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p53 protein expression in epithelial ovarian cancer and it is association with clinicopathological features as seen in selected histopathology laboratories in Kampala
No full textBackground: Globally, cancer of the ovary is the 7th most frequently diagnosed among women. The majority of the women in low- and middle-income countries (LMICs) are diagnosed at a late stage that is untreatable leading to high levels of mortality. Epithelial ovarian cancer represents that vast majority of ovarian cancer worldwide. Altered expression of p53 proteins have been linked to mutation in the p53 gene and increases a woman’s risk of developing ovarian cancer. The altered expression of p53 have prognostic implications.
Objectives: To determine the expression of p53 protein in epithelial ovarian cancer and associated clinicopathologic features as seen in selected laboratories in Kampala.
Material and Methods: A cross-sectional laboratory study was conducted at Makerere University's College of Health Sciences' Pathology department. Using records of paraffin embedded tissue blocks of patients histologically diagnosed with ovarian cancer at Department of Pathology, Makerere University, Mulago National Referral Hospital, Department of Pathology; Uganda Cancer Institute and Multisystem Clinical Laboratory. Tissue blocks and clinicopathologic information were obtained from the archives and records. Serial sections were cut from tissues and stained with H&E for histological confirmation followed by immunohistochemistry using a mouse derived monoclonal antibody p53. Data was entered and analysed using SPSS and presented in form of tables, graph, and pi-charts.
Results: Data of 104 formalin fixed paraffin embedded tissue blocks histologically diagnosed with EOC were analyzed. The mean age of patients were 49 (SD±13) years. The majority of the patients 93 (89.4%) had serous ovarian carcinoma histological type. Well differentiated EOC constituted majority of the samples (33.7. %) followed by poorly differentiated (31.7%) and moderately differentiated histological grade (26.9). The prevalence of p53 protein expression was 68.3% (71/104). There was no association between p53 expression and the age, histology type and histology grade of epithelial ovarian cancer.
Conclusion: The present study showed that 68.3% of the specimens were positive for p53 expression in epithelial ovarian cancer as seen in selected histopathology laboratories in kampala.p53 expression was not significantly associated with age, histological subtype or tumour grade
Prevalence, factors associated and coping mechanisms of low self-esteem among adolescents with sickle cell disease attending Mulago National Referral Hospital Sickle Cell Clinic
No full textA dissertation submitted to the directorate of Research and Graduate Training in partial fulfilment for the award of a Master of Medicine Degree in Paediatrics and Child Health of Makerere University.Background: Sickle Cell Disease (SCD) is a chronic genetic disorder affecting about 112 per 100,000 live births globally, with adolescents being a vulnerable population. Beyond the physical symptoms, SCD has a profound impact on an adolescent’s mental health due to increased morbidity. Learning positive coping strategies is crucial in SCD management as it reduces depression and strengthens family bonding. However, there is limited information about low self-esteem among adolescents with SCD in Uganda. Objective: To determine the prevalence, factors associated, and coping mechanisms of low self-esteem among adolescents with SCD attending the Sickle Cell Clinic (SCC) at Mulago National Referral Hospital (MNRH). Methods: This was a sequentially explanatory mixed methods study conducted at the SCC of MNRH, between January 2024 and March 2024. 356 adolescents were enrolled, and quantitative data on prevalence and factors associated with low self-esteem was assessed using Rosenberg self-esteem (RSE) and interviewer-administered questionnaires. Qualitative data on coping mechanisms was collected from nine adolescents (five with normal and four with low self-esteem) using in-depth interviews and three key informant interviews among health workers. Results: The prevalence of LSE was 21.6% (95% CI 17.6-26.3%), with low school absenteeism (PR 0.94, p=0.012), increased physical activity (PR 0.94, p=0.005) and limited social involvement (PR 1.16, p=0.014) as associated factors to LSE. Coping mechanisms were; medication adherence, eating healthy with drinking plenty of water, engaging in social activities and hobbies, praying, and awareness of their peers with SCD. Conclusion: Adolescents with SCD are at risk of developing low self-esteem. Thus, healthcare providers, parents, and teachers should encourage and support adolescents with SCD to engage in safe and manageable physical and social activities and promote experiences of success and positive peer relations which are important sources of self-esteem.HEPI-SSHU project,
Fogarty International Centre of the National Institutes of Health,
U.S Department of State’s Office of the U.S Global AIDS Coordinator and Health Diplomacy
(S/GAC),
Presidents' Emergency Plan for AIDS Relief (PEPFAR) under award number
1R25TW011213
Prevalence and factors associated with treatment abandonment among children undergoing cancer therapy at Uganda Cancer Institute.
