepsy misconceptions and stigma reduction interventions in sub-Saharan Africa, a systematic review.

Epilepsy Behav 2018 08 13;85:21-27. Epub 2018 Jun 13.

Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center & Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA.. Electronic address:

Objective: This systematic review identified papers that described epilepsy misconceptions or stigma in sub-Saharan Africa (SSA) and research interventions focused on reducing these misconceptions.

Materials And Methods: Publications in the English language from January 2000 to October 2017 that described original research conducted in SSA on misconceptions about epilepsy were utilized.

Results: Twenty-three publications were identified. Studies were from Nigeria (N = 4), Cameroon (N = 4), Uganda (N = 3), Zambia (N = 2), Ethiopia (N = 2), Tanzania (N = 2), Kenya (N = 2), Ghana, Zimbabwe, Benin, and Mali (N = 1 each). The studies included assessments of misconceptions among healthcare providers and medical students (N = 3), high school students (N = 2), teachers (N = 2), the general public (N = 10), people with epilepsy (N = 7), and traditional healers (N = 1). Only two studies had stigma-focused interventions. Majority of the studies reported limitations to socialization with people with epilepsy and various beliefs associated with epilepsy.

Conclusions: Epilepsy misconceptions, stigmatizing cultural beliefs, and perceptions were widely prevalent in SSA, and there are a few studies targeting epilepsy stigma. Existing stigma-reduction educational approaches may be impractical for general population implementation. Scalable approaches to reduce stigma are urgently needed within SSA.
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http://dx.doi.org/10.1016/j.yebeh.2018.04.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355646PMC
August 2018

Association between Maternal Pelvis Height and Intrapartum Foetal Head Moulding in Ugandan Mothers with Spontaneous Vertex Deliveries.

Obstet Gynecol Int 2016 29;2016:3815295. Epub 2016 Feb 29.

Department of Obstetrics and Gynaecology, School of Medicine, Makerere University College of Health Sciences, New Mulago Hospital Complex, Kampala, Uganda.

Introduction. In Sub-Saharan Africa, excessive foetal head moulding is commonly associated with cephalopelvic disproportion and obstructed labour. This study set out to determine the associations of maternal pelvis height and maternal height with intrapartum foetal head moulding. Methods. This was a multisite secondary analysis of maternal birth records of mothers with singleton pregnancies ending in a spontaneous vertex delivery. A summary of the details of the pregnancy and delivery records were reviewed and analysed using multilevel logistic regression respect to foetal head moulding. The alpha level was set at P < 0.05. Results. 412 records were obtained, of which 108/385 (28%) observed foetal head moulding. There was a significant reduction in risk of foetal head moulding with increasing maternal height (Adj. IRR 0.97, P = 0.05), maternal pelvis height (Adj. IRR 0.88, P < 0.01), and raptured membranes (Adj. IRR 0.10, P < 0.01). There was a significant increased risk of foetal head moulding with increasing birth weight (Adj. IRR 1.90, P < 0.01) and duration of monitored active labour (Adj. IRR 1.21, P < 0.01) in the final model. Conclusion. This study showed that increasing maternal height and maternal pelvis height were associated with a significant reduction in intrapartum foetal head moulding.
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http://dx.doi.org/10.1155/2016/3815295DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789430PMC
April 2016

Stillbirths in sub-Saharan Africa: unspoken grief.

Lancet 2016 Feb 19;387(10018):e16-e18. Epub 2016 Jan 19.

School of Medicine, Makerere University College of Health Sciences, PO Box 7072, Kampala, Uganda.

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http://dx.doi.org/10.1016/S0140-6736(15)01171-XDOI Listing
February 2016

A secondary analysis to determine variations of dental arch measurements with age and gender among Ugandans.

BMC Res Notes 2015 Sep 10;8:428. Epub 2015 Sep 10.

Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, New Mulago Hospital Complex, P.O.Box 7072, Kampala, Uganda, East Africa.

Background: Dental arch dimensions are useful in dental practice and in forensic odontology. Local data is essential because ethnic differences exist in dental arch dimensions. In the Ugandan population no studies had been done on dental arch dimensions. The objective of the current study was to determine the variations in dental arch dimensions with age and gender in a sample of dental casts from the Ugandan population.

