Journal articles: 'Lacor Hospital (Gulu, Uganda)'

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Accorsi, S., P. A. Onek, S. Declich, M. Lukwiya, P. D. Mattei, and M. Fabiani. "The increasing burden of infectious diseases on hospital services at St Mary's Hospital Lacor, Gulu, Uganda." American Journal of Tropical Medicine and Hygiene 64, no. 3 (March 1, 2001): 154–58. http://dx.doi.org/10.4269/ajtmh.2001.64.154.

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Pecorella, Irene, Tom Richard Okello, and Martin David Okwang. "Incidence of male breast carcinoma in North Uganda: A survey at Lacor Hospital, Gulu, during 2009–2016." Breast Disease 40, no. 2 (June 18, 2021): 95–100. http://dx.doi.org/10.3233/bd-201068.

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BACKGROUND: Little information is available on male breast cancer (MBC) incidence from sub-Saharan Africa. OBJECTIVE: This is a retrospective study on MBC in rural North Uganda, based on the pathology records of a private, non-profit, missionary hospital. METHODS: All male patients that had histological diagnosis of breast carcinoma from January 2009 to December 2016 were included in this study. RESULTS: In time span of 8 years, there were 337 consecutive breast cancer presentations, including 21 MBC (6.2%). The latter patients showed advanced disease (mean symptom duration: 20.3 months; mean tumour size: 5 cm) skin ulceration and ipsilateral lymph node metastasis: 60%). The mean age was 60.52 years (from 30 to 85 yrs). Ductal infiltrating carcinoma was the prevalent histological type in our series (65%), followed by an unusually high rate of papillary carcinomas (15%). There appeared to be a prevalence for left breasts (11 LT versus 6 RT; 64.7%), a finding also observed in the majority of MBC. CONCLUSIONS: This study is representative of the scenario in Northern Uganda, where MBC accounts for 6.2% of breast cancers, More information on the occurrence and risk factors of this unusual neoplasm in African countries may prompt prevention of chronic liver disease and early recognition and treatment of MBC.

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Felice, Alex, Jacopo Barbieri, Ander Martinez Alonso, Maarten Messagie, and Thierry Coosemans. "Challenges of Phasing out Emergency Diesel Generators: The Case Study of Lacor Hospital’s Energy Community." Energies 16, no. 3 (January 28, 2023): 1369. http://dx.doi.org/10.3390/en16031369.

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Power outages of the electricity grid threaten the proper operation of critical infrastructure such as hospitals. To cope with this problem, emergency diesel generators (DGs) are often used to guarantee continuous and resilient electricity supply, resulting in increased costs and greenhouse gas (GHG) emissions. Thus, this study aims to investigate the economic feasibility of both reducing and replacing emergency diesel generators with solar photovoltaic (PV) systems, battery energy storage systems (BESS) and demand-side management. A mixed-integer quadratically constrained program is used to find the optimal configuration in terms of capacities of new assets, as well as the optimal scheduling of both BESS and flexible loads, that minimises the levelised cost of energy (LCOE). The model is applied to an existing hospital and its surrounding community located in Gulu, Uganda. The results show that full replacement of the DGs will require an additional 500 kWp of PV and 1591 kWh of BESS. This new configuration will decrease LCOE by 26% compared to the actual situation, with a simple payback time of 6.2 years and a reduction of 74% in GHG emissions.

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Towner, Jonathan S., Pierre E. Rollin, Daniel G. Bausch, Anthony Sanchez, Sharon M. Crary, Martin Vincent, William F. Lee, et al. "Rapid Diagnosis of Ebola Hemorrhagic Fever by Reverse Transcription-PCR in an Outbreak Setting and Assessment of Patient Viral Load as a Predictor of Outcome." Journal of Virology 78, no. 8 (April 15, 2004): 4330–41. http://dx.doi.org/10.1128/jvi.78.8.4330-4341.2004.

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ABSTRACT The largest outbreak on record of Ebola hemorrhagic fever (EHF) occurred in Uganda from August 2000 to January 2001. The outbreak was centered in the Gulu district of northern Uganda, with secondary transmission to other districts. After the initial diagnosis of Sudan ebolavirus by the National Institute for Virology in Johannesburg, South Africa, a temporary diagnostic laboratory was established within the Gulu district at St. Mary's Lacor Hospital. The laboratory used antigen capture and reverse transcription-PCR (RT-PCR) to diagnose Sudan ebolavirus infection in suspect patients. The RT-PCR and antigen-capture diagnostic assays proved very effective for detecting ebolavirus in patient serum, plasma, and whole blood. In samples collected very early in the course of infection, the RT-PCR assay could detect ebolavirus 24 to 48 h prior to detection by antigen capture. More than 1,000 blood samples were collected, with multiple samples obtained from many patients throughout the course of infection. Real-time quantitative RT-PCR was used to determine the viral load in multiple samples from patients with fatal and nonfatal cases, and these data were correlated with the disease outcome. RNA copy levels in patients who died averaged 2 log10 higher than those in patients who survived. Using clinical material from multiple EHF patients, we sequenced the variable region of the glycoprotein. This Sudan ebolavirus strain was not derived from either the earlier Boniface (1976) or Maleo (1979) strain, but it shares a common ancestor with both. Furthermore, both sequence and epidemiologic data are consistent with the outbreak having originated from a single introduction into the human population.