No full textA research report for partial fulfillment of the requirements for the Award of the Degree of Master of Medicine in Pediatrics and Child Health of Makerere University.Background: Treatment abandonment (TA) is a major contributor to treatment failure and poor treatment outcomes for children with cancer in low and middle-income countries (LMICs). However, there is limited literature on the prevalence of TA in these countries. Study objective: To assess the prevalence and factors associated with treatment abandonment among children aged 1-17 years undergoing cancer therapy at Uganda Cancer Institute. Methods: Explanatory sequential two-phase design study was conducted. Quantitative methods were a retrospective cross-sectional study of 352 children 1-17 years diagnosed with cancer at the Uganda Cancer Institute between June 2023 and August 2023, the qualitative methods were in-depth interviews with 12 caregivers, and 8 key informant interviews with staff at UCI. Quantitative data was analysed using STATA version 15.0, and qualitative data was manually analysed using inductive thematic analysis Results: Of the 335 (58.2% males) patients recruited, 79.4% have 0-5 siblings, 71.3% were attended to by peasant caregivers, and 63.9% were cared for by biological parents. The prevalence of TA was 191/335 (57%). Children from a family of at least 6 siblings increased the risk of TA by 10% compared to children with 0 to 5 siblings (APOR=1.1, 95% CI: 1.1–1.2). Children who had peasant attendants had a 9% chance of experiencing treatment abandonment more than those with other occupations (APOR=1.09, 95%CI: 1.01-1.18). Coming from Northern Uganda increased the risk of TA by 15% compared to being in the Central region (APOR=1.15, 95% CI: 1.05–1.26). Key informants agree that TA is indeed a major problem among child patients on treatment at the UCI. Both caregivers, and key informants highlighted long distances from the health facility, large family size, financial constraints, treatment side effects, community influence, and alternative medicine as the main reasons for TA.Conclusion: Treatment abandonment is a major problem among children undergoing cancer therapy at the UCI. The study identified long distances from health facility (UCI), large family size characterised by many children and extended family, and financial constraints as the key factors associated with TA. Operationalization of regional centres and psychosocial support can help reduce the rate of TA
Prevalence and factors associated with malnutrition among head and neck cancer patients at the Uganda Cancer Institute Mulago
No full textDissertation submitted in partial fulfillment of the requirements for the Award of the Degree of Master of Medicine in Ear, Nose and Throat of Makerere University.Background: Undernutrition is a major source of morbidity and mortality in cancer patients. These patients are susceptible to nutritional depletion due to the physical and metabolic effects of cancer, as well as anticancer therapies. Malnutrition has been known to be associated with poor prognosis in cancer patients and its presence can limit patient response to anti-cancer treatment therapies (chemotherapy, chemo-radiation, surgery). However, there is limited data regarding the magnitude and predictors of malnutrition among patients with HNC in Uganda.Objective: To assess the prevalence of malnutrition and the contributing factors among HNC patients at Uganda Cancer Institute, Mulago. Methodology: A cross-sectional study was conducted at the Uganda Cancer Institute during the HNTB over a period of 6 months. Consecutive sampling was employed where all new patients with HNC were enrolled as they arrived at the HNC tumor board. 154 patients above 18 years who had a histological diagnosis of HNC and provided informed consent were selected and recruited into the study. Structured questionnaires were administered and Anthropometry measurements were taken and recorded in the structured questionnaires. Results: 154 HNC patients with a median age of 50 years were recruited in our study. The sex distribution showed a male predominance of 63%. Most participants had oral cavity tumours (29.9%). The prevalence of malnutrition was 32.5% using a BMI of <18.5kg/m2 and 39.6% using Serum Albumin <35g/l. Stage IV disease was the most significant factor affecting the nutritional status of HNC patients P=0.002 with serum albumin as the assessment method and a P=0.03 with BMI as the assessment tool. Conclusion: Using both methods, the prevalence of malnutrition was high with each assessment tool though higher with albumin than BMI. The tumour stage emerged as the most significant factor. It is important to identify and address factors that contribute to malnutrition in HNC patients to reduce morbidity and mortality
Priority index for road maintenance interventions of greater Kampala metropolitan area based on rout choice.
