School of Medicine (Sch. of Med.) Collections

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Factors associated with knowledge among youth attending the teenage center at China-Uganda Friendship Hospital, Kampala, Uganda

(Makerere University, 2025) Ssentongo, Emmanuel

Background: There is a high number of new infections among young adults in Uganda. These are highest youth aged 15-24 years. Insufficient knowledge on HIV could be a major reason for these high numbers. There is limited literature on factors associated with HIV knowledge among this age group in central Uganda. This study aimed to assess HIV knowledge and factors associated among youth attending the teenage center at China-Uganda Friendship Hospital, Naguru (CUFH). Methods: A cross-sectional study conducted among the youth attending the CUFH. A systematic random sampling was used to select 383 participants. An interviewer-administered questionnaire which was modified from a validated HIV-KQ-18 questionnaire was used for data collection. Descriptive statistics were computed with frequencies, means, median, and interquartile ranges. Factors associated with levels of knowledge on HIV were determined by bivariate and multivariate logistic regression. A P-value of > 0.05 was used as a measure of statistical significance. Results: The study enrolled 383 participants. The level of adequate HIV knowledge was 41.5% having adequate knowledge. The mean age of participants was 19.65 years (SD 2.59). The majority were female 79.9%, not married 67.6%, and identified as christian 74.7%. The most frequently mentioned sources of HIV information were health facilities 47.3%, followed by family 38.1%. Conclusion: The level of adequate HIV knowledge was low. Age, the belief that HIV can be transmitted by witchcraft, and the belief that circumcision offers full protection against HIV were factors associated with the adequate level of HIV knowledge.
Prevalence and predictors of generalised anxiety disorder symptoms among adult patients with type 2 diabetes mellitus at Mulago National Referral Hospital

(Makerere University, 2025) Jumba, Araphat

Background; Diabetes mellitus (DM) is associated with several physical and psychological conditions including Generalised Anxiety Disorder (GAD). Patients with comorbid DM and GAD do not properly adhere to DM self-care management practices, which worsens their glycemic control, making them prone to diabetic complications hence increasing their morbidity and mortality. In Uganda, the link between DM and GAD has not been investigated. Thus, this study aimed to establish the prevalence and predictors of GAD symptoms among adult patients with Type 2 DM (T2DM) attending the diabetes clinic at Mulago National Referral Hospital(MNRH). Objectives; To determine the prevalence and predictors of GAD symptoms among adult patients with T2DM attending the diabetes clinic at MNRH. Methods; Three hundred thirty-six (336) patients were conveniently sampled and assessed using a semi-structured interviewer-administered questionnaire to capture socio-demographic characteristics, biological and psychological predictors of GAD symptoms while a 7-item GAD tool was used to assess GAD symptoms. Simple frequency was used to determine proportions, logistic regression using bivariate and multivariate analysis was done to determine the predictors of GAD symptoms. Results; Out of 336 patients sampled, 50 (14.9%) had significant symptoms of GAD. More than half 216 (64.3%) of whom were females and 238 (70.8%) were middle-aged adults (36-64 years). The majority 201 (59.8%) of these had been living with diabetes for less than 10 years and more than half 204 (60.7%) were married. There was a statistically significant association between proximity to the hospital (PR 0.55, 95% CI 0.23-1.0, P-value 0.119), marital status (PR 1.43, 95% CI 0.85-2.38, P-value 0.172), chronic diabetic complications (PR 0.40, 95% CI 0.24-0.67, P-value <0.001), family history of mental illness (PR 3.02, 95% CI 1.78-4.91, P-value <0.001) and alcohol use (PR 1.89, 95% CI 0.93-3.35, P-value 0.048) with GAD symptoms. Not married marital status, absence of chronic diabetic complications and family history of mental illness independently predicted significant GAD symptoms among participants. Conclusion; Findings from this study reflect a low prevalence of significant GAD symptoms among adult patients with T2DM. Single adult patients with T2DM recently diagnosed, without chronic diabetic complications as well as those with a family history of mental illness are likely to have symptoms of GAD. Therefore, they should be routinely screened for anxiety and be provided with integrated mental health support services.
Pulmonary microthrombosis and associated demographics in fatal covid-19 cases at Mulago national referral hospital, Kampala.

(Makerere University, 2025-11-03) Peter, Kungu

Pulmonary micro thrombosis (PMT) emerged as a consequential complication in fatal COVID-19, significantly impacting morbidity and mortality globally (WHO, 2022) Despite its recognized significance, there existed a paucity of data concerning its prevalence and associated demographic factors and comorbidities in sub-Saharan African settings, such as Kampala, Uganda. This knowledge gap hindered evidence-based management of the disease in such settings. Objective: This study sought to determine the prevalence of pulmonary microthrombi and establish its association with sex, age and comorbidities namely diabetes, hypertension, and HIV among patients who died of COVID-19 and had an autopsy done at Mulago National Referral Hospital. Methods: A cross-sectional study with a retrospective approach on archived formalin fixed paraffin embedded (FFPE) lung tissue blocks of COVID-19 patients who died and had an autopsy done at Mulago National Referral Hospital (MNRH) from June 2020 to September 2021 were studied. The sample size was 120, Hematoxylin and Eosin, and and Modified Carstairs stain were used. Results: 120 lung tissue cases were enrolled and analysed. The mean age of the deceased from where the specimens were taken was 59, standard deviation ±15. The majority were males, 52.5% (n=63) and most, 86.7% (n=104) had an unknown HIV status. Slightly less than half, 46.7% (n=56) were hypertensive, and most, 67.5% (n=81) didn’t have diabetes or unknown to have diabetes. There was an association between pulmonary microthrombi in fata COVID-19 and sex at MNRH. Conclusion: The prevalence of pulmonary microthrombi among patients who died of COVID19 and had an autopsy done at Mulago National Referral Hospital was high (65%). In this autopsy-based study, male sex was the only independent predictor of pulmonary microthrombosis. On multivariate logistic regression, females were significantly less likely to exhibit microthrombi compared to males (aOR ≈ 0.4, p = 0.035). In contrast, age, HIV infection, diabetes mellitus, and hypertension showed no statistically significant associations with pulmonary microthrombosis, as their odds ratios approximated unity and p-values exceeded the 0.05 threshold. These results highlight sex-specific vulnerability, while the non significant variables may reflect limitations of retrospective data capture and study power rather than absence of biological effect.
Prevalence and factors associated with comorbid cognitive impairment and depression among Stroke patients attending Mulago National Referral Hospital, Neurology Clinic : a cross-sectional study

