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Deciphering Rifampicin resistance among Tuberculosis patients who have trace and indeterminate results on Xpert MTB/RIF ultra assay
No full textA dissertation submitted to the department of Immunology and Molecular Biology in partial fulfilment of the requirements for the award of a degree of master of science in Immunology and Clinical Microbiology of Makerere UniversityAlthough WHO endorsed the GeneXpert test as the first initial test for Tuberculosis diagnosis, some of the GeneXpert Ultra results include MTB detected trace, RIF resistance indeterminate which necessitates a sample rerun, increasing the time necessary for treatment initiation. This study aimed to decipher Rifampicin resistance among tuberculosis patients who have trace and indeterminate results. 403 Sample results with MTB detected and Rifampicinn resistance indeterminate on Xpert MTB/RIF Ultra assay stored at the Mycobacteriology BSL-3 Laboratory from 2018 to 2023 were retrieved, thawed, sub-cultured using BACTECTM MGITTM960 System and subjected to a first line Drug susceptibility test, first line Line-Probe assay and a repeat GeneXpert to decipher Rifampicin resistance. Results: 403 sample results were retrieved from the database of which 31 (7.7%) were MGIT culture positive and 372 (92.3%) were culture negative. Of the 31 culture-positive isolates, 24/31 (77.4%) were confirmed MTBc positive, with sputum samples being the predominant sample type (87.5%) followed by stool samples at 4.7% and nasal swabs at 2.7%. Notably, 4/24 (16.7%) of samples turning MGIT culture positive were baseline samples. Of the 24 MTBc positive isolates, 19 stored isolates were successfully found and retested, revealing a complex pattern with no detected rifampicin resistance. The prevalence of rifampicin resistance was determined as nil based on phenotypic DST. No mutations were detected among cases with rifampicin resistance indeterminate results, and only one mutation related to isoniazid (INH) resistance was identified using LPA. Our study revealed no missed rifampicin resistance among patients with GeneXpert ultra-trace and rifampicin indeterminate results with both first line DST and LPA
Prevalence and factors associated with probable anxiety disorders among elderly persons living with HIV at Mulago ISS clinic. A cross-sectional study
No full textA research dissertation submitted to the School of Medicine, Clinical Epidemiology Unit in partial fulfillment of the requirements for the award of Masters of Science in Clinical Epidemiology and Biostatistics of Makerere UniversityIntroduction:
HIV/AIDS is a major public health issue globally. Due to advancements in ART therapy, more people with HIV are living longer with about 1.4 million infected people in Uganda. Anxiety disorders are often unrecognized and undetected in older persons living with HIV(PLHIV) yet they impair an elderly person’s physical health, and decrease the ability to perform daily activities.
Objective
To determine the prevalence and factors associated with anxiety disorders among elderly PLHIV at Mulago ISS clinic.
Methods:
A cross-sectional study was conducted at Mulago ISS-clinic among 273 systematically selected participants living with HIV/AIDS on antiretroviral therapy for at least 6 months between April and May 2024. Interviews were conducted using the GAD-7 screening tool to help identify individuals who may be at risk for anxiety disorders and structured questionnaires for socio-demographics, and psychological factors. Drug and clinical factors data were extracted from records and entered into EpiData and later to STATA version 14 for analysis. Prevalence was reported as a percentage and modified poisson regression analysis was used to determine the factors associated with anxiety disorders
Results:
The prevalence of probable anxiety disorders was 16.8%(95% CI 12.5-21.6). Employment status (aPR- 2.113, 95% CI 1.252-3.567), family history of mental health disorder (aPR-2.041, 95% CI 1.228-3.394), stigma (aPR-2.564, 95% CI 1.544-4.257) and family support (aPR-2.169, 95% CI 1.272-3.699) were significantly associated with having probable anxiety disorders.