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Ogwang, Martin D., Weiqiang Zhao, Leona W. Ayers, and Sam M. Mbulaiteye. "Accuracy of Burkitt Lymphoma Diagnosis in Constrained Pathology Settings: Importance to Epidemiology." Archives of Pathology & Laboratory Medicine 135, no. 4 (April 1, 2011): 445–50. http://dx.doi.org/10.5858/2009-0443-ep.1.

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Abstract Context.—Burkitt lymphoma (BL) is endemic in Uganda and because of the high incidence, diagnosis is often presumed during clinical care and epidemiologic studies. Objectives.—To assess the accuracy of the clinical and the local pathology diagnosis of BL as assessed by an outside pathology review diagnosis and to understand the limitations on histopathology practice in a resource-constrained setting at 1 hospital in Uganda. Design.—Clinically presumed pediatric (<15 years) BL cases with biopsies and pathology reports, from 1993 to 2007, were identified at St Mary's Hospital, Lacor (Gulu, Uganda). Local histopathology procedures, hematoxylin-eosin–stained tissue sections, and formalin-fixed paraffin-embedded blocks were reviewed onsite by an outside pathologist, followed by outside study that included tissue microarray immunohistochemistry and in situ hybridization. Results.—Local pathology laboratory procedures were inconsistent and suboptimal, especially for tissue fixation. There were 88 clinically presumed BL cases. Sixty-three could be reviewed by outside pathology (25 cases of lost blocks or no remaining tumor) and showed a clinical diagnostic accuracy of 75% (47 confirmed of 63), with a possible range of 62% to 85%, depending on the actual diagnosis of the 25 nonevaluable cases. There were 64 BL cases diagnosed by local pathology. Forty-five could be reviewed by outside pathology (19 cases of lost blocks or no remaining tumor) and showed a local pathology diagnostic accuracy of 82% (37 confirmed of 45), with a possible range of 58% to 88%, depending on the actual diagnosis of the 19 nonevaluable cases. Non-BL diagnoses included other non-Hodgkin lymphomas, Hodgkin lymphoma, and benign infectious lymphadenopathy. Conclusions.—Accuracy of clinical diagnosis of BL was reduced by inclusion of other diseases with similar clinical presentations. Local pathology, using morphology alone, only marginally improved clinical accuracy and often could not support outside pathology review due to inadequate laboratory procedures. There is an urgent need to improve pathology services in Uganda before conducting high-quality clinical and epidemiologic studies.

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Ocan, Apollo, Caesar Oyet, Fred Webbo, Bashir Mwambi, and Ivan Mugisha Taremwa. "Prevalence, morphological characterization, and associated factors of anemia among children below 5 years of age attending St. Mary’s Hospital Lacor, Gulu District, Northern Uganda." Journal of Blood Medicine Volume 9 (October 2018): 195–201. http://dx.doi.org/10.2147/jbm.s184126.

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Ogwang, David M. "Dyspepsia: Endoscopy Findings in Uganda." Tropical Doctor 33, no. 3 (July 2003): 175–77. http://dx.doi.org/10.1177/004947550303300322.

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Lacor hospital, a mission hospital with a bed capacity of 460, serves the population of northern Uganda — other hospitals in the area use it as a referral hospital. The study was conducted in the endoscopy unit from November 1999 to 31 August 2000. The department of surgery runs the endoscopy unit with the surgeon heading the endoscopy team. Routine diagnostic and therapeutic endoscopy is carried out weekly for elective cases, and emergency service is as and when required.

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Bosisio, Alessandro, Matteo Moncecchi, Gabriele Cassetti, and Marco Merlo. "Microgrid design and operation for sensible loads: Lacor hospital case study in Uganda." Sustainable Energy Technologies and Assessments 36 (December 2019): 100535. http://dx.doi.org/10.1016/j.seta.2019.100535.

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Okello, T., D. Ogwang, N. Alema, and I. Pecorella. "An Evaluation of 605 Endoscopic Examination in a Rural Setting, Lacor Hospital in Northern Uganda." British Journal of Medicine and Medical Research 15, no. 10 (January 10, 2016): 1–7. http://dx.doi.org/10.9734/bjmmr/2016/24412.

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Okello, T. R., Kansime Kansime, J. Odora, J. A. Apio, and I. Pecorella. "Barriers and factors affecting personal protective equipment usage in St. Mary’s Hospital Lacor in Northern Uganda." East and Central African Journal of Surgery 22, no. 1 (July 19, 2017): 59. http://dx.doi.org/10.4314/ecajs.v22i1.8.

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Kitara, DL, P. Pirio, D. Acullu, and CP Opira. "TB co-infection with HIV/AIDS: a unique radiological presentation at Lacor hospital -a postconflict northern Uganda." African Journal of Infectious Diseases 9, no. 2 (May 5, 2015): 21. http://dx.doi.org/10.4314/ajid.v9i2.1.

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Kitara, D., P. Pirio, D. Acullu, and C. Opira. "Tuberculosis (TB) Co-infection with HIV/AIDS: Clinical Presentation at Lacor Hospital, a Post-conflict Northern Uganda." British Journal of Medicine and Medical Research 5, no. 3 (January 10, 2015): 386–95. http://dx.doi.org/10.9734/bjmmr/2015/12191.