No full textA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfillment of the requirements for the award of the degree of Master of Science in Civil Engineering of Makerere University.Road infrastructure requires timely maintenance interventions to serve through its design life.
Literature indicates that natural and artificial phenomena like adverse weather negatively
impact roads resulting into permanent deformation and as such, institutions around the world
deploy different maintenance methodologies to improve resilience using different forms of
priority indices like AHP and Fuzzy Logic technique. The study discusses the limitations of
AHP and Fuzzy Logic technique while proposing the use of CCTV camera data to generate a
priority index based on user route choices. Using simple random sampling technique, roads
within GKMA with different traffic counts within a period of seven months were selected and
a route choice model was used to predict user route preferences. Pavement visual condition
analysis was also undertaken. Results revealed that roads with higher vehicular traffic volume
exhibit more extreme level of damage, consequently increase travel time and affect travel
speeds. The projected growth of traffic demand by 29.52% highlights the escalating
challenges faced by the transportation network in the GKMA. This growth underscores the
necessity for proactive planning and infrastructure development to accommodate the
increasing demand while considering the revealed preferences of commuters. The results
provided valuable insights for policymakers and urban planners by revealing the trade-offs
individuals make when choosing routes, the factors that induce indifference, and the
homogeneity of preferences within the studied population. The study provides evidence that a
maintenance specific priority index that is based on route choice will aid policy makers and
engineers to make decisions on criteria selection for road maintenance and also predict future
traffic volumes on roads to guide transport system improvements and traffic police
deployment decisions on point of traffic congestion. Route choice analysis gives valuable
insights on decision making patterns and preferences of users in aggregate context. This is
important in making decisions on allocation of resources to maintain the transport network
operating at high serviceabilit
The horizon of knowledge: embracing the non-linearity of human understanding
No full textBookThe Horizon of Knowledge: Embracing the Non-Linearity of Human Understanding by Isaac Christopher Lubogo is a profound intellectual exploration that challenges the conventional paradigms of knowledge acquisition and comprehension. This book delves into the intricacies of human cognition, arguing that our understanding of the world is not a linear progression but a complex, interwoven web of experiences, insights, and interpretations. Lubogo critiques the traditional models of education and thought that prioritize straightforward, linear learning paths, revealing how these systems often fail to capture the true essence of human understanding. Through an interdisciplinary approach that spans philosophy, science, psychology, and education, the book illuminates the nonlinear nature of knowledge, drawing on concepts from quantum mechanics to complexity theory to illustrate how our minds engage with the world. Lubogo's work is a call to embrace the uncertainty and complexity inherent in the pursuit of knowledge, advocating for a shift in how we educate, think, and engage with the world. By challenging readers to reconsider the foundations of their understanding, The Horizon of Knowledge offers a transformative perspective on the nature of learning and the human experience. This book is not merely an academic treatise but a philosophical invitation to expand the boundaries of thought and to accept the nonlinear, often unpredictable journey that true understanding requires
Determination of Anti-HBsAg antibody titers among children under five years who received Hepatitis B vaccine under UNEPI in Kawempe Division, Kampala-Uganda