Conclusion:
One in every six elderly persons living with HIV may have a probable anxiety disorder. Being unemployed, having a family history of mental health disorders, having stigma and having inadequate family support were significantly associated with having a probable anxiety disorder. Healthcare workers should provide comprehensive anxiety screening and patient-centered care for elderly persons with HIV, while the government develops financial empowerment strategies, supports mental health through family groups, and public campaigns to reduce HIV stigma and educate families on effective support
Peace support operations: challenges and prospects for Uganda Police Force
No full textA dissertation submitted in partial fulfillment of the requirements for the award of the Degree Of Master of Arts in Peace and Conflict Studies of Makerere UniversityUganda's contributions to peacekeeping operations during the past 20 years have primarily taken the shape of military officers, police, prison officials, and civilian experts who have been sent on missions since mid-2004, 52 of the 61 Ugandans serving in UN peacekeeping operations right now are police (R Gowan, M Gleason 2012). This dissertation aimed to explore the challenges and prospects faced by the Uganda Police Force in peace support operations. The following objectives guided the study, to evaluate the peace support activities carried out by UPF, to examine the challenges UPF faces during peace support operations, and to suggest more suitable measures for enhancing UPF‘s peace support operations. The study was conducted using a qualitative approach employing a single case research design with a study population of 61 respondents. Data was collected through interviews, analysis of existing reports, and Focus Group Discussions. The findings revealed that the Uganda Police Force has participated in different peace support operations and has registered both successes and failures. The failures are due to several challenges such as insufficient funding, logistical inadequacies, security threats and terrorism, inadequate police personnel, poor infrastructure, language and cultural barriers, corruption and misconduct, and gender inequality. However, the study also identified several prospects for the Uganda Police Force in their peace support operations, including financial reforms, silencing the guns, political and practical re-assurances, change of conflict landscape, establishment of a track record by the UN and AU, technological advancements and gender equality training. The study concludes with recommendations for the Uganda Police Force on how to address the challenges and maximize the prospects for successful peace support operations
Antisocial behaviours, peer influence and depression among school going adolescents In Lubaga Division, Kampala
No full textA research dissertation submitted to the School of Psychology in partial fulfillment of the requirements for the award of a Master of Science in Clinical Psychology Degree of Makerere UniversityThe purpose of the study was to investigate the relationship between antisocial behaviours, peer influence and depression among school-going adolescents. Adolescence is a developmental stage characterized by many challenges including anti-social behaviours like fighting with colleagues at school, negative peer influence, as well as psychological challenges and consequences such as depression. Despite the growing concerns there is paucity of evidence in the Ugandan context about the linkage between, antisocial behaviours peer influence and depression among school-going adolescents. To explore this relationship, the study employed a quantitative study whilst using a correlational research design. A total of 130 respondents were selected from one secondary school in Kampala district using purposive sampling technique. Data was analyzed using SPSS version 23. Results revealed a significant relationship between antisocial behaviours and depression among school-going adolescents (r (128) = -.27, p =.002.), a significant relationship was found between depression and peer influence (r(128) = -.21, p = .015), and there was a significant relationship between peer influence and antisocial behaviour (r(128) = -.21, p <.001). Peer influence was also found to mediate the relationship between antisocial behaviour and depression among school-going adolescents (b = -.148, SE = .065, 95% CI = .34, .053). Based on these findings, it is recommended that schools and policymakers develop interventions to address depression and promote positive peer influence, with emphasis on encouraging pro-social behaviours. Educational institutions could also implement mental health programs to reduce depression symptoms and mitigate the risk of antisocial behaviour in adolescent
Analyze the effectiveness of inventory management among pharmaceutical businesses in Uganda: a case of Ecopharm Uganda Limited
No full textA research report submitted to the School of Business, College of Business and Management sciences in partial fulfillment for the requirements for the award of Master of Business Administration Degree of Makerere UniversityThe study examined the effectiveness of inventory management among pharmaceutical businesses in Uganda in reference to Ecopharm Uganda limited. It was premised on three objectives which include; to identify the techniques of inventory management being used by Ecopharm to manage inventory, to evaluate the Challenges faced by Ecopharm in using inventory management techniques and to examine strategies to improve inventory management at Ecopharm Uganda. To achieve these objectives, the study employed a cross-sectional and descriptive research Design with a quantitative approach that entailed the collection of numerical data from 91 Ecopharm staff, selected from a