Mak IR Repository (Makerere University)
Not a member yet
9127 research outputs found
Sort by
Length of hospital stay, in-patient mortality, and factors associated with mortality among HIV- associated cryptococcal meningitis patients at tertiary hospitals in Uganda
No full textA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfillment of the requirements for the award of a Master of Public Health Degree of Makerere University.Abstract Introduction: Cryptococcal meningitis (CM) remains the second most common and lethal opportunistic infection among People Living with HIV (PLWHIV) in sub-Saharan Africa. Currently, patients are managed on single high-dose liposomal amphotericin B and flucytosine. However, there is no sufficient data on whether the new treatment regimen has an effect on reducing inpatient mortality and length of hospital stay in the real-world setting. The study intended to investigate the proportion of inpatient mortality, length of hospital stay (LOS), and factors associated with mortality among patients of HIV-Cryptococcal meningitis. Methods: A cross-sectional study design, where a review of medical records of 173 patients admitted between December 2022 and May 2023 at 11 tertiary facilities was conducted. Medical records of HIV-CM pts were reviewed following the facility archive system and data was entered using the Kobo App. Univariate descriptive statistics were used to summarize the background characteristics. Modified Poisson regression was used to ascertain factors associated with mortality at bivariable and, multivariable associations were presented through adjusted prevalence ratios with their 95% confidence intervals. All the data analysis was conducted using STATA Corp 15. Study findings: Of the 173 patients’ medical records reviewed, the majority (58.4%), were males with a median age of 38 years (IQR= 30, 48) and over a half (55.5%) were married. Forty percent had altered mental status (GCS <15) on admission. The percentage of inpatient mortality was 35.8%, which significantly varied by health facility. The mean LOS was 8.2±6.7 days. Factors associated with mortality were Male sex [adjusted prevalence ratio (APR); 1.87, 95%CI (1.21-2.87)], p-value=0.005), admission with a convulsion [APR, 1.86, 95%CI (1.21-2.86), p value=0.005)], altered mental status [APR; 1.66, 95%CI (1.07-2.57), p-value=0.023], and comorbid condition [APR, 2.26 95%CI (1.44-3.53), p-value=0.006]. Therapeutic lumbar punctures were significantly associated with reduced mortality [APR; 0.47, 95%CI (0.29-0.73), p value=0.001]. Conclusion: Almost 4 of every 10 patients admitted with HIV-CM died, on average spending more than a week in the hospital. Male sex, admission with a convulsion, altered mental status, and comorbid conditions were independently associated with mortality. Therapeutic LPs significantly reduced inpatient mortality. Health workers should be trained and empowered with skills to perform LPs and as well, include HIV-CM awareness in the comprehensive package of care for people living with HIV.Meningitis Group (IDI and Minnesota
Measuring efficiency of maize production in Uganda: a data envelopment analysis approach
No full textA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfilment of the requirements for the of award of a degree of Master of Science in Quantitative Economics of Makerere University KampalaThe study measured efficiency of maize production in Uganda. The study aimed at achieving two objectives i.e., to establish the performance of maize production in Uganda (at ZARDI and District level) and to determine how much inputs are required for the inefficient Decision Making Units to achieve maximum efficiency. The study used secondary data collected by National Agricultural Research Organisation(NARO) on 1445 maize and bean farmers in Uganda in 2020. The study used the Output oriented Data Envelopment Analysis model that basically answers two questions i.e., which DMUs performs better than the other and what is required to make the inefficient ones efficient. From the findings, only Bulindi ZARDI was established inefficient only operating at 95% among the ZARDIs. At district level, Kiryandongo, Masindi, Bugiri, Kiboga, Sironko, Nakaseke, Bukwo, Kole, Kakumiro, Kyankwanzi, Mityana and Iganga were marked as inefficient implying operating below 100% capacity. Sensitivity analysis on benchmarks, shadow price and slacks were done to answer the second objective. The bench mark analysis was done to establish where inefficient DMUs should draw lessons from. The shadow price analysis was done to show the unit worth of inputs ie the marginal effect/productivity of a resource to the final efficiency score. The slack analysis showed room for improvement for inefficient DMUs to be efficient. Bulindi which is inefficient among the ZARDIs has a considerable surplus of excess capacity of inputs i.e., 89.02 acres, 974 persons of Hired Labour, 16.4 litres of herbicides, 29.7 litres of pesticides, 6.45kgs of inorganic fertilizers and 4.63 litres of inorganic fertilisers suggesting optimum resource allocation and utilization of underutised resources. The inefficient districts have an excess capacity of Acreage under Maize Production, Hired Labour, Family Labour, Herbicides in litres, Pesticides in litres, Organic Fertilisers (Manure)-kg, Inogarnic Fertilisers(kg) and Inorganic Fertilisers in litres by 267.89, 968, 1463, 29.34, 37.17, 4.84, 45.16 and 18.46 units respectively suggesting suggesting need for improvement in the utilization of resources (since the resources are underutilized). The study suggested recommendations that include redistributing excess inputs, optimizing resources and improving input usage, facilitating knowledge transfer, capacity building and training, monitoring and evaluation, research & innovation and financial support for technology adoption to improve maize production in Uganda