Method: This was a secondary analysis of dental casts previously prepared using mandibular and maxillary arch impressions of 220 children (85 boys and 135 girls) aged 12-17 years recruited from schools in Kampala, Uganda. Dental arch dimensions for the maxilla and mandibular casts were taken using a digital vernier calliper. The data was analysed using the means based independent samples t test to obtain the descriptive statistics with regression analysis being used to obtain the regression coefficients and constants using STATA 12.

Results: The overall maxillary dimensions were significantly smaller in females than males by 1.50 mm (95% CI -2.91 to -0.09, P = 0.04), controlling for age group. The overall dimensions of the mandible were also smaller in younger participants, though this was not statistically significant.

Conclusion: From this study we observed significant differences in arch dimensions between males and females that are of forensic value for this population. There is need for more study of the differences in arch dimensions with age using a larger and more age diverse study population.
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http://dx.doi.org/10.1186/s13104-015-1411-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566201PMC
September 2015

A cross sectional study evaluating screening using maternal anthropometric measurements for outcomes of childbirth in Ugandan mothers at term.

BMC Res Notes 2015 Jun 2;8:205. Epub 2015 Jun 2.

Department of Obstetrics and Gynaecology, School of Medicine, Makerere University College of Health Sciences, New Mulago Hospital Complex, Kampala, Uganda.

Background: Birth related newborn and maternal mortality/morbidity remains high in most of sub-Saharan Africa compared to the rest of the world. In this low income region there is a need for valid, low cost, easy to use mass screening tests. This study looked at the screening value of maternal: height, weight and pelvis height, for assessing the outcomes of parturition in Ugandan mothers at term.

Methods: This was a multi site cross-sectional study on mothers with singleton pregnancies in labour at various hospitals in different parts of Uganda. A summary of the details of the pregnancy, maternal height, weight and the delivery record were captured and analysed to generate descriptive and inferential (multilevel logistic regression analysis) and diagnostic (Receiver Operator Curve analysis) statistics.

Results: We recruited 1146 mothers from all the study sites during the study period of whom 987 (86.13%) had normal deliveries and healthy babies. Mothers with adverse outcomes included 107 mothers that had caesarean section and 52 mothers who had vaginal deliveries with foetal Apgar score of ≤7 at 5 min of whom 11 had fresh still births. Maternal height (Adj OR 0.97, 95% CI 0.94-1.00) and maternal pelvis height (Adj OR 0.73, 95% CI 0.61-0.86) were significantly associated with adverse pregnancy outcomes. The combination of maternal: height (<150 cm), weight (>55.7 kg) and pelvis height (>8.95 cm) had the best diagnostic value with a combined area under the curve of 0.60.

Conclusions: It was observed that an increase in either maternal pelvis height or maternal height was associated with a significant reduction in adverse pregnancy outcomes. The cut off values of all three evaluated maternal anthropometric measurements were of low test accuracy as screening tests even when used together. Further research is needed to develop low cost screening tools for use in low income settings.
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http://dx.doi.org/10.1186/s13104-015-1183-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467626PMC
June 2015

Factors influencing health professions students' use of computers for data analysis at three Ugandan public medical schools: a cross-sectional survey.

BMC Res Notes 2015 Feb 25;8:54. Epub 2015 Feb 25.

Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.

Background: Effective utilization of computers and their applications in medical education and research is of paramount importance to students. The objective of this study was to determine the association between owning a computer and use of computers for research data analysis and the other factors influencing health professions students' computer use for data analysis.

Methods: We conducted a cross sectional study among undergraduate health professions students at three public universities in Uganda using a self-administered questionnaire. The questionnaire was composed of questions on participant demographics, students' participation in research, computer ownership, and use of computers for data analysis. Descriptive and inferential statistics (uni-variable and multi- level logistic regression analysis) were used to analyse data. The level of significance was set at 0.05.

Results: Six hundred (600) of 668 questionnaires were completed and returned (response rate 89.8%). A majority of respondents were male (68.8%) and 75.3% reported owning computers. Overall, 63.7% of respondents reported that they had ever done computer based data analysis. The following factors were significant predictors of having ever done computer based data analysis: ownership of a computer (adj. OR 1.80, p = 0.02), recently completed course in statistics (Adj. OR 1.48, p =0.04), and participation in research (Adj. OR 2.64, p <0.01).