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Garang, Piok G., Richard A. Odoi, and Joan N. Kalyango. "Adherence to Antiretroviral Therapy in Conflict Areas: A Study among Patients Receiving Treatment from Lacor Hospital, Uganda." AIDS Patient Care and STDs 23, no. 9 (September 2009): 743–47. http://dx.doi.org/10.1089/apc.2009.0073.

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Amone, Derrick, Christopher Okot, Patrick Mugabi, Tom Richard Okello, and David Martin Ogwang. "Case Report: Swallowed toothbrush in the stomach of a 56 year female at St Mary’s Hospital Lacor, Uganda." AAS Open Research 1 (April 18, 2018): 5. http://dx.doi.org/10.12688/aasopenres.12842.1.

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Toothbrush swallowing is a rare occurrence. Toothbrush swallowing presents a risk of impaction and perforation along the gastrointestinal tract. This case report describes a 56 year old female that presented to the emergency unit of St Mary’s Hospital Lacor with a 1 day history of chest pain after a toothbrush was pushed down her throat by a traditional healer who was managing her for pharyngitis. The chest pain was associated with difficulty in breathing. She also reported dull abdominal pain. There was no history of vomiting or drooling of saliva. On examination, we found that she was in pain and had respiratory distress with a respiratory rate of 32 breath/ min and was using accessory muscles. There was no oedema, aneamia or jaundice. Blood pressure of 120/80 mmHg and pulse rate of 87 beats/ min. The abdominal findings were normal, but ultrasound scan suggested that the toothbrush was in the stomach. The plain erect abdominal x-ray was inconclusive. She was admitted to the ward for conservative management. After 2 weeks we decided to do exploratory laparotomy and we found the toothbrush in the stomach, that we removed and closed the abdomen in layers. Post-operatively the patient recovered uneventfully on the ward. Toothbrush swallowing is a rare occurrence. The commonest foreign bodies ingested by adults are bones, spoons and dentures. Toothbrush ingestion occurs commonly among patients with psychiatric conditions like bulimia or anorexia nervosa, schizophrenia and bezoar. Most swallowed toothbrushes have been found in the esophagus or the stomach of affected patients. Most people who swallowed their toothbrushes did so entirely without erotic intent, as with this case where the patient had the brush pushed down her throat by a traditional healer. This is the first case of toothbrush swallowing in this hospital.

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Mike, Mbazira. "Survival Factors of Burkitts Lymphoma Patients at Discharge: The Case of St. Mary’s Hospital Lacor in Northern Uganda." American Journal of Health Research 2, no. 1 (2014): 9. http://dx.doi.org/10.11648/j.ajhr.20140201.12.

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Alobo, Gasthony, Cristina Reverzani, Laura Sarno, Barbara Giordani, and Luigi Greco. "Estimating the Risk of Maternal Death at Admission: A Predictive Model from a 5-Year Case Reference Study in Northern Uganda." Obstetrics and Gynecology International 2022 (March 17, 2022): 1–8. http://dx.doi.org/10.1155/2022/4419722.

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Background. Uganda is one of the countries in the Sub-Saharan Africa with a very high maternal mortality ratio estimated at 336 deaths per 100,000 live births. We aimed at exploring the main factors affecting maternal death and designing a predictive model for estimation of the risk of dying at admission at a major referral hospital in northern Uganda. Methods. This was a retrospective matched case-control study, carried out at Lacor Hospital in northern Uganda, including 130 cases and 336 controls, from January 2015 to December 2019. Multivariate logistic regression was used to estimate the net effect of the associated factors. A cumulative risk score for each woman based on the unstandardised canonical coefficients was obtained by the discriminant equation. Results. The average maternal mortality ratio was 328 per 100,000 live births. Direct obstetric causes contributed to 73.8% of maternal deaths; the most common were haemorrhage (42.7%), sepsis (24.0%), hypertensive disorders (18.7%) and complications of abortion (2.1%), whereas malaria (23.5%) and HIV/AIDS (20.6%) were the leading indirect causes. The odds of dying were higher among women who were aged 30 years or more (OR 1.12; 95% CI, 1.04–1.19), did not attend antenatal care (OR 3.11; 95% CI, 1.36–7.09), were HIV positive (OR 3.13; 95% CI, 1.41–6.95), had a caesarean delivery (OR 2.22; 95% CI 1.13–4.37), and were referred from other facilities (OR 5.57; 95% CI 2.83–10.99). Conclusion. Mortality is high among mothers referred late from other facilities who are HIV positive, aged more than 30 years, lack antenatal care attendance, and are delivered by caesarean section. This calls for prompt and better assessment of referred mothers and specific attention to antibiotic therapy before and after caesarean section, especially among HIV-positive women.

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Chiesa, Annacarla, Emmanuel Ochola, Letizia Oreni, Paolo Vassalini, Giuliano Rizzardini, and Massimo Galli. "Hepatitis B and HIV coinfection in Northern Uganda: Is a decline in HBV prevalence on the horizon?" PLOS ONE 15, no. 11 (November 18, 2020): e0242278. http://dx.doi.org/10.1371/journal.pone.0242278.

