Student's Journal of Health Research Africa
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PATTERNS OF INFECTIONS AND ANTIMICROBIAL RESISTANCE AMONG GRAM NEGATIVE ORGANISMS IN A TERTIARY CARE HOSPITAL
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Regional variation in the distribution of various organisms is noted. Monitoring the use of antimicrobials and constant review of sensitivity patterns is imperative. The main aim of this study was to determine the species prevalence of Gram-negative isolates, including antibiotic resistance patterns, from various clinical specimens.
Materials and methods
A hospital-based observational descriptive study was conducted to identify and perform an antibiotic susceptibility test of Gram-negative bacilli from clinical samples. The VITEK 2 Compact (30 card capacity) system was used, where a fluorogenic methodology for organism identification and a turbidimetric method for susceptibility testing was performed. The method used for antimicrobial susceptibility testing was the doubling dilution technique for MIC based on the microdilution method.
Results
A total of 970 clinical samples were received, of which culture positivity was seen in 391(40.3%) cases. The most common specimen was urine at 35.1% (45/128), followed by a blood sample at 27.3% (35/128). The most common isolate was Escherichia coli 36.0% (47/128), followed by Klebsiella pneumoniae 16.4% (21/128) and Burkholderia cepacia 11.7% (15/128). Among the IPD patients, Escherichia coli showed maximum sensitivity to amikacin 67.7% and gentamicin 61.2%; 55.5% of the strains of Acinetobacter baumannii were sensitive to ceftazidime. Pseudomonas aeruginosa was sensitive to cefepime, cefoperazone/sulbactam, and levofloxacin, 70.0% each respectively. 86.6% of strains of Burkholderia cepacia retained susceptibility to meropenem.
Conclusion
This study isolates (lactose-fermenting bacteria) were sensitive to trimethoprim-sulfamethoxazole, levofloxacin, and amoxicillin/clavulanic acid. On the other hand, the non-lactose-fermenting bacteria were susceptible to imipenem, meropenem, and levofloxacin.
Recommendation
Recommendations include strongly preferred alternative drugs for active or combination treatments
USING MATERNITY WAITING HOME TO PROMOTE EARLY INITIATION OF BREASTFEEDING WITH IN THE FIRST HOUR OF BIRTH IN NIMULE HOSPITAL, MAGWI COUNTY.
Get PDFBackground.
Health staff have identified problems with breastfeeding children from 0-6 months especially practicing early initiation of breastfeeding within the first hour of birth in health facilities thus making the need for establishing a Maternity Waiting Home. The aim of this writing was to assess the use maternity waiting home to promote early initiation of breastfeeding within the first hour of birth in Nimule Hospital, Magwi County.
Results.
At least 78% of mothers of Magwi County breastfed their children within the first hour of birth which was a good practice while 22% of mothers breastfed their children after one hour of birth which was not a good practice. All pregnant women who delivered in the MWH had early initiated breastfeeding within the first hour of birth for 328 newborn babies standing at 100%; Maternal outcomes were good showing that 328 live births stood at 100% and no death stood at 0.0%; Immediate neonatal outcomes have shown 327 live births stands at 99.69% with 3 stillbirths stands at 0.91%; Neonatal outcomes have shown that 325 were discharged stands at 99.08%, 1 died stands at 0.30% and some 3 were referred stands at 0.91%.
Conclusion.
Outcomes among the MWH for users had contributed to the observed differences. However, many women with high-risk pregnancies did not use MWH for early initiation of breastfeeding indicating a probable gap in awareness of usefulness, or other inability to stay due to other responsibilities at home. Otherwise, the use of MWH could have improved the maternal outcomes in Magwi County especially for early initiation of breastfeeding within the first hour of birth.
Recommendation.
There is a need to educate mothers and providers on the benefits of the MWH which is the early initiation of breastfeeding with the first hour of birth during the routine ANC
A COMPARATIVE STUDY OF THE OUTCOME OF TYMPANOPLASTY USING METHYLENE BLUE STAINED AND UNSTAINED TEMPORALIS FASCIA GRAFT: A COHORT STUDY
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An inflammatory condition that affects both the middle ear space and the mastoid air cell system, chronic suppurative otitis media causes long-term or irreversible alterations in the tympanic membrane, such as atelectasis, dimeric or monomeric formation, perforation, tympanosclerosis, the formation of a retraction pocket, or cholesteatoma.
Objectives
The study's objective was to assess and contrast the results of tympanoplasty utilizing unstained temporalis fascia graft and methylene blue stain, as well as the functional outcomes of patients based on follow-up.