Conclusions: Owning a computer, participation in research and undertaking courses in research methods influence undergraduate students' use of computers for research data analysis. Students are increasingly participating in research, and thus need to have competencies for the successful conduct of research. Medical training institutions should encourage both curricular and extra-curricular efforts to enhance research capacity in line with the modern theories of adult learning.
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http://dx.doi.org/10.1186/s13104-015-1013-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4346114PMC
February 2015

A qualitative analysis of health professionals' job descriptions for surgical service delivery in Uganda.

Hum Resour Health 2014 12;12 Suppl 1:S5. Epub 2014 May 12.

Background: The ever increasing demand for surgical services in sub-Saharan Africa is creating a need to increase the number of health workers able to provide surgical care. This calls for the optimisation of all available human resources to provide universal access to essential and emergency surgical services. One way of optimising already scarce human resources for health is by clarifying job descriptions to guide the scope of practice, measuring rewards/benefits for the health workers providing surgical care, and informing education and training for health professionals. This study set out to determine the scope of the mandate to perform surgical procedures in current job descriptions of surgical care health professionals in Uganda.

Methods: A document review was conducted of job descriptions for the health professionals responsible for surgical service delivery in the Ugandan Health care system. The job descriptions were extracted and subjected to a qualitative content data analysis approach using a text based RQDA package of the open source R statistical computing software.

Results: It was observed that there was no explicit mention of assignment of delivery of surgical services to a particular cadre. Instead the bulk of direct patient related care, including surgical attention, was assigned to the lower cadres, in particular the medical officer. Senior cadres were assigned to perform predominantly advisory and managerial roles in the health care system. In addition, a no cost opportunity to task shift surgical service delivery to the senior clinical officers was identified.

Conclusions: There is a need to specifically assign the mandate to provide surgical care tasks, according to degree of complexity, to adequately trained cadres of health workers. Health professionals' current job descriptions are not explicit, and therefore do not adequately support proper training, deployment, defined scope of practice, and remuneration for equitable surgical service delivery in Uganda. Such deliberate assignment of mandates will provide a means of increasing surgical service delivery through further optimisation of the available human resources for health.
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http://dx.doi.org/10.1186/1478-4491-12-S1-S5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4108889PMC
December 2015

Musculoskeletal pain and school bag use: a cross-sectional study among Ugandan pupils.

BMC Res Notes 2014 Apr 9;7:222. Epub 2014 Apr 9.

Anatomy Department, School of Biomedical Sciences, College of Health Sciences, Makerere University, P O Box 7072, Kampala, Uganda.

Background: Though seen as a convenient method of carrying books and other scholastic materials including food items, schoolbags are believed to contribute to back and other musculoskeletal problems in school going children. This study set out to determine the prevalence of low back and other musculoskeletal pains and describe their relationship with schoolbag use in pupils.

Results: This was a cross-sectional descriptive study involving 532 pupils from six primary schools with a mean age of 13.6 years. Analyses included the chi- square test, independent t tests, regression analysis and test for trend across ordered groups. Backpacks were the most common type of schoolbag and younger children carried disproportionately heavier bags. Urban pupils were younger, carried significantly heavier bags, and less likely to complain about schoolbag weight than the rural pupils. About 30.8% of the pupils carried schoolbags which were more than 10% of their body weight. About 88.2% of pupils reported having body pain especially in the neck, shoulders and upper back. About 35.4% of the children reported that carrying the schoolbag was the cause of their musculoskeletal pain. The prevalence of lower back pain was 37.8%. There was significant association between low back pain and; method of bag carriage (p < 0.0001), long duration of walking (odds ratio 2.67, 95% CI 1.38- 5.16) and the time spent sitting after school (p = 0.02). Only 19% had lockers at school.

Conclusion: Urban pupils were younger, carried significantly heavier bags, and less likely to complain about schoolbag weight than the rural pupils. The majority of pupils complained of musculoskeletal pain of which 35.4% was attributed to the schoolbags.The prevalence of lower back pain was 37.8%. Schools need to provide lockers and functional libraries in order to avoid excessive loading and repetitive strain injuries.
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http://dx.doi.org/10.1186/1756-0500-7-222DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983861PMC
April 2014

Musculoskeletal disorder risk factors among nursing professionals in low resource settings: a cross-sectional study in Uganda.