No full textA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfillment of the requirements for Award of the Degree of Masters of Science in Immunology and Clinical Microbiology of Makerere University.Background: Hepatitis B Virus is a global health threat with estimated 257 million people chronically infected with the infection (WHO 2017). HBsAg sero prevalence is approximately 3.6% with high endemicity observed in African population. In Uganda, the national prevalence is 10% and the Ministry of health integrated childhood Hepatitis B vaccination on the Uganda National Extended Programme on Immunization since 2002 to reduce on high morbidity and mortality rates in the country. The prevalence of immunological non responsiveness of HBV in children under 5years have not been indicated in Uganda. Objective: The objectives of the study were to determine the levels of Hepatitis B vaccine specific anti-HBs antibodies in children under 5years of age as well as prevalence of acute, chronic and resolved HBV exposure, Obtain the prevalence of non-response to HBV Vaccine in under 5year old childhood recipients. Method: The study was cross-sectional nested in a parent study titled “Childhood responses to Hepatitis B Vaccine in Uganda; The role of Human Leukocyte Antigen (HLA) and T-cell Receptor (TCR) diversity. We aimed at using 501 archived serum samples from vaccine recipients under 5years of age at CFU Medical Centre in Kawempe division. Archived serum samples from the parent study were thawed and Combo test was performed on all for detection of antigens and Antibodies thus, HBsAg, HBeAg and HBcAb in serum prevalence of exposure of HBV infection will be obtained. Antibodies titers were performed by Roche COBAS e-411. Results: Majority of the study participants were combo HBV susceptible 65.5%, participants that had detectable Hepatitis B Antibodies and the responders were (95.9%) with moderate levels of response 48.8% and non-responders of 4.1%. Acute infection was 1.6% with lowest 0.2% chronic. Conclusion: The study revealed that 65.5% of the study participants were not vaccine protected and those with HBV vaccine protection were 95.9% that were recorded as responders.4.1% non-response rate was recorded and 1.6% of the participants had acute infection. Recommendations Public Health intervention should be done by Ministry of Health-Uganda to evaluate UNEPI Hepatitis B Vaccination programme with the essence of improving efficacy and potency of HBV Vaccine
Magnetic resonance imaging findings and associated factors among young adults with knee pain at three radiology centres in Uganda
No full textA dissertation submitted to the College of Health Sciences in partial fulfillment of the requirements for the award of a degree of Master of Medicine in Radiology of Makerere UniversityBackground: Knee pain is a common musculoskeletal complaint globally, yet there is limited data on the prevalence and specific MRI findings among the Ugandan population. This prospective study aimed to investigate MRI findings among young adults aged 18 to 40 years presenting with knee pain at three radiology centers in Uganda. Objectives: This study aimed to describe the MRI findings and associated factors among young adults with knee pain at three radiology centers. Methodology: A cross-sectional study was conducted at three radiology centers among 84 participants. Data collected was analysed using STATA version 15. Numerical data was summarized using means and standard deviations for normally distributed continuous variables, and medians and interquartile ranges for skewed continuous variables. Nominal data was summarized using proportions and percentages. Modified Poisson regression analysis was used to determine factors associated with pathological MRI findings. Results: A total of 84 participants with knee pain were recruited. The mean age was 29 years. Patients with joint effusion contributed 71(28.2%) cases, 61(24.3%) cases had meniscus injury and 56(22.3%) cases had anterior cruciate ligament (ACL) tear. Most participants had a history of trauma 88.1%. Pathological MRI findings were significantly associated with clinical symptoms of knee swelling and stiffness. Conclusion and recommendations: This study has shown a high prevalence of knee MRI pathological changes in young adults. MRI of the knee joint is beneficial to young adults with traumatic injury and with the presence of clinical symptoms
Resource Recovery from Fecal Sludge Cake through Black Soldier Fly (Hermetia illucens) Larvae Composting
No full textA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfilment of the requirements for the award of the degree of Master of Science in Agricultural Engineering of Makerere UniversityBlack Soldier Fly Larva (BSFL) composting presents a sustainable approach to reclaiming nutrients from Fecal Sludge Cake (FSC) generated during Fecal Sludge (FS) treatment. This study investigated the potential of BSFL composting for resource recovery from FSC while evaluating its impact on greenhouse gas (GHG) emissions. Treatments used in the study include (T0, (100%FSC), T2 (75%FSC: 25%CM), T5 (75%FSC: 25%FVW), T3 (65%FSC: 25%CM), T6 (65%FSC: 25%FVW), T4 (55%FSC: 45%CM), T7 (55%FSC: 45%FVW), T8 (100%FVW), T9 (100%CM). The moisture content decreased in all treatments, ranging from 17.23% to 45.23% in T8 and T9, respectively. Total Volatile