Materials and Methods
It was a comparative prospective cohort research conducted at a single center. The study was carried out between 2020 and 2021, or for a total of one year. Ear, nose, and throat (ENT) research was conducted at King George's Medical University (K.G.M.U.) in Lucknow, Uttar Pradesh, India. Eighty patients in all took part in the study.
Results
The study compared tympanoplasty outcomes using unstained versus methylene blue-stained temporalis fascia grafts. Both groups showed significant improvements in air conduction and air-bone gap (p<0.001). Post-operative complaints and graft integrity were similar between the groups. Graft integrity remained intact in 87.5% (Group I) and 82.5% (Group II) cases at 3 months.
Conclusion
According to the study's findings, between the groups' pre-operative symptoms and otoscopic findings, there was no meaningful difference. Mean changes in air conduction thresholds and air-bone gap values were significantly different among the study groups.
Recommendation
It is recommended to consider both unstained and methylene blue-stained temporalis fascia grafts as effective options for tympanoplasty, with similar functional outcomes and graft integrity
FACTORS ASSOCIATED WITH HOME BASED CARE SERVICES IN THE CONTROL OF COVID-19 INFECTION IN SHEEMA MUNICIPALITY, SHEEMA DISTRICT. A RESTROSPECTIVE STUDY.
Get PDFIntroduction: Home care and home health companies offer a range of services to help people stay safe in their homes, including physical therapy, occupational therapy, nursing, personal care support, and transportation.
Objective: The study analyzed COVID-19 suspects' use of Home Based Care (HBC), identified social, demographic, economic, and environmental factors, and established policies for HBC agencies.
Methodology: A study involving 394 participants aged 10-80 with mild COVID-19 symptoms in home care examined factors related to home-based care services and COVID-19 infection control using logistic regression analyses.
Results: Of the 394 home care participants in the research, 80.2% were able to control their COVID infection. HBC-related factors were washing hands with soap and water, keeping a safe distance from coworkers, wearing masks, taking precautions, touching the mouth, nose, or eyes with dirty hands, and people who were unable to recall or found it difficult to break bad habits. Participants who used masks when they were out of the house most of the time (about 75% of the time) had a 95% lower chance of controlling their COVID-19 infection, according to the multivariate analysis (aOR=0.05; 95%CI (0.0-0.41); p=0.005). The odds of controlling a COVID-19 infection were 98% lower for participants who occasionally (about 25% of the time) used masks when they were outside (aOR=0.02; 95%CI (0.0-0.3); p=0.005) and 92% lower for participants who mainly (approximately 75% of the time) followed precautions when making purchases to prevent virus contamination.
Conclusion: Home Based Care significantly impacted COVID-19 infection control, with 80.2% of participants using services, highlighting its importance in maintaining continuity of care, especially for vulnerable individuals.
Recommendations: The study suggests that global implementation of evidence-based practice guidelines and federal policy changes can enhance preparedness for future disasters and pandemics. Uganda's Ministry of Health should strengthen these strategies, including home-based care services
“A clinical cross-sectional study on thyroid goitre: correlation of high-resolution ultrasonography and fine needle aspiration cytology with histopathological examination.”
No full textBackground:
High-resolution ultrasonography (USG) detects nodules in 19–67% of cases, with higher prevalence in women and older adults. To evaluate the clinical, pathological, and demographic characteristics of patients with thyroid goitre and to assess the correlation between clinical findings, imaging, and histopathological outcomes.
Material and methods:
This descriptive cross-sectional study was conducted from 2022 to 2024 in the Departments of General Surgery, Pathology, and Radiology, South Central Railway Hospital, Lalaguda. All consenting patients presenting with thyroid goitre were included until the target sample size of 60 was reached. Each underwent clinical evaluation, ultrasonography, fine needle aspiration cytology (FNAC), and histopathological examination.
Results:
Most participants (41.7%) were aged 40–50 years, 30% were above 50 years, and 6.7% were under 30 years. Females predominated (83.3%). An insidious onset was reported in 90% of cases. Clinically, 41.7% were asymptomatic, while difficulty in swallowing (16.7%) was the most frequent symptom, followed by palpitations (10%), weight loss (8.3%), pain (6.7%), constipation (6.7%), weight gain (5%), and voice change (5%). Thyroid swellings most frequently measured 6×4 cm (21.7%) and 4×5 cm (20%). Morphologically, 83.3% of the specimens showed a butterfly shape. TIRADS imaging classified 38.3% as TIRADS 2, 21.7% as TIRADS 3, 20.0% as TIRADS 5, 18.3% as TIRADS 4, and 1.7% as TIRADS 1. FNAC revealed 56.7% as Bethesda 2 (benign), while 33.3% showed suspicious or malignant cytology.