sample of 132 staff among its branches in Kampala. Data was analysed using the statistical package for social science (SSPS Version 27). The study Ecopharm employs various inventory management techniques, with automated inventory systems rated highest at mean = 4.53 and SD = 0.689, reflecting strong confidence in their real-time monitoring capabilities. The Just-in-Time (JIT) technique received mixed feedback (mean = 3.67, SD = 1.221), while ABC analysis was positively viewed (mean = 3.85, SD = 1.021). The ERP system showed moderate agreement (mean = 3.37, SD = 1.404), indicating a need for further training, and regular audits were deemed essential (mean = 3.71, SD = 1.655). Key challenges include frequent stockouts (mean = 3.84, SD = 1.522), difficulties in demand forecasting (mean = 3.68, SD = 1.281), and poor integration with supply chain partners (mean = 3.56, SD = 1.352). To improve inventory management, respondents support strengthening supplier relationships (mean = 4.21, SD = 1.278), implementing advanced forecasting tools (mean = 3.96, SD = 1.192), and enhancing staff training (mean = 4.09, SD = 1.170), along with utilizing data analytics (mean = 4.00, SD = 1.085) and conducting regular audits (mean = 3.95, SD = 1.089). The study recommends that Ecopharm invest in automated inventory systems to ensure effective real-time stock monitoring and optimize inventory management practices. Given the mixed opinions on the Just-in-Time (JIT) technique, the organization should provide further training and support to maximize its benefits. Additionally, improving demand forecasting is crucial, and investing in advanced forecasting tools will enhance Ecopharm's ability to predict patient needs, leading to better stock management and increased customer satisfaction. Strengthening relationships with suppliers and improving integration with supply chain partners are also essential to mitigate stockouts and replenishment delays, ultimately enhancing overall operational efficiency
Measurement of production rates for manual trenching on construction projects
No full textA project report submitted to the Directorate of Research and Graduate Training in partial fulfillment of the requirements for the award of the Master of Science in Construction Management of Makerere University.Trenches, a preliminary activity in construction for foundations, road drainage and laying
utilities in most developing countries, particularly Uganda is done manually using tools such
as hoes, pick axes, and spades. Production rates for various manual trenching techniques are
essential for effective planning before commencement, however, there is still a lack of proper
benchmarks. In response to this, a field measurement study was conducted with the main aim
of finding factors affecting production rates for manual trench excavation in construction work
and developing a simulation model to compute overall production rates.
The study implemented factor analysis using Principal Component Analysis to develop a
relative importance ranking of factor relevance using Minitab and provides a benchmark
production rate for excavating trenches generated using Monte Carlo Simulation run in
Wolfram Mathematica. PCA-factor analysis revealed three principal factors significantly
affecting production rates: crew configuration, as the most significant, followed by weather
conditions, and ground type with Euclidean distances of 0.845, 0.750, and 0.689 respectively.
The less significant factors were soil type at the fourth position followed by the horizontal
alignment, and the longitudinal slope category with Euclidean distances of 0.682, 0.626, and
0.624. The findings emphasize the importance of considering these factors to perfect manual
trenching operations. The highest average production rate of 0.860 m3/hour/person was
achieved by a 2-man crew under straight-flat alignment, with soft sandy-clay soils and a skilled
crew. On the other hand, the lowest average production rate of 0.447 m3/hour/Person was seen
for a crew working under straight-steep alignment, with hard gravel soils and dry weather
conditions. The results from the Monte Carlo simulation identified the most probable
production rate as 0.738 m3/hr/Person, with a standard deviation of 0.032 m3/hr/Person,
kurtosis of 2.983 m3/hr/Person, and skewness of 0.379 m3/hr/Person. This study contributes
to improving trenching processes, resource allocation, and decision-making in construction
projects. On the business perspective, production rates are a key performance indicator and
tracking them enables the business owners to analyse their performances, establish targets
while setting standards for success and identifying areas of improvement
Social-psychological determinants of perceived transfer of hard and soft agricultural skills training among smallholder farmers of Central Uganda
No full textA thesis submitted to the Directorate of Research and Graduate Training in partial fulfillment of the requirements for the award of the degree of Doctor of Philosophy in Agricultural and Rural Innovation of Makerere UniversityFarmer training is a key strategy for developing skills that contribute to increased productivity
in the fields of small-scale farmers. Remarkably, the realization of training benefits depends
on farmers applying the training to their fields. However, the factors that determine the
subsequent perceived transfer of training, including those with mediating effects, are not
known. It remains unclear how different factors in the training transfer system interact to
subsequently influence the application of acquired knowledge and skills among smallholder
farmers. This study examined the influence of socio-psychological factors on the perceived
training transfer of agricultural skills training among smallholder farmers in central Uganda.