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Background The available data concerning hepatitis B virus (HBV) infection in Uganda are limited, particularly in the case of people living with HIV/AIDS (PLWH). HBV is not routinely tested when starting antiretroviral therapy (ART). We aimed to determine the prevalence, the correlates of the risk of HBV infection, and the association with outcomes of ART among PLWH attending a busy HIV clinic in a referral hospital in Northern Uganda. Patients and methods From April to June 2016, a random sample of 1000 PLWH attending the outpatients’ clinic of St. Mary’s Hospital, Gulu, Uganda were systematically selected to undergo a rapid hepatitis B surface antigen (HBsAg) test after administering a questionnaire in this cross-sectional study. HIV care parameters were obtained from client files. Multivariate logistic regression and general linear model were used for the analysis. Results 950 of the 985 evaluable patients (77% females; mean age 42.8 years) were receiving ART. The overall prevalence of HBsAg was 7.9% (95% confidence interval [CI] 6.2–9.6%), and was significantly lower among the females (6.8% vs 11.7%; p = 0.020). The factors independently associated with higher HBV infection were having lived in an internally displaced persons’ camp (adjusted odds ratio [aOR] 1.76, 95% CI 1.03–2.98; p = 0.036) and having shared housing with HBV-infected people during childhood (aOR 3.30, 95% CI 1.49–7.32; p = 0.003). CD4+ T cell counts were significantly lower in HBV patients (p = 0.025), and co-infection was associated with a poorer CD4+ T cell response to ART (AOR 0.88; 95% CI 0.79–0.98; p = 0.030). Conclusions The observed prevalence of HBV among the PLWH may be underestimated or a signal of HBV decline in the region. The factors favouring horizontal HBV transmission identified suggest extending HBV screening and vaccine prophylaxis among PLWH.

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Obol, James, Kitara David Lagoro, and Orach Christopher Garimoi. "Knowledge and Misconceptions about Malaria among Pregnant Women in a Post-Conflict Internally Displaced Persons' Camps in Gulu District, Northern Uganda." Malaria Research and Treatment 2011 (September 14, 2011): 1–7. http://dx.doi.org/10.4061/2011/107987.

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Background. In Uganda Malaria continues to be a major public health problem accounting for about 30–50% of all outpatient consultations and 35% of hospital admissions and a leading cause of mortality and morbidity. Pregnant women and their unborn children are vulnerable to malaria. Methods. A cross-sectional survey was conducted in 20 postconflict IDP camps of Gulu district selected randomly as clusters. 769 pregnant women were interviewed. Results. The majority of the respondents 85% have ever heard about malaria. Most (80%) 571 respondent attributed malaria to be transmitted by mosquito bites, 15 said cold weather, 53 said dirt, and 35 said not sleeping under net. Most (91%) 683 respondents mentioned that malaria was caused by mosquito, 28 mentioned cold food, 3 mentioned playing in the rain, 19 mentioned cold weather, and 6 mentioned eating mangos. Conclusion. Most pregnant women in the post conflict IDP camps have relatively high knowledge about malaria transmission, signs, symptoms, and consequences during pregnancy. However, majority of respondents had misconception about the cause of malaria while a few had misconception about the mode of malaria transmission.

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Bongomin, Felix, Mercy Chelangat, Anthony Eriatu, Bruno Chan Onen, Priscilla Cheputyo, Stephen A. Godmercy, Eddymond Ekuk, Francis Idony, and James Henry Obol. "Prevalence and Factors Associated with Contraceptive Use among HIV-Infected Women of Reproductive Age Attending Infectious Disease Clinic at Gulu Regional Referral Hospital, Northern Uganda." BioMed Research International 2018 (June 10, 2018): 1–8. http://dx.doi.org/10.1155/2018/9680514.

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Background. Reproductive planning by HIV-infected women is essential, as it helps to prevent transmission of HIV to their unborn babies. Integrating contraceptive services to routine HIV care significantly increases the use of modern contraceptive methods, thus reducing vertical transmission of HIV. Objectives. To determine the prevalence and factors associated with contraceptive use among HIV-infected women attending Infectious Disease Clinic (IDC) at Gulu Regional Referral Hospital (GRRH) in Northern Uganda. Methodology. A hospital-based cross-sectional study was performed. We used simple random sampling to recruit HIV-infected women receiving routine care from IDC, GRRH, into our study. Sample size was estimated using modified Kish-Leslie formula and semistructured questionnaire was used for data collection. Data was entered into EpiData version 3.1 and analysed using Stata v11.0. We used logistic regression model to assess the associations and any factor with p≤0.05 was considered statistically significant. Results. The prevalence of contraceptive use was found to be 36% (95% CI 31 – 40%). Factors which promoted contraceptive use were as follows: being married (aOR=2.68, 95% CI 1.54-4.65, p<0.001) and monthly income of $35 -250 (aOR= 2.38, 95% CI: 1.39- 4.09, p=0.002). Factors that hindered contraceptive use were having no child (nulliparity) (aOR= 0.16; 95% CI: 0.05-0.49; p=0.002) and age range of 31-49 years (aOR= 0.53; 95% CI: 0.33 - 0.84; p=0.007). Conclusion. In this study, just over a third of sexually active HIV-infected women reported use of modern contraceptives. This is a low level of usage and, therefore, clinicians and stakeholders should sensitise HIV-infected women on the importance of contraceptive use in the fight against HIV/AIDS and encourage them to use contraceptives to avoid vertical transmission of HIV through unintended pregnancy.