(Makerere University, 2025) Katama, Sadat

Introduction: Individuals with stroke suffer from both cognitive impairment and depression at varying degrees, with these two conditions negatively affecting quality of life and delaying improvement during rehabilitation. Frequency of co-occurrence of these conditions is likely to be high given their high individual prevalence. There is paucity of data on the comorbidity of cognitive impairment and depression after stroke especially in the sub-Saharan context. Objectives: This study determined the prevalence and factors associated with comorbid cognitive impairment and depression among stroke patients at Mulago National Referral Hospital in Uganda. Methods: This was a quantitative cross-sectional study conducted from October 2024 to January 2025. It included participants aged ≥18 years with a confirmed stroke status recruited by consecutive sampling. The Mini-Mental State Exam (MMSE) was used to collect data on cognitive function while the Patient Health Questionnaire 9 (PHQ-9) was used to assess for depression. The Barthel Index assessed functionality based on activities of daily living. Cognitive impairment was based on a MMSE cut off score of ≤23 while depression was based on a PHQ-9 cut off score of ≥10. Data were analysed with Stata version 15.1 with the association between comorbid cognitive impairment and depression with the independent variables being determined using logistic regression. Results: The study recruited 173 participants with a mean age of 53.4 years (SD = 13.8) majority of whom were males 80 (58.0%), unemployed 90 (65.2%), and married 122 (70.5%). Comorbid cognitive impairment and depression was found in 25 participants representing 14.5%). After adjusting for age and sex, diabetes mellitus (OR = 4.8, CI 1.680 – 13.550, p = 0.003) was found to be significantly associated with comorbid cognitive impairment and depression. Conclusion: Comorbidity of cognitive impairment and depression is common among stroke patients at Mulago National Referral Hospital, affecting nearly 15% of survivors. The strong association of diabetes mellitus highlights the need for routine screening and integrated management of cognitive and mood disorders, particularly among stroke survivors with metabolic comorbidities. Early identification and multidisciplinary intervention may improve recovery and overall quality of life in this population.
Patterns and factors associated with malignant conjunctival growths among adult patients with conjunctival growths attending eye clinic in Mulago National Referral Hospital

(Makerere University, 2024) Nansubuga, Irene

Background: Conjunctival growths encompass a wide spectrum of lesions that can be benign, pre-malignant, and malignant tumors. Malignant conjunctival growths can cause visual loss, eyeball loss, or even death if not well managed. Conjunctival growth surgeries are the most common surgery in Mulago National Referral Hospital eye department; however, little is known about the patterns and factors associated with malignant conjunctival growths. General objective: To determine the patterns and factors associated with malignant conjunctival growths among adult patients attending the Eye Clinic at Mulago National Referral HospitalMethods: This was a quantitative, cross-sectional study conducted at Mulago National Referral Hospital (MNRH) Eye Clinic. Patients with conjunctival swellings were consented and recruited consecutively and Data was collected using a structured, pre-tested questionnaire and entered into EpiData 4.2 which was exported to STATA 17 for analysis. Descriptive statistics were presented as means, standard deviation (SD), frequencies, and proportions. Factors associated were assessed using logistic regression to obtain odds ratios with their corresponding P-values at a 95% confidence interval. Results: A total of 110 participants were included in this study. Their mean age was 49 (SD=+/-13) years. 29% of the conjunctival growths were malignant and the rest were non-malignant (benign and pre-malignant). Of the malignant growths encountered, the majority had Squamous Cell Carcinoma (SCC) at 90.6%, and 9.4% had conjunctival melanoma. Amongst those with SCC, most participants had carcinoma in situ (38%), followed by well-differentiated growths at 31%. All participants with conjunctival melanoma had pT1a pathological staging. White color (aOR:39.6, 95% CI=2.83-553.51), mixed color (aOR:17.6,95%CI=1.51205.02), sub-epithelial involvement (aOR:1, 95%CI= 0.000-0.0237), Leucoplakia (aOR:1, 95%CI= 0.001-0.313), Pigmentation(aOR:0.3,95%CI=0.000-0.658) and having a rough texture (aOR:10.8,95% CI =1.23-94.51) were indicators of malignancy.Conclusion: The commonest malignant conjunctival growth was SCC followed by malignant conjunctival melanoma. Carcinoma in situ was the most common histological pattern while for conjunctival melanoma was the pT1a stage. Leucoplakia, pigmentation, rough texture, and sub-epithelial involvement were found to be highly associated with conjunctival malignancy.

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