BMC Nurs 2014 Feb 24;13(1). Epub 2014 Feb 24.

Anatomy Department, School of Biomedical Sciences, College of Health Sciences, Makerere University, P,O, Box 7072 Kampala, Uganda.

Background: Musculoskeletal disorders (MSD) constitute one of the main occupational hazards among health care workers. However, few epidemiological studies on work related MSD among nursing professionals have been carried out in Africa. The purpose of this study was to assess the work related musculoskeletal disorders and associated risk factors among nursing professionals in Uganda.

Methods: This was a cross-sectional study of MSD among 880 nursing professionals from five selected hospitals in Uganda. Data was collected using a questionnaire adapted from the Dutch Musculoskeletal and Nordic Musculoskeletal questionnaires. Descriptive (mean, standard deviation and percentages) and inferential (Chi square test and logistic regression analysis) statistics were used to analyse data. Alpha level was set at p < 0.05.

Results: A total of 741 completed questionnaires were analysed (response rate 85.4%). The average age of the respondents was 35.4 (SD 10.7) years and a majority were female (85.7%). The average working hours per week was 43.7 (SD 18.9 hours). The 12-month period-prevalence of MSD at anybody site was 80.8%. The most common site of MSD was the lower back (61.9%). Significant risk factors for reported MSD included often working in a slightly bent posture (adjOR 2.25, 95% CI 1.20-4.26), often working in a slightly twisted posture for long (adjOR 1.97, 95% CI 1.03-3.77), mental exhaustion (adjOR 2.05, 95% CI 1.17-3.5), being absent from the work station for more than 6 months due to illness or an accident (adjO|R, 4.35, 95% CI 1.44-13.08) and feeling rested after a break (adjOR 2.09, 95% CI 1.16-3.76).

Conclusions: Musculoskeletal disorders affect more than 80% of nursing professionals in Uganda with the most commonly, affected site being the lower back. Significant risk factors for MSD include; being absent from the work station for more than 6 months due to illness or an accident, working in awkward postures, pushing/pulling of heavy loads and mental exhaustion. There is a need for greater advocacy, better working conditions and adoption of strategies to reduce occupational injuries.
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http://dx.doi.org/10.1186/1472-6955-13-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3940025PMC
February 2014

The introduction, methods, results and discussion (IMRAD) structure: a Survey of its use in different authoring partnerships in a students' journal.

BMC Res Notes 2011 Jul 21;4:250. Epub 2011 Jul 21.

Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, New Mulago Hospital Complex, Kampala Uganda.

Background: Globally, the role of universities as providers of research education in addition to leading in main - stream research is gaining more importance with demand for evidence based practices. This paper describes the effect of various students and faculty authoring partnerships on the use of the IMRAD style of writing for a university student journal.

Findings: This was an audit of the Makerere University Students' Journal publications over an 18-year period. Details of the authors' affiliation, year of publication, composition of the authoring teams and use of IMRAD formatting were noted. Data analysis gave results summarised as frequencies and, effect sizes from correlations and the non parametric test. There were 209 articles found with the earliest from 1990 to latest in 2007 of which 48.3% were authored by faculty only teams, 41.1% were authored by student only teams, 6.2% were authored by students and faculty teams, and 4.3% had no contribution from the above mentioned teams. There were significant correlations between the different teams and the years of the publication (rs = -0.338 p < 0.01 one tailed). Use of the IMRAD formatting was significantly affected by the composition of the teams (Χ2 (2df) = 25.621, p < 0.01) especially when comparing the student only teams to the faculty only teams. (U = 3165 r = - 0.289). There was a significant trend towards student only teams over the years sampled. (z = -4.764, r = -0.34).

Conclusions: In the surveyed publications, there was evidence of reduced faculty student authoring teams as evidenced by the trends towards students only authoring teams and reduced use of IMRAD formatting in articles published in the students' journal. Since the university is expected to lead in teaching of research, there is need for increased support for undergraduate research, as a starting point for research education.
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http://dx.doi.org/10.1186/1756-0500-4-250DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154165PMC
July 2011
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