Specifically, the study aimed to determine: 1) the influence of contextual factors on transfer
system factors; 2) the mediating effects of perceived content validity in the relationship
between perceived trainee motivation and perceived training transfer; 3) the mediating effects
of perceived transfer design in the relationship between farmers' perceived work setting and
perceived training transfer; and 4) whether the predictors of perceived training transfer of soft
and hard skills differed when the skills were offered by the same training organization. A crosssectional study was conducted among 603 randomly selected smallholder farmers one month
after they received agricultural training from two selected NGOs (CARITAS and CEDO)
operating in Rakai, Lyantonde, and Luweero districts. Linear regression results showed that
both situational and demographic variables significantly influenced perceived motivation to
transfer (R2 = .15, p≤.001), Perceived content validity (R2 = .22, p ≤ .001), and perceived
extension worker support (R2 = .33, p ≤ .001). For objective two, perceived intrinsic motivation
directly influenced perceived training transfer (β = 0.246; t = 2.991; P < .05), and its influence
was partially mediated by perceived content validity (β = 0.325; t = 2.693; P < .05). For
objective three, the results show that perceived household resources and support directly
influenced perceived training transfer while perceived extension worker support did not.
Furthermore, perceived transfer design mediated the influence of the two work environment
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factors (perceived household resources and support and perceived extension worker support)
on the perceived training transfer of agricultural skills training. For objective four results
showed that irrespective of the organization conducting the training, the perceived transfer of
either soft or hard skills training was enhanced by trainees’ perceived intrinsic and extrinsic
motivation as well as the expectation of household resources and support from household
members. This study has demonstrated the influence of social-psychological factors on
perceived training transfer, beyond the traditional direct predictors. It is therefore,
recommended to pay particular to both the direct and mediating factors for optimal training
transfer of agricultural training
Prevalence and factors associated with generalized anxiety disorder in healthcare workers at China-Uganda Friendship Hospital Naguru and Kiruddu National Referral Hospital
No full textA research dissertation submitted in partial fulfillment of the requirement for the award of the Degree in Master of Medicine in Psychiatry of Makerere University.Background: Generalized anxiety disorder is common in health workers and is associated with
reduced productivity at the work place as the patients are usually restless and, on the edge, irritable with difficulty in concentrating. They also usually have sleep problems and this further affects their quality of work. For the healthcare workers (HCWs) whose work usually requires a high level of attention and concentration this can be challenging and often results in poor quality of services provided. However, the majority of literature on generalized anxiety in health workers is not from low resource settings which may have different drivers of the illness. More studies in health care workers from sub-Saharan Africa including Uganda are required to inform appropriate policy formulation. Objectives: The aim of this study was to determine the prevalence and factors associated with generalized anxiety disorder in health care workers at China Uganda Friendship Hospital Naguru (CUFH-N) and Kiruddu National Referral Hospital (KNRH) Methods: This was a cross-sectional study in which data was collected from 288 health care workers over a period of six weeks. We recruited health care workers who were above 18 years of age. Probability proportionate to size sampling method selected the number of participants to recruit per cadre of the HCWs in CUFH-N and Kiruddu NRH. Consecutive sampling then selected the participants to be recruited. After obtaining informed consent, the module for generalized anxiety disorder from the MINI 7.0.2 was used to diagnose GAD. Data on socio-demographics, coping skills, perceived stress and occupational stress were collected using a socio-demographic questionnaire, the Brief-COPE inventory by Carver, perceived stress scale by Sheldon Cohen and work stress questionnaire by Holmgren respectively. Descriptive statistics estimated the prevalence of GAD while factors associated with GAD were analyzed using multivariable logistic regression. Results The prevalence of generalized anxiety disorder was 9.03% among health care workers at the China Uganda Friendship Hospital, Naguru and Kiruddu National Referral hospital. 64.2% of the participants were female. 56.3% were nurses. The factors associated with generalized anxiety disorder were a positive family history of mental illness (AOR 3.03[95% CI: 1.28; 7.14]; p-11
