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Risk factors for death in children during inpatient treatment of severe acute malnutrition: a prospective cohort study
Get PDFThe study assessed risk factors for death in children who were treated for malnutrition in a hospital.Background: Children who receive in-hospital treatment of severe acute malnutrition often have high mortality rates, and the reasons are not well understood.
Objective: We assessed risk factors for death in children who were treated for malnutrition in a hospital.
Design: In a prospective observational study of 120 children who were receiving in-hospital treatment of severe acute malnutrition in Uganda with therapeutic formulas F-75 and F-100, we collected data on symptoms, clinical findings, plasma markers of refeeding syndrome (electrolytes and phosphate), and acute phase reactants, and recorded the nutritional therapy given in hospital.
Results: Seventeen children (14%) died. Clinical risk factors for death were the presence of oral thrush (HR: 5.0; 95% CI: 1.6, 15.2), a caretaker-reported severity of illness on a visual analog scale (HR: 1.7; 95% CI: 1.1, 2.6), impaired consciousness (HR: 16.7; 95% CI: 3.1, 90.4), and a capillary refill time >2 s (HR: 3.9; 95% CI: 1.4, 11.3). HIV infection was not associated with mortality (HR: 3.0; 95% CI: 0.7, 12.4), which was most likely due to low power. Biochemical risk factors were a plasma C-reactive protein concentration >15 mg/L on admission and low plasma phosphate that was measured on day 2 (HR: 8.7; 95% CI: 2.5, 30.1), particularly in edematous children. The replacement of F-75 with unfortified rice porridge to ameliorate diarrhea was associated with a higher risk of death, particularly if given during the first 2 d (HR: 5.0; 95% CI: 1.9, 13.3), which was an association that remained after adjustment for potential confounders (HR: 69.5; 95% CI: 7.0, 694.6).
Conclusions: Refeeding syndrome may occur in children who are treated for malnutrition, even with moderately low plasma phosphate, and, in particular, in children with edematous malnutrition. The replacement of F-75 with unfortified rice porridge is associated with increased risk of death, which is possibly mediated by lowering plasma phosphate. The identified clinical risk factors may potentially improve the triage of children with malnutrition. This trial was registered at www.isrctn.com as ISRCTN55092738
8. Omusajja omugaga
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Development of Sustainable African Libraries as Centers of Literacy and Languages Development in Uganda and Ethiopia
Get PDFThis is a Conference Paper on Development of Sustainable African Libraries as Centers of Literacy and Languages Development in Uganda and EthiopiaThe joint action research sets out to deepen knowledge and understanding of key issues in libraries as centers of literacy and languages development in Uganda and Ethiopia. The School Library (SL) and Community Library (CL) approaches have been used for more than two decades in Ethiopia and a decade in Uganda. But, their effectiveness and impact has not been researched. The need is to document the experiences of UgCLA in Uganda and CODE Ethiopia; and to analyse the lessons learned for possible replication in the African practices. In Uganda, we found community libraries and, in some instances, rural private primary school libraries as some of the most effective models for instilling a love of reading in children and their families. Joined together under Uganda Community Library Association (UgCLA), some of these libraries have received the support of Friends of African Village libraries to carry out their activities. They operate in spaces donated by individuals, schools and communities. The books procured from the local market, donated and sometimes supplied by national library of Uganda in conjunction with Book AID International are mostly in English. Reading materials in local languages are very scarce both in homes and community. The few that exist are in schools and even these are inadequate as they are used only during class time. The children and parents have no opportunity to read with their children and so the children have limited time to practice reading their mother tongue on their own outside the classroom. UgCLA has helped libraries in Busoga Cluster to gather, write and create books on the African Storybooks project where 24 out of 120 stories have been published. This experience is to being replicated into 17 other languages that constitute 75 % of the languages used in Uganda. Similarly, CODE Ethiopia (CE), working with government and school libraries has achieved the same goal of literacy development in rural and semi-urban communities. Since 1994, CE has established 97 community libraries in 97 different districts of the country. CE has a practical model of establishing and transferring the ownership of the libraries to respective communities and government organizations. However, it keeps supporting them whenever there is material, financial and technical support. CE is working with CODE and IREX/Beyond Access in new literacy development activities using tablets in the ‘Hacking Literacy Approach’ to create community libraries, develop supplementary materials, distribute readers for free, train librarians, book developers and Library Management Committees and to acquire and distribute books obtained through donations and local purchase. CE also holds the Burt Award for African Young Adult Literature. The study is looking into ways of improving access to literacy materials to which the libraries have contributed but have no significant access. Mentoring of story writers and readers in content creation and establishing, strengthening and monitoring of reading clubs and literacy facilitators is on-going to hopefully impact positively on the availability and use of the literacy materials on the market. The study is documenting the stories of 12 selected libraries in Uganda and Ethiopia and the library activities put in place