Conclusion:
This study underscores the importance of combining imaging and cytological evaluation for accurate diagnosis of thyroid nodules. Correlation of TIRADS, FNAC, and histopathology improves diagnostic precision, guiding timely clinical management and enhancing patient outcomes.
Recommendations:
Wider application of standardized USG-based TIRADS reporting and Bethesda cytological classification should be encouraged to reduce unnecessary surgeries. Early evaluation of thyroid swellings, particularly in high-risk groups such as women over 40, is recommended
Supervision stress: The psychological impact of poor supervision on postgraduate students - A qualitative single-case study design.
Get PDFBackgroundPostgraduate students often encounter significant academic pressures, with poor supervision emerging as a critical yet underexplored contributor to psychological distress. Inadequate supervisory support, inconsistent communication, and delayed feedback can severely hinder research progress while intensifying stress, anxiety, and burnout. Although research indicates a strong correlation between supervisory relationships and student mental health, institutional responses, particularly in resource-constrained South African universities, remain insufficient.
Methods
A qualitative single-case study design was employed at a South African public university. Data were gathered through semi-structured interviews and focus groups involving 20 participants: 12 postgraduate students, 5 academic supervisors, and 3 postgraduate program coordinators. Purposive sampling ensured participants had relevant supervisory experience. The thematic analysis focused on emotional strain, academic delays, coping mechanisms, and institutional responses.
Results
Eighty percent (80%) of students reported moderate to severe emotional stress linked to poor supervision. Common stressors included infrequent feedback, unclear research direction, and supervisor unavailability. Students frequently expressed feelings of isolation, self-doubt, and, in some cases, depression. Supervisors cited high workloads and limited training as barriers to effective supervision. Coordinators acknowledged the absence of institutional tools to track student well-being or assess supervisory effectiveness.
Conclusion
The study demonstrates that poor supervision is a significant driver of psychological distress among postgraduate students. Despite the risks, institutions often lack proactive mechanisms to support student mental health or improve supervisory practices.
Recommendations
Universities should implement compulsory supervision training that incorporates mental health awareness, communication, and conflict resolution. A centralized system for monitoring supervision quality and student well-being is essential. This should include timely feedback, accessible complaint processes, and mental health support. Regular supervisor evaluations based on student feedback are crucial to promoting accountability and enhancing postgraduate experiences
Prevalence and factors associated with extra-spousal partnerships among currently married individuals in Rakai, Uganda: A Cross-sectional study.
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While extra-marital relations have been associated with increased risk for HIV infection in previous studies, extant literature on the prevalence and factors associated with these sexual relationships remains largely limited. We assessed the prevalence and factors associated with extra-spousal partnerships among currently married individuals.
Methods
This secondary analysis uses data from a large cross-sectional study conducted among married individuals aged 15-49 years in Rakai, Uganda. We used a generic definition of marriage to include all individuals who considered themselves as “married” irrespective of category. Extra-spousal sexual partnerships were defined as concurrent sexual relationships between a married individual and another person (of the opposite sex) with whom they were not currently married. We determined the prevalence of extra-spousal partnerships and used a modified Poisson regression model to assess factors independently associated (at P<0.05) with extra-spousal partnerships, after adjusting for potential confounders. We used STATA (version 14.0) for data analysis.
Results
Of 2,103 currently married individuals, 51.5% (n=1,084) were females; 66.1% (n=1,391) were in their first marriage ever, while 83.3% (n=1,751) had been married for five or more (5+) years. Thirteen per cent (n=282) reported extra-spousal partnerships; 4.5% (n=49) among females and 22.9% (n=233) among males. Being HIV-positive, being in the third or higher marital order marriage, engagement in housework (among women), and being male were significantly associated with engaging in extra-spousal partnerships. Being 35 years or older was protective against engaging in extra-spousal partnerships.
Conclusion
One in ten currently married individuals engaged in extra-spousal partnerships. Extra-spousal partnerships were more common among men, individuals living with HIV, those with a higher number of previous marriages, and women engaged in housework than their counterparts.
Recommendations
Targeted HIV prevention interventions, including those that focus on men and previously married individuals, are urgently needed to protect married individuals from the risk of extra-spousal partnerships
Antibiogram of uropathogens from cases of urinary tract infections in a tertiary care hospital: A cross-sectional study.
Get PDFBackgroundUrinary tract infections (UTIs) are among the most common bacterial infections affecting people of all ages. The increasing prevalence of antimicrobial resistance among uropathogens presents a major clinical challenge, particularly in empirical treatment. This study aimed to identify the prevalence of uropathogens and evaluate their antibiotic susceptibility patterns in a tertiary care setting.