value= 0.011), perceived stress per unit increase (AOR 1.16 [95% CI: 1.06; 1.26]; p=0.001), avoidant coping (AOR 1.27 [95% CI: 1.13; 1.43]; p-value=< 0.001), occupational stress due to individual demands and commitment (AOR 1.20 [95% CI: 1.09; 1.31]; p=< 0.001) and work to leisure time interference(AOR 1.25 [95% CI: 1.06; 1.48];p=0.007). Conclusion The results indicate a high prevalence of generalized anxiety disorder in health care workers at the China Uganda Friendship hospital, Naguru and Kiruddu national referral hospital. Health care workers with higher levels of perceived stress per unit increase, poor coping, work stress and with longer years of employment have an increased likelihood of developing generalized anxiety disorder. These findings call for health promotion interventions specially designed for health workers to regularly screen for stress and anxiety symptoms
An investigation on the effect of improved production systems on the yield of common beans among small scale farmers in Uganda
No full textA dissertation submitted to the directorate of graduate research training in partial fulfilment of the requirements for the award of a Degree of Master of Statistics of Makerere UniversityCommon beans are vital for food security and livelihoods of Ugandan small-scale farmers. However, the effect of improved production systems on the yield of common beans remains under studied. This study, therefore aimed to investigate the effect of improved production systems on the yield of common beans among small scale farmers in Uganda. Data was analyzed from 4,386 Ugandan common bean farmers collected through the Uganda National Panel Surveys (UNPS) in 2015/16, 2018/19, and 2019/20. Descriptive statistics characterized the farmers, and Pearson rank correlation identified potential factors influencing the yield of common beans. Finally, a random effects linear regression model was fitted to examine the effect of improved production systems on the yield of common beans among small scale farmers in Uganda at a 5% level of significance. The overall average yield of common beans was approximately 926 kgs/acre with a 95% CI of (909.34, 941.72). In 2015/2016, the average yield was 939 kgs/acre, 904 kgs/acre in 2018/2019, and 934 kgs/acre in 2019/2020. A random effects linear regression model identified significant positive associations between yield of common beans and the application rates of organic fertilizer used (kgs/acre) (Coeff = 0.002, 95% CI: 0.001, 0.031), application rates of inorganic fertilizer used (kgs/acre) (Coeff = 0.003; 95% CI: 0.001, 0.025), farmer’s age (Coeff = 0.004; 95% CI: 0.003, 0.017), farmers’ education status specifically educated (Coeff = 0.098; 95% CI: 0.009, 0.187), and crop area (acres) (Coeff = 0.010; 95% CI: 0.008, 0.012). Conversely, farmers from the Eastern (Coeff = -0.281; 95% CI: -0.400, -0.161), Northern (Coeff = -1.235; 95% CI: -1.365, -1.105), and Western regions of Uganda (Coeff = -1.679; 95% CI: -1.763, -1.595) had significantly lower yields compared to those in the Central region. The results indicate that the productivity of common beans in Uganda has improved but remains low. These findings suggest that promoting organic or inorganic fertilizer use, increasing land allocation for beans, and potentially tailoring extension services based on farmer experience could be effective strategies to improve overall bean production in Uganda. Additionally, tailoring interventions and support programs to address specific regional challenges faced by these farmers may lead to more sustainable agricultural practices that will improve the yields of common beans
Trauma exposure, resilience, posttraumatic stress disorder and posttraumatic growth among Refugees in Kyaka II Settlement in Uganda
No full textA research dissertation submitted to Makerere University College of Humanities and Social Sciences, School of Psychology, Department of Mental Health and Community Psychology in partial fulfillment of the requirement for the award of the Degree of Master of Science in Clinical Psychology of Makerere University.Refugees experience or witness various traumatic events and these events can have a negative impact on their wellbeing. Whereas some refugees may go on to experience positive outcomes and become more resilient after being exposed to traumatic events, some suffer post trauma challenges such as PTSD. The aim of this study was to determine the relationship between trauma exposure, resilience, posttraumatic stress disorder and posttraumatic growth among refugees in Kyaka II settlement in Uganda. A cross sectional study, correlational in nature was conducted with 181 participants including 100 females. The questionnaires were researcher administered and data were analyzed using SPSS. Pearson correlation was used for relationships and process macro for mediation. A positive significant relationship between trauma exposure and PTSD (r= 0.446, p<0.01); resilience and PTG (r= 0.748, p<0.01); negative significant relationship between trauma exposure and resilience (r= -0.360, p<0.01) and also between resilience and PTSD (r= -0.675, p<0.01) were observed and Resilience was found to mediate the relationship between trauma exposure and PTSD (B = 0.43, 95% CI: [0.27, 0.62]). In conclusion I noted that PTSD and PTG coexist, I also observed that the most common type of traumatic event that the participants reported was physical injury (74%), that majority of the refugees (99.1%) having lived in the host country for a long period of time (1-20 years and the study focused on addressing factors targeting building resilience, PTG and addressing PTSD. Refugees would benefit from comprehensive community mental health services and post-trauma interventions focusing on resilience and post-traumatic growth