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Muwanguzi, E., J. Eros Oboi, A. Nabbamba, and R. Wanyama. "Treatment outcome and associated factors for severely malnourished children (1–5 years) admitted to Lacor Hospital and Gulu Regional Referral Hospital in Uganda." Journal of Nutritional Science 10 (2021). http://dx.doi.org/10.1017/jns.2021.11.

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Abstract Globally, severe acute malnutrition (SAM) accounts for >1/3–0⋅5 of deaths in children <5 years, and approximately 54 % deaths in developing countries. The minimum international standard set for the management of SAM is a cure rate of at least 75 % and death rate <10 %. The present study was conducted to determine treatment outcome and associated factors among children 1–5 years hospitalised with SAM in Lacor and Gulu Regional Referral Hospital (GRRH) in 2017. A retrospective observational method supplemented with a qualitative inquiry was done. A total of 317 patients’ records were reviewed in either hospital; checklist data were analysed using SPSS version 16 with P-values <0⋅05 considered for statistical significance. The case fatality rate (CFR) was 12⋅6 % (GRRH) and 9⋅5 % (Lacor). The average length of stay (LOS) was 14⋅69 d (GRRH) and 14⋅10 d (Lacor). There was statistical significance between Human Immunodeficiency Virus (HIV) status, blood transfusion, type of SAM, treatment provision at admission, antibiotics, mid-upper arm circumference (MUAC), hospital category and treatment outcome. In total, ten key informants were interviewed and they reported the presence of co-infections and severity of SAM complications as having an important bearing on treatment outcome. A significant proportion of patients were discharged not cured 19⋅9 % (Lacor) v. 16⋅4 % (GRRH). The CFR in GRRH was higher than the WHO recommendation. The LOS in both hospitals was within recommended. These results provide a generalisable problem in most African hospitals and could explain the persistently high rates of SAM in Africa.

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Awor, Silvia, Benard Abola, Rosemary Byanyima, Christopher Garimoi Orach, Paul Kiondo, Dan Kabonge Kaye, Jasper Ogwal-Okeng, and Annettee Nakimuli. "Prediction of pre-eclampsia at St. Mary's hospital lacor, a low-resource setting in northern Uganda, a prospective cohort study." BMC Pregnancy and Childbirth 23, no. 1 (February 8, 2023). http://dx.doi.org/10.1186/s12884-023-05420-z.

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Abstract Background Pre-eclampsia is the second leading cause of maternal death in Uganda. However, mothers report to the hospitals late due to health care challenges. Therefore, we developed and validated the prediction models for prenatal screening for pre-eclampsia. Methods This was a prospective cohort study at St. Mary's hospital lacor in Gulu city. We included 1,004 pregnant mothers screened at 16–24 weeks (using maternal history, physical examination, uterine artery Doppler indices, and blood tests), followed up, and delivered. We built models in RStudio. Because the incidence of pre-eclampsia was low (4.3%), we generated synthetic balanced data using the ROSE (Random Over and under Sampling Examples) package in RStudio by over-sampling pre-eclampsia and under-sampling non-preeclampsia. As a result, we got 383 (48.8%) and 399 (51.2%) for pre-eclampsia and non-preeclampsia, respectively. Finally, we evaluated the actual model performance against the ROSE-derived synthetic dataset using K-fold cross-validation in RStudio. Results Maternal history of pre-eclampsia (adjusted odds ratio (aOR) = 32.75, 95% confidence intervals (CI) 6.59—182.05, p = 0.000), serum alkaline phosphatase(ALP) < 98 IU/L (aOR = 7.14, 95% CI 1.76—24.45, p = 0.003), diastolic hypertension ≥ 90 mmHg (aOR = 4.90, 95% CI 1.15—18.01, p = 0.022), bilateral end diastolic notch (aOR = 4.54, 95% CI 1.65—12.20, p = 0.003) and body mass index of ≥ 26.56 kg/m2 (aOR = 3.86, 95% CI 1.25—14.15, p = 0.027) were independent risk factors for pre-eclampsia. Maternal age ≥ 35 years (aOR = 3.88, 95% CI 0.94—15.44, p = 0.056), nulliparity (aOR = 4.25, 95% CI 1.08—20.18, p = 0.051) and white blood cell count ≥ 11,000 (aOR = 8.43, 95% CI 0.92—70.62, p = 0.050) may be risk factors for pre-eclampsia, and lymphocyte count of 800 – 4000 cells/microliter (aOR = 0.29, 95% CI 0.08—1.22, p = 0.074) may be protective against pre-eclampsia. A combination of all the above variables predicted pre-eclampsia with 77.0% accuracy, 80.4% sensitivity, 73.6% specificity, and 84.9% area under the curve (AUC). Conclusion The predictors of pre-eclampsia were maternal age ≥ 35 years, nulliparity, maternal history of pre-eclampsia, body mass index, diastolic pressure, white blood cell count, lymphocyte count, serum ALP and end-diastolic notch of the uterine arteries. This prediction model can predict pre-eclampsia in prenatal clinics with 77% accuracy.

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Alema, ON, DO Martin, and TR Okello. "Endoscopic findings in upper gastrointestinal bleeding patients at Lacor hospital, northern Uganda." African Health Sciences 12, no. 4 (February 1, 2013). http://dx.doi.org/10.4314/ahs.v12i4.19.