Exploring e-commerce adoption among the youths in Kampala District: a case study of Jumia Uganda
No full textA research report submitted to the College of Business and Management Sciences in partial fulfillment of the requirements for the award of a Master of Business Administration of Makerere UniversityThis study explores the adoption of e-commerce among Kampala’s youths, using the Jumia Uganda platform as a case study. The study’s objectives included understanding the drivers, barriers, and experiences of youths regarding e-commerce adoption, focusing on the Jumia e-commerce platform. A qualitative research approach was employed, using an exploratory research design. The target population consisted of youths aged 18-30 who regularly use the Jumia platform. Purposive sampling was used to select 32 participants from Kampala’s five administrative divisions. Qualitative data were collected through in-depth interviews and analyzed thematically. The findings revealed key drivers of e-commerce adoption, including convenience, affordability, and access to wide product variety. However, significant barriers were identified, such as limited payment options, poor internet connectivity, and digital literacy issues. Experiences with return policies showed that unclear guidelines, slow processing, and inadequate customer service deterred many from making online purchases. Participants expressed a preference for clearer policies and faster return processes. Recommendations include enhancing user convenience through improved mobile apps and delivery systems, strengthening cybersecurity, promoting digital literacy, ensuring reliable connectivity, developing clear return guidelines, and engaging customer service to foster a supportive digital marketplace for Kampala’s youth. Future research should expand sample sizes to include diverse demographics, explore rural youths’ experiences, compare e-commerce platforms, employ mixed-methods approaches, and conduct longitudinal studies to assess evolving perceptions of return policies in Uganda’s e-commerce landscape
Exploring school administrators’ management behavior : a case study of two government-aided secondary schools in Bushenyi District
No full textA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfilment of the requirements for the award of a Degree of Master of Education (Educational Management) of Makerere University.Like many rural districts in Uganda, Bushenyi District has had undesirable reports in the recent past regarding school administrators’ management behavior such as poor national examination and resource management (time and finances). This triggered the need to explore the administrators’ management behavior with an aim of improving teaching and learning outcomes. Employing a duo-case study design, I explored prevalent management practices, identified administrators’ enhancement needs and examined challenges faced by administrators in two selected secondary schools within the district as the study objectives. By addressing prevalent management practices, administrators’ needs, and challenges faced by administrators, the research sought to inform the development of tailored interventions and support mechanisms to improve the effectiveness of school management in promoting better teaching and learning outcomes. Through in-depth interviews with administrators (key primary participants) and document reviews, I collected data to understand the existing management practices and to uncover areas for improvement. I then analysed the data thematically. I discovered that some administrators in Bushenyi District lack desirable management behavior evidenced by poor financial management practices such as sole financial management with no traced accountabilities whatsoever. I also found out that administrators are qualified teachers at least in the two case studies but do not undergo induction after assuming a new office and there are no on-going trainings to equip them with the needed skills thus explaining their incompetency in school management. I recommend that there be professional development programs tailored for school administrators that are continuous in nature in order to ensure desirable management behavior
Microbiome-induced immune resistance to mycobacterium tuberculosis at the Airway Mucosa