Wegendereze Engo weli wano
No full textThis is a story warning young children to be careful of the Tiger which is dangerous to human beings.This is a story warning young children to be careful of the Tiger which is dangerous to human beings
Burengye bw'eizooba bwa Uganda
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Mass media, women and public life in Uganda : interrogating representation, interaction and engagement
Get PDFDoctor of Philosophy in Centre for Communication, Media and Society. University of KwaZulu-Natal, Durban 2017.This study was motivated by the strides Uganda has made towards the growth of the media and women’s participation in public life. The puzzle is that this increased participation of women in public life is hardly captured in the media, particularly public affairs programmes on the broadcast media. This study, therefore, interrogates women’s media participation through representation, interaction and engagement as components of conjunctural factors that are relevant to facilitating women’s participation in public life. The research is informed by critical theory, and in particular feminist thought, cultural studies and public sphere theory. The marginalisation and oppression of women advanced by feminist theorists, the systems of representation through power and knowledge in cultural studies, and the open participation of discursive programmes that demystify gatekeeping practices in traditional programming in public sphere theory, were the frames used to guide this study. I use multi-method and multidisciplinary approaches that entail quantitative content analysis, qualitative case studies and grounded theory to interrogate the influence of the broadcast media on women’s participation in public life. The thesis of my research is that women’s media participation in public affairs programmes through representation conceptualised as voice and visibility, interaction as consultation and conversation and engagement as involvement and influence, would facilitate women’s participation in public life. Limited representation, interaction and engagement, therefore, frustrate or at least do not advance, women’s participation in public life, contrary to the perceived potential and transformative role of the media. I find that participation remains minimal. The problem is not just the media which has in most studies is found responsible for the negative portrayal of women, but a complex interrelationship between women and the state, society and the media. The state opens up space for women and, paradoxically, closes it, culture defines women’s role in society, and the media reproduces cultural narratives that are injurious to women. Women push back, sometimes but often remain loyal to the state, respond to cultural expectations and ignore the media or disengage from it. This, thus thwarts meaningful opportunities for participation that could help change the perceptions about women’s role in society as well as mobilise and motivate women to participate in public life. The implication for policy and current strategies for women’s empowerment, in particular affirmative action pursued in Uganda and elsewhere, is huge. There is need to rethink the existing models of women’s empowerment and the gender equality agenda, cognisant of the current paradigm of neoliberalism, in particular liberalism and globalism, that thrive on competition, communication and competence
Designing a Paved Road Using Geogrids to Reduce the Thickness of the Pavement Layers
Get PDFThis is a proceeding paper presented at the 9th South African Young Geotechnical Engineers Conference, 13, 14 & 15 September 2017 – Salt Rock Hotel, Dolphin Coast, Durban, KwaZulu-Natal 575 on Designing a Paved Road Using Geogrids to Reduce the Thickness of the Pavement Layers.Performance and durability of road pavements are significantly dependent on the strength and stability of the underlying soil layers, most especially the subgrade pavement layer. Currently, in Uganda most roads are constructed through low lying areas characterized by soft, hence weak, clay soils. The main practice, of improving the strength of such subgrade layers, has been to import stronger lateritic soils and dump them in layers over the weaker soils in thicknesses of more than 1.0 m. This is expensive, especially in terms of the haulage costs, and not environmentally friendly. Additionally, the lateritic soils are also getting depleted. Hence the need to utilize alternative means of increasing the strength of weak subgrades. This study focused on the application of Geogrids in pavement layers to reduce their overall thickness and life cycle costs of the road. A low-lying section on the Bajjo road, a bypass connecting Mukono to Seeta, was used as a case study. According to the AASHTO classification system of subgrade materials, the subgrade soils fell under the soil ranges of A-7, A-7-6, and A-6 group, therefore a poor subgrade material requiring stabilization. The average CBR was determined as 19%.
The inclusion of the Geogrid reduced the overall layer works thickness by 25% and it’s cost effective by 42% over the whole lifecycle of the road
(Colour – in) Lumasaba I—R
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