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Baguma, Steven, Christopher Okot, Nelson Onira Alema, Paska Apiyo, Paska Layet, Denis Acullu, Johnson Nyeko Oloya, et al. "Factors Associated With Mortality Among the COVID-19 Patients Treated at Gulu Regional Referral Hospital: A Retrospective Study." Frontiers in Public Health 10 (April 11, 2022). http://dx.doi.org/10.3389/fpubh.2022.841906.

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BackgroundThe advent of the novel coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide. As of December 2021, there is inadequate data on the outcome of hospitalized patients suffering from COVID-19 in Africa. This study aimed at identifying factors associated with hospital mortality in patients who suffered from COVID-19 at Gulu Regional Referral Hospital in Northern Uganda from March 2020 to October 2021.MethodsThis was a single-center, retrospective cohort study in patients hospitalized with confirmed SARS-CoV-2 at Gulu Regional Referral Hospital in Northern Uganda. Socio-demographic characteristics, clinical presentations, co-morbidities, duration of hospital stay, and treatments were analyzed, and factors associated with the odds of mortality were determined.ResultsOf the 664 patients treated, 661 (99.5%) were unvaccinated, 632 (95.2%) recovered and 32 (4.8%) died. Mortality was highest in diabetics 11 (34.4%), cardiovascular diseases 12 (37.5%), hypertensives 10 (31.3%), females 18 (56.3%), ≥50-year-olds 19 (59.4%), no formal education 14 (43.8%), peasant farmers 12 (37.5%) and those who presented with difficulty in breathing/shortness of breath and chest pain 32 (100.0%), oxygen saturation (SpO2) at admission <80 4 (12.5%), general body aches and pains 31 (96.9%), tiredness 30 (93.8%) and loss of speech and movements 11 (34.4%). The independent factors associated with mortality among the COVID-19 patients were females AOR = 0.220, 95%CI: 0.059–0.827; p = 0.030; Diabetes mellitus AOR = 9.014, 95%CI: 1.726–47.067; p = 0.010; Ages of 50 years and above AOR = 2.725, 95%CI: 1.187–6.258; p = 0.018; tiredness AOR = 0.059, 95%CI: 0.009–0.371; p < 0.001; general body aches and pains AOR = 0.066, 95%CI: 0.007–0.605; p = 0.020; loss of speech and movement AOR = 0.134, 95%CI: 0.270–0.660; p = 0.010 and other co-morbidities AOR = 6.860, 95%CI: 1.309–35.957; p = 0.020.ConclusionThe overall Gulu Regional Hospital mortality was 32/664 (4.8%). Older age, people with diabetics, females, other comorbidities, severe forms of the disease, and those admitted to HDU were significant risk factors associated with hospital mortality. More efforts should be made to provide “additional social protection” to the most vulnerable population to avoid preventable morbidity and mortality of COVID-19 in Northern Uganda.

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Kitara, LD, AD Anywar, D. Acullu, E. Odongo-Aginya, J. Aloyo, and M. Fendu. "Antibiotic susceptibility of Staphylococcus aureus in suppurative lesions in Lacor Hospital, Uganda." African Health Sciences 11, no. 3 (September 28, 2011). http://dx.doi.org/10.4314/ahs.v11i3.70068.

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Obol, James Henry, Reema Harrison, Sophia Lin, Mark James Obwolo, and Robyn Richmond. "Perceptions of key informants on the provision of cervical cancer prevention and control programme in Uganda: implication for cervical cancer policy." BMC Public Health 20, no. 1 (September 14, 2020). http://dx.doi.org/10.1186/s12889-020-09482-y.

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Abstract Background Uganda has one of the highest burdens of cervical cancer globally. In 2010 the Ugandan Ministry of Health launched the Strategic Plan for Cervical Cancer Prevention and Control with the hope of developing cervical cancer policy in Uganda. This study explored the beliefs of senior key informants in Uganda about cervical cancer prevention, the control programme, and the relevance of cervical cancer policy. Methods We conducted 15 key informant interviews with participants from six organisations across Northern and Central Uganda. Participants were drawn from district local government health departments, St. Mary’s Hospital Lacor, Uganda Nurses and Midwifery Council, non-governmental organisations (NGOs) and Ministry of Health in Kampala, Uganda. The interview recordings were transcribed and analysed using thematic analysis. Results Seven themes emerged relating to the cervical cancer prevention and control programmes in Uganda: (1) policy frameworks for cervical cancer, (2) operationalising cervical cancer prevention and control, (3) financial allocation and alignment, (4) human resources and capability, (5) essential supplies and vaccines, (6) administrative data and resource distribution, and (7) cervical cancer services. Conclusions The key informants perceive that the lack of a cervical cancer policy in Uganda is hindering cervical cancer prevention and control programmes. Therefore, the Ministry of Health and stakeholders need to work together in coming up with an effective policy framework that will accelerate efforts towards cervical cancer prevention and control in Uganda.

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Nyeko, Richard, Valeria Calbi, Boniface Otto Ssegujja, and Grace Flona Ayot. "Treatment outcome among children under-five years hospitalized with severe acute malnutrition in St. Mary’s hospital Lacor, Northern Uganda." BMC Nutrition 2, no. 1 (March 22, 2016). http://dx.doi.org/10.1186/s40795-016-0058-6.