No full textThis is a thesis submitted to the Directorate of Research and Graduate Training For the Award of a Doctor of Philosophy of Makerere UniversityRationale: Mycobacterium tuberculosis (M.tb) remains one of the deadliest infectious pathogens globally. Amidst efforts to control the disease, challenges such as long treatment duration, drug toxicity, and resistance underscore the need for novel therapeutic strategies. Until recently, emerging evidence suggests that some individuals, referred to as TB resistors, despite intense and persistent exposure to the bacilli, never acquire TB infection or clear the pathogen, remaining persistently negative for TST and IGRA. This persistently IGRA-negative phenotype suggests either resistance to M.tb infection at the respiratory mucosa or restriction of M.tb replication. To date, mechanisms of immune resistance to M.tb remain unknown and, if fully elucidated, may
provide insight into novel therapeutic strategies. The airway microbiome has been implicated in the modulation of airway mucosal immunity and could play a significant role in mediating immune resistance against M.tb among resistors. It is plausible that the airway microbiome-immune crosstalk determines resistance to M.tb attachment and infection of the respiratory mucosa or restriction of M.tb replication within alveolar macrophages. Deciphering which microbiome signatures induce robust immune responses remains a significant area to undertake. Aims and methods: In this study, we set out to characterize airway microbiome signatures driving immune resistance to M.tb in a rural Ugandan cohort of IGRA-negative individuals. To achieve our objective, we first developed a novel airway microbiome-immune library using COPD as an unbiased chronic airway inflammation environment. We performed detailed airway microbiome profiling based on M.tb-specific IFNg responses by QuantiFERON-TB GOLD assay and M.tb burden by TB GeneXpert. Using the airway microbiome-immune library as a reference, we predicted and validated microbiome-immune pathways associated with M.tb-specific immune responses among QFT-negative individuals. Results: Using a chronic airway inflammation “model”, we successfully deciphered the airway-microbiome-immune crosstalk and underpinned top signatures driving the immune response. We successfully underpinned a novel airway microbiome signature, accurately discriminating active TB from LTBI and healthy controls. M.tb rather than IFNg response strongly influenced airway microbiome diversity. Using the airway microbiome immune library, we showed that the airway microbiome signatures enriched among IGRA-negative individuals likely “induce” a non-specific inflammatory response that “mobilizes” a mixed immune phenotype of innate and adaptive immune cells, such as DCs, B cells, Th1, Th2, Th17, and memory helper T cells, to orchestrate a robust immune response. Independent mass flow cytometric analysis supported these results. Further interrogation of anti-M.tb-immune responses among IGRA-negative versus positive individuals using airway transcriptomic analysis revealed TNF-a, type I, and II interferons as hallmark signaling pathways enriched among IGRApositive versus IGRA-negative individuals. Interestingly, airway cytokine profiling revealed a positive trend towards increased pro-inflammatory cytokines among the IGRA-negative versus IGRA-positive individuals despite a robust pro-inflammatory cytokine response among M.tbstimulated blood from IGRA-positive versus IGRA-negative individuals. Conclusions and Recommendations: These findings suggest that the airway microbiome could be critical in TB control. Furthermore, the local airway responses could differ from the systemic response and could be vital in containing M.tb. Further studies are warranted to explore these findings.Fogarty International Center (FIC) at the National Institutes of Health (NIH) through the Global Infectious Diseases Fellowship Program (D43TW009093) at Makerere University and Rutgers, the State University of New Jersey, USA
Strategies for improving access to debt finance in SMEs in Uganda: a case of construction SMEs in greater Kampala Metropolitan Area (GKMA)
No full textA research report submitted to the College of Business and Management Sciences in partial fulfillment of the requirements for the award of the degree of Masters of Business Administration of Makerere UniversityThis study explores the challenges and opportunities faced by construction small and medium-sized enterprises (SMEs) in the Greater Kampala Metropolitan Area regarding access to debt financing. The research aims to elucidate the levels of awareness regarding various debt financing options, assess the accessibility of these financial resources, identify constraints impeding access, and propose strategies to enhance financing opportunities for construction SMEs. The findings reveal a significant disparity in awareness among SMEs regarding different financing sources. While there is a robust recognition of commercial banks as a primary source of financing (mean score of 4.52), awareness of alternative options such as microfinance institutions, Savings and Credit Cooperative Organizations (SACCOs), government loan programs, and international development funds is notably low, with mean scores of 2.39, 2.52, 2.09, and 1.67, respectively. This limited awareness presents a critical gap, suggesting that SMEs may overlook viable financial avenues that could support their growth. In terms of access to debt financing, bank loans emerge as the most utilized option, with a mean score of 3.34 reflecting