Solids (TVS) also decreased in the final frass compared to initial samples, with the highest reduction in T2 (11.01%) and the least in T0 (5.25%). Nitrogen content (% N) consistently increased across all samples, with the highest percentage increase in T9 (0.54%) and the lowest in T7 (0.02%). While T9 experienced a slight decrease (3.54%) in total phosphorus content, all other treatments showed an increase, with the highest in T8 (47.98%). Potassium content increased in all treatments, with the highest increase in T8 (44.5%). Organic carbon (%OC) decreased across all samples, with the greatest reduction in T2 (29.82%). The largest decrease in the C/N ratio occurred in T3 (60.99%), with the smallest in T6 (19.45%). Silicon content increased for all treatments, with the highest in T8 (53.76%). Iron (Fe) content also increased in different treatments, with the highest in T9 (32.25%). Other heavy metals exhibited a decrease in concentration across all treatments, such as molybdenum (MO) in T0, copper in T5, zinc (Zn) in T9, and lead (Pb) in T8. Larvae from various treatments showed varying levels of metal accumulation, with the highest accumulations observed in Cu in T5, MO in T8, Pb in T7, Zn in T0, and Fe in T7. In terms of larval development, T8 yielded the highest weights, ranging from 210-212 mg, while T9 and T4 had the lowest weights, ranging from 6-12.4 mg and 12-14.6 mg, respectively. Pathogen reduction was observed, with the highest reduction in T8 (3.23logCFU/g) and least reduction in T6 (0.45logCFU/g). For Staphylococcus aureus, T4 (1.29logCFU/g) was the highest reduction, with T8 (0.102logCFU/g) as the least reduction. The highest carbon dioxide (CO2) emission factor was observed in T8 registering an astonishing 15,302.16 g/kg, while T0 was the lowest emitter, with 326.21 g/kg. Treatments using Cattle Manure (CM) exhibited the lowest CO2 emissions. No traces of methane were detected in T3, while T6 showed higher methane emissions. The findings from this study provide valuable insights into the potential of BSFL composting for Fecal Sludge Cake resource recovery, emphasizing changes in nutrient profiles, heavy metals, larval development, pathogen reduction, and greenhouse gas emissions. These results underscore the importance of optimizing substrate compositions and microbial activities during BSFL composting to enhance sustainability and minimize environmental impact
Predictors of research productivity among academic staff with PhDs in universities in Uganda from Bean’s (1982) Model
No full textA dissertation 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 Educational Management of Makerere University.In this study, I sought to examine the predictors of research productivity among academic staff with a PhD in universities in Uganda from Bean’s (1982) model. To Bean, the research productivity of an academic staff arises out of individual variables (research goals, collaboration with research colleagues, research resources, equity of rewards, and research legitimacy) after being influenced by organisational variables (research emphasis, university reputation, university size, university affluence, and university autonomy). I used a positivist paradigm within a Cartesian philosophy, and employed a cross-sectional survey design. A total of 217 academic staff with PhDs, whom I randomly sampled from three universities, provided data by completing SAQs. The study had four hypotheses. I tested three of these using both Pearson’s linear correlation coefficients and multiple linear regression. In contrast, I tested the fourth hypothesis using mediation analysis. None of the organisational variables was found to be a significant predictor of research productivity. Of the individual variables, only collaboration with research colleagues and equity of rewards were significant predictors of research productivity. University reputation significantly predicted research goals and collaboration with research colleagues. University affluence significantly predicted research resources and equity of rewards. University autonomy significantly predicted research legitimacy. Lastly, the results showed significant mediation between research emphasis and research productivity by research goals; university reputation and research productivity by jointly research goals and collaboration with research colleagues; and university affluence and research productivity by research legitimacy. Because the prediction of research productivity by most of the individual and organisational variables individually was not statistically significant, I recommend that university managers consider attending to these factors in synergy if the research productivity of their academic staff with PhDs is to improve