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Odongo, Pancras, Ronald Wanyama, James Henry Obol, Paska Apiyo, and Pauline Byakika-Kibwika. "Impaired renal function and associated risk factors in newly diagnosed HIV-infected adults in Gulu Hospital, Northern Uganda." BMC Nephrology 16, no. 1 (March 31, 2015). http://dx.doi.org/10.1186/s12882-015-0035-3.

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Awor, Silvia, Rosemary Byanyima, Benard Abola, Paul Kiondo, Christopher Garimoi Orach, Jasper Ogwal-Okeng, Dan Kaye, and Annettee Nakimuli. "Prediction of stillbirth low resource setting in Northern Uganda." BMC Pregnancy and Childbirth 22, no. 1 (November 19, 2022). http://dx.doi.org/10.1186/s12884-022-05198-6.

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Abstract Background Women of Afro-Caribbean and Asian origin are more at risk of stillbirths. However, there are limited tools built for risk-prediction models for stillbirth within sub-Saharan Africa. Therefore, we examined the predictors for stillbirth in low resource setting in Northern Uganda. Methods Prospective cohort study at St. Mary’s hospital Lacor in Northern Uganda. Using Yamane’s 1967 formula for calculating sample size for cohort studies using finite population size, the required sample size was 379 mothers. We doubled the number (to > 758) to cater for loss to follow up, miscarriages, and clients opting out of the study during the follow-up period. Recruited 1,285 pregnant mothers at 16–24 weeks, excluded those with lethal congenital anomalies diagnosed on ultrasound. Their history, physical findings, blood tests and uterine artery Doppler indices were taken, and the mothers were encouraged to continue with routine prenatal care until the time for delivery. While in the delivery ward, they were followed up in labour until delivery by the research team. The primary outcome was stillbirth 24 + weeks with no signs of life. Built models in RStudio. Since the data was imbalanced with low stillbirth rate, used ROSE package to over-sample stillbirths and under-sample live-births to balance the data. We cross-validated the models with the ROSE-derived data using K (10)-fold cross-validation and obtained the area under curve (AUC) with accuracy, sensitivity and specificity. Results The incidence of stillbirth was 2.5%. Predictors of stillbirth were history of abortion (aOR = 3.07, 95% CI 1.11—8.05, p = 0.0243), bilateral end-diastolic notch (aOR = 3.51, 95% CI 1.13—9.92, p = 0.0209), personal history of preeclampsia (aOR = 5.18, 95% CI 0.60—30.66, p = 0.0916), and haemoglobin 9.5 – 12.1 g/dL (aOR = 0.33, 95% CI 0.11—0.93, p = 0.0375). The models’ AUC was 75.0% with 68.1% accuracy, 69.1% sensitivity and 67.1% specificity. Conclusion Risk factors for stillbirth include history of abortion and bilateral end-diastolic notch, while haemoglobin of 9.5—12.1 g/dL is protective.

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Aliku, Twalib, Andrea Beaton, Sulaiman Lubega, Alyssa Dewyer, Amy Scheel, Jenipher Kamarembo, Rose Akech, Craig Sable, and Peter Lwabi. "Profile of congenital heart disease and access to definitive care among children seen at Gulu Regional Referral Hospital in Northern Uganda: a four-year experience." Journal of Congenital Cardiology 5, no. 1 (May 24, 2021). http://dx.doi.org/10.1186/s40949-021-00064-0.

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Abstract Objectives The aim of this study was to describe the profile of Congenital Heart Disease [CHD] and access to definitive surgical or catheter-based care among children attending a regional referral hospital in Northern Uganda. Methods This was a retrospective chart review of all children aged less than 17 years attending Gulu Regional Referral Hospital Cardiac clinic from November 2013 to July 2017. Results A total of 295 children were diagnosed with CHD during the study period. The median age at initial diagnosis was 12 months [IQR: 4–48]. Females comprised 59.3% [n = 175] of cases. Diagnosis in the neonatal period accounted for only 7.5 % [n = 22] of cases. The commonest CHD seen was ventricular septal defect [VSD] in 19.7 % [n = 58] of cases, followed by atrioventricular septal defect (AVSD) in 17.3 % [n = 51] and patent ductus arteriosus (PDA) in 15.9 % [n = 47]. The commonest cyanotic CHD seen was tetralogy of Fallot [TOF] in 5.1 % [n = 15], followed by double outlet right ventricle [DORV] in 4.1 % [n = 12] and truncus arteriosus in 3.4% [n = 10]. Dextro-transposition of the great arteries [D-TGA] was seen in 1.3 % [n = 4]. At initial evaluation, 76 % [n = 224] of all CHD cases needed definitive intervention and 14 % of these children [n = 32] had accessed surgical or catheter-based therapy within 2 years of diagnosis. Three quarters of the cases who had intervention [n = 24] had definitive care at the Uganda Heart Institute (UHI), including all 12 cases who underwent catheter-based interventions. No mortalities were reported in the immediate post-operative period and in the first annual follow up in all cases who had intervention. Conclusions There is delayed diagnosis of most rural Ugandan Children with CHD and access to definitive care is severely limited. The commonest CHD seen was VSD followed by AVSD. The majority of patients who had definitive surgery or transcatheter intervention received care in Uganda.