varied experiences among respondents in terms of application and approval processes. However, the study indicates low engagement with microfinance loans (mean score of 1.45) and government loans (1.06), highlighting a cautious approach to debt among SMEs. Notably, 57.58% of respondents reported that less than 10% of their total capital is sourced from debt, indicating a risk-averse financial strategy. The analysis identifies several constraints hindering access to debt finance, with high-interest rates (mean score of 4.48) and stringent collateral requirements (4.33) as the most significant barriers. Lengthy approval processes (3.70) and inconsistent cash flow (4.27) further complicate financing efforts. Conversely, factors such as poor credit history and insufficient financial records are perceived as less critical, suggesting that addressing high-interest rates and collateral demands should be prioritized to improve financing accessibility. Respondents propose various strategies to enhance access to debt financing, emphasizing the need for the reduction of interest rates (mean score of 4.45) and the easing of collateral requirements (4.12). Other strategies include streamlining loan approval processes (3.85) and increasing awareness of financing options (3.21), along with offering financial literacy and management training (3.42). Encouraging banks to develop tailored financing solutions for the construction sector is particularly highlighted, with a mean score of 4.33. In conclusion, this study underscores the critical need for targeted initiatives aimed at improving awareness and accessibility of debt financing for construction SMEs in Greater Kampala. Addressing identified constraints and implementing the recommended strategies could significantly enhance the financial landscape for these enterprises, thereby fostering their growth and contribution to the regional economy. Future research should focus on evaluating the effectiveness of awareness campaigns and the impact of tailored financial products on SME development
Influence of donor cash flows and donor fundraising on the operations and management of NGOS after COVID19: A case of Evidence Action
No full textA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfillment of the requirements for the award of a degree of Master of Arts in Business Administration, Makerere UniversityThe study examined the Influence of Donor Cashflows and donor fundraising on the operations and management of Non-Governmental Organizations after COVID19 with Evidence Action as a case study. The study was guided by two specific objectives which included to examine the influence of donor cash flow on operations and management of Evidence Action after COVID-19 and to establish the influence of donor fundraising on operations and management of Evidence Action after COVID-19. The study adopted a cross-sectional research design that involved the use of both qualitative and quantitative research methods. Qualitative research involves the study of cases and makes little use of numerical data or statistics but relies heavily on verbal data and subjective analysis. Quantitative research involves the use of both numerical data and discrete variables to get the respondents level of understanding about the topic under study. The preference for a cross-sectional research design is because it collects information from a random sample that has been drawn from different categories of the population at a point in time. This was all applied on a sample size of 125 respondents using questionnaires. From the study findings, cash management had a positive but insignificant effect on operations and management of Non-Governmental Organizations. This implies that cash flow management and donor fundraising had no influence on the operations performance. Further, it was also established that the size of the company had a negative and insignificant effect on the operations and management of Non-Governmental Organizations. This concluded that cash flow had a positive but insignificant influence on the operations and management of Non-Governmental Organizations. Therefore, this study recommends that non-government organisations should create a comprehensive crisis management plan that includes strategies for handling future pandemics or emergencies as one of the solutions. Also establishing an emergency response team and designate roles and responsibilities and stockpiling essential supplies and resources for quick deployment during crises is key
Microbial environmental contamination and infection prevention and control practices in the maternity ward of Buwenge General Hospital
No full textA dissertation submitted as partial fulfillment for the award of Master of Medicine in Microbiology, Makerere UniversityA 2017 review found that 42.6% of African countries lacked adequate antimicrobial resistance data, with widespread resistance among clinical isolates. In Uganda, despite IPC guidelines, healthcare workers often lack awareness, especially in maternity wards, leading to high risks of postpartum infections for mothers and newborns. This study’s main goal was to determine the distribution and antimicrobial resistance profiles of isolates from the maternity ward of Bugembe General Hospital (BGH