MethodsA cross-sectional study was conducted at a government tertiary care hospital in Guntur district, Andhra Pradesh, India. A total of 100 urine samples from patients suspected of UTIs were collected and cultured using standard microbiological techniques. Isolated bacterial pathogens were identified, and their antibiotic susceptibility profiles were determined using the Kirby-Bauer disk diffusion method. Data were recorded and analyzed using Microsoft Excel, and results were expressed in percentages and graphically represented.
ResultsOut of 100 urine samples analyzed, 34% showed significant bacteriuria. Among the 34 positive isolates, 91.2% (31/34) were Gram-negative bacteria. Escherichia coli was the most prevalent uropathogen, accounting for 48.4% (15/31) of Gram-negative isolates, followed by Klebsiella species at 22.6% (7/31). Antibiotic susceptibility testing revealed the highest sensitivity to Nitrofurantoin (79.4%, 27/34), followed by Carbapenems (64.7%, 22/34). Resistance was notably high against commonly used antibiotics such as Ampicillin and third-generation Cephalosporins.
ConclusionThe findings underscore the dominance of Gram-negative bacteria, particularly E. coli, in UTIs and the growing resistance to frequently prescribed antibiotics. Nitrofurantoin and Carbapenems demonstrated relatively high effectiveness against the isolated strains, suggesting their continued role in empirical therapy. Regular surveillance and antibiogram development are essential to guide appropriate antibiotic use and combat rising antimicrobial resistance.
RecommendationsPromote local antibiogram usage, restrict empirical antibiotic misuse, encourage stewardship programs, update treatment guidelines periodically, and educate healthcare professionals continuously
Self-esteem and its associated demographic factors among undergraduate nursing students at a tertiary institution in Southwestern Uganda: A cross-sectional study.
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Self-esteem refers to one’s positive or negative attitude towards oneself and the evaluation of one’s thoughts and feelings overall about oneself. It is a vital element in a person’s life as it affects the overall human behaviours and relationships. The level of self-esteem has an impact on the way one accepts responsibilities, their communication skills, and the way one cooperates with others, human response to stressful life events, and how to deal with positive and negative emotions.
Purpose: To assess levels of self-esteem and demographic factors associated with self-esteem levels among undergraduate nursing students of Mbarara University of Science and Technology.
Methodology
The study used a cross-sectional study design and recruited 139 students who are undergraduate nurses at Mbarara University of Science and Technology. The self-esteem of the participants was measured using the Rosenberg Self-esteem Scale (RSES), and data were analyzed using SPSS version 23.
Results
59.70% of the participants had moderate levels of self-esteem, 40.3% had low self-esteem, and no one had high self-esteem. Of all the assessed demographic factors, age, sex, year of study, program of study, marital status, sponsorship program, and religion, year of study was the only factor significantly associated with levels of self-esteem.
Conclusion
There are no undergraduate nursing students with high self-esteem at Mbarara University of Science and Technology.
Recommendations
Additional research on self-esteem and associated demographic factors ought to be done using much larger populations so as to have enough data to make adequate statistical analysis, probably a study involving nursing students from different nursing institutions all at once. A qualitative study, as well as to further describe the relation between self-esteem and associated demographic factors, is key in further understanding this concept
Improving the awareness of healthy dietary practices and non-communicable diseases among adults in Mbingo community.
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Non-communicable diseases have posed a serious health problem both in developed and LMICs. The main NCDs that are diet-related include DM, HTN, CA, CVDs hence NR-NCDs. The dietary factor has been noted with evidence to be the highest contribution to these diseases as a lot of people are relegated to consuming unhealthy diets with many dietary practices that pose health risks. This project aimed at improving the awareness of healthy nutritional practices and non-communicable diseases among adults in Mbingo Community.
Results
Conducted massive sensitization and education to all adults 18 to 65 years in the MBH community. Provided monthly education in churches, schools, social gatherings, and clinics by trained health and community workers. Training of health professionals and CHWs in behavior and attitude change towards unhealthy dietary practices among adults, Community utilization of NCD services, and Resource mobilization with leadership was done. Conducted massive screening among adults 18 to 65 years in the MBH community and referred diagnosed cases with complications to health facilities for better management and NCD clinics for better networking.
Conclusion
The NCD problem globally, in Cameroon and MBH community is a crucial issue due to increased morbidity and mortality. Several risk factors have been known to contribute to the incidence and prevalence, with unhealthy dietary risk factors being the most prominent among others.
Recommendation
The Ministry of Health should set out funds right down to regional levels for Nutrition awareness and campaign programs, and monitor its implementation to ensure that the budgeted funds are used as planned