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Ojara, Morris, Gloria Owomugisha, Isaac Staron Kibunga, Lucy Grace Asio, Ibrahim Bwaga, Thomas Nabugere, Richard Martin Tuwayenga, Eric Nzirakaindi Ikoona, and David Lagoro Kitara. "Knowledge, attitude and occupational risks to hepatitis B infection among health workers in Gulu Regional Referral Hospital, Northern Uganda: a cross-sectional study design." Pan African Medical Journal 39 (2021). http://dx.doi.org/10.11604/pamj.2021.39.138.23724.

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Olum, Sam, Jacob Eyul, Daniel Ocen Lukwiya, and Neil Scolding. "Tetanus in a rural low-income intensive care unit setting." Brain Communications 3, no. 1 (2021). http://dx.doi.org/10.1093/braincomms/fcab013.

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Abstract Tetanus is a potentially severe but preventable infection. In resource-rich settings, vaccination programmes have reduced tetanus to a rare disease, though still carrying an overall mortality of some 13%. However, in low-income settings, tetanus remains common, and is a significant cause of mortality—though major World Health Organisation programmes are successfully targeting neonatal and maternal disease. Data concerning the frequency and outcomes of non-neonatal tetanus in low-income settings are very sparse. We aimed to utilize a unique intensive care unit-based dataset to elicit clinical and demographic features and mortality in a large cohort of tetanus patients admitted over an eleven-year period to a single hospital centre in a rural low-income setting in northern Uganda. A total of 268 patients with tetanus were admitted to the Intensive Care Unit at St Mary’s Hospital, Lacor between 2005 and 2015; the records of 190 were retrievable and had sufficient information to be assessed. 29 were neonates (median age 7 days, IQR 0), 52 children (1–16yrs; median age 11 years, IQR 4.5) and 109 were adults (median age 42 years, IQR 23). There was no seasonal pattern in the frequency of admissions. Of the 190 patients, 69 had endotracheal intubation with intermitent positive pressure ventilation, and 57 patients had central line placement. The overall mortality was 51.5–72.4% in neonatal disease, 25% in children and 57.8% in adults. The requirements for neither central line insertion, nor endotracheal intubation, nor intermittent positive pressure ventilation were independently linked to mortality rates. By contrast with neonatal and childhood disease, there was a marked male preponderance in adult tetanus—94 males and 15 females (gender difference P < 0.001)—and although year-on-year breakdown suggested no obvious upward or downward trend over the span of our study in total numbers of tetanus admissions, a trend towards an increasing incidence of adult tetanus was apparent.These findings confirm that adult tetanus remains a major problem in rural low-income settings, particularly in males, and suggests that more resources should be devoted to vaccination programmes targeting men.

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Mwaka, Amos Deogratius, Seti Taremwa, Winnie Adoch, Jennifer Achan, Peruth Ainembabazi, Grace Walego, Moses Levi Ntayi, Felix Bongomin, and Charles Benstons Ibingira. "Patients’ attitudes towards involvement of medical students in their care at university teaching hospitals of three public universities in Uganda: a cross sectional study." BMC Medical Education 22, no. 1 (July 2, 2022). http://dx.doi.org/10.1186/s12909-022-03576-4.

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Abstract Background Comfort of patients with medical students is important and promotes appropriate clinical reasoning and skills development in the students. There is however limited data in this field in Uganda. In this study, we examined the attitudes and comfort of patients attending care at the medical and obstetrics/gynecology specialties in teaching hospitals of three public universities in Uganda. Methods We conducted a cross sectional study among patients attending care at teaching hospitals for three public universities; Makerere University (Mak), Mbarara University of Science and Technology (MUST), and Gulu University (GU). Logistic regression was used to determine the magnitude of associations between independent and dependent variables. Two-sided p < 0.05 was considered statistically significant. Results Eight hundred fifty-five patients participated in the study. Majority were aged 18 — 39 years (54%, n = 460), female (81%, n = 696) and married (67%, n = 567). Seventy percent (n = 599) of participants could recognize and differentiate medical students from qualified physicians, and had ever interacted with medical students (65%, n = 554) during earlier consultations. Regarding attitudes of patients towards presence of medical students during their consultations, most participants (96%; n = 818) considered involvement of medical students in patients’ care as essential ingredient of training of future doctors. Most participants prefer that medical students are trained in the tertiary public hospitals (80%; n = 683) where they attend care. Participants who were single/never married were 68% less likely to recognize and differentiate medical students (aOR = 0.32, 95%CI: 0.22 — 0.53) from other members of the healthcare team as compared with married participants. Participants with university education had 55% lower odds of being comfortable with presence of medical students during consultation compared to those with primary education (aOR = 0.45, 95%CI: 0.21 — 0.94). Participants from MUST teaching hospital had twofold higher odds of being comfortable with presence of medical students compared to participants from Mak teaching hospitals (aOR = 2.01; 95%CI: 1.20 — 3.39). Conclusion Patients are generally comfortable with medical students’ involvement in their care; they prefer to seek care in hospitals where medical students are trained so that the students may contribute to their care. Medical students need to introduce themselves appropriately so that all patients can know them as doctors in training; this will promote patients’ autonomy and informed decisions.

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Journal articles on the topic 'Lacor Hospital (Gulu, Uganda)'

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