Self-esteem, peer relations and depression among school going adolescents In Rubaga Division, Kampala District
No full textA research dissertation submitted to the School of Psychology in partial fulfillment for the award of a Master’s Degree in Counseling of Makerere University.This study investigated the relationship betweenself-esteem, peer relations and depression amon school going adolescents in Rubaga Division, Kampala District. A correlation research design was used to conduct the study, it involved two schools in Kampala district participants were selected using stratified random sampling, in the two schools. The total sample of this study consisted of 200 senior two, three and five students. Pearson correlation coefficient was used to investigate the relationship between the variables. The study found that (r = - 0.061, p>0.05) self-esteem was found to be negative and not significantly related to peer realtions, self-esteem was found not to be significantly related to depression (r = 0.032, p>0.05), peer relations were found to be positive and significantly related to depression(r = 0.287, p>0.000), peer relations do not moderate the relationship between self esteem and depression. Peer relations are an important predictor of depression. Good peer relations help adolescents cope with depression more effectively. Self-esteem is not an important influencer of depression among school going adolescents in Rubaga Division. It was recommended that school going adolescents need to be given adequate information of regarding mental health , self awareness , heathy relationships and self esteem as well as the dangers of depression. This will help the adolescents to fight depression
Pesticides Use among Banana Farmers in Sheema District and their impact on anurans
No full textA Thesis 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 Environment and Natural Resources of Makerere UniversityBananas (Musa spp.) are an indispensable pillar of global food security and economic growth, serving as both a staple food and cash crop. The vulnerability of the banana crop to pests and diseases necessitates the use of pesticides. This research sought to unravel the extent of pesticide use among banana farmers in Sheema district, Uganda and the environmental ramifications. A cross-sectional survey was carried out where 136 banana farmers were randomly selected from four Sub-Counties. Questionnaires were administered to gather information on the farmers' demographic characteristics and their pesticide use practices. In order to assess the effect of pesticide use (type, dosage and frequency of application) on anurans population, pesticide treated (pesticide-used) plots and control (pesticide-free) plots were compared. The capture-recapture method with pitfall traps was used. Results showed that 44.5% of the farmers were using pesticides with 49.2% using insecticides and 50.8% using herbicides. Dudu Guard constituted 58.06% of the insecticides being used and Force Up 45.2% of the herbicides. Most of the pesticides were classified under Class II and Class III. However, Carbofuran belonging to class 1b was also being used. Regression analysis revealed that gender, farm size, mixed farming, age, farming experience were the significant determinants of pesticide use (p-value < 0.05). Additionally, 78.7% of farmers understood pesticide labels, and 83.6% had received training on pesticide use. Majority (73.5%) stored pesticides in a store house while 82.4% burn empty containers after use. Farmers expressed a big concern for food safety (68.9% strongly agree) and soil contamination (54.1% strongly agree) due to pesticide use. Results further revealed that farmers under dosed Force Up, and Jembe 48SL, adhered to the recommended doses for Lava, Nimbecidine, Dudu Guard, and Imiforce. Dudu Cyper 5EC, Delforce, Carbofuran, Glufosun, and Weedmaster were overdosed. Farmers applied Rocket, Jembe 48SL, Glufosun, and Weedmaster at the recommended frequencies. Lava, Nimbecidine, Delforce, Imiforce, and Force Up were used less frequently than recommended. Dudu Cyper 5EC was applied correctly (66.67%) and Dudu Guard (94.12%) was used below recommended frequency. All farmers correctly used Carbofuran 1−5 times/year. The impact of pesticides on anurans, results showed that anuran populations were lower (p value < 0.05) in pesticide-treated plots (average of 18 anurans) as compared to control plots (average of 66 anurans). A chi-square test comparing anuran populations in control and pesticide-treated plots across four sub-counties revealed significant population reductions in Kasaana (p value < 0.001), Kabwohe (p value = 0.003), Kigarama (p value < 0.001) and Kashozi (p value = 0.02), highlighting the detrimental effects of pesticide use on anuran populations. In light of these findings, the study advocates for the promotion of safe pesticide practices through enhanced extension services, further training, and awareness programs. Encouragement of integrated pest management strategies and alternative methods should aim to reduce over-reliance on pesticides. Moreover, stringent and continuous monitoring and regulation of pesticide use are seen as vital measures to safeguard the environment and ensure sustainable agricultural practices