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Effectiveness of a combined tranexamic acid and oxytocin versus oxytocin alone in prevention of primary postpartum hemorrhage among women undergoing caesarean section at Kampala International University-Teaching Hospital
(Kampala International University, 2021-11) Waris Mohamed Adam
Background: Primary Postpartum hemorrhage is a challenge, particularly in developing countries like Uganda where most women develop anemia aggravated by late caesarian section delivery. The present study determined the effectiveness of combined tranexamic-oxytocin combination versus oxytocin alone in prevention of postpartum hemorrhage among women undergoing caesarean section at Kampala International University-Teaching Hospital (KIU-TH).
Methods: The study was Randomized controlled trial carried out among pregnant mothers who delivered by caesarean Section at KIU-TH between August 2021 and October 2021. For this comparative study, 168 participants were put in each arm (oxytocin alone and combined TXA and oxytocin).
Results: Of the 336 pregnant women that delivered by caesarean section, a combined tranexamic acid and oxytocin were more effective than oxytocin alone in terms of amount of blood loss in both during (383.57±550.23±8.79) and after 24hour post CS (396.7 ±5.80 vs 576.86±6.90) (p<0.05), the overall incidence of PPH was 8.33% and there was a significant difference in both groups (p<0.05). Hemoglobin and hematocrit reduction in the TXA group was higher than the Oxytocin group [Hb: - 2.11±0.30 vs -1.85±0.45 g/dL or hematocrit; -3.44±1.33 vs -1.64±2.61) (p< 0.05). There were significant difference between the two groups with respect to additional uterotonics (7.14% vs 19.64%, p < 0.05)
Conclusions: The effectiveness of TXA and oxytocin was significantly higher than that of Oxytocin alone in terms amount of blood loss in both during and after 24-hour post caesarean section, incidence of PPH, need for additional uterotonics and improvement of postoperative hemoglobin and hematocrit.
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Key words: Primary postpartum heamorrhage, Caesarean section, Tranexamic acid
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Perinatal and Maternal Outcomes of Induction of Labour Using Oral Misoprostol in Premature Rupture of Membranes at Hoima Regional Referral Hospital, Uganda
(Kampala International University, 2020-01) Rajab Babikir Abdallah Araba
Background: Premature rupture of membranes (PROM) is among the most common causes of maternal and perinatal morbidity and mortality. This could be due to an increase in the latent period from rupture of membranes to delivery interval. Some of the complications of PROM included maternal or perinatal infections that could be prevented by induction of labor using effective methods such as oral misoprostol administration. However, the perinatal and maternal outcomes following such intervention had not been well studied in our setting.
Objectives: To determine the perinatal and maternal outcomes of induction of labour (IOL) using low dose oral misoprostol (25μg/25ml) solution in premature rupture of membranes at Hoima Regional Referral Hospital, Uganda.
Research methods and materials: This was a longitudinal study which was conducted among pregnant women at term with PROM admitted in maternity ward at Hoima Regional Referral Hospital from February to April, 2019. 78 pregnant women were enrolled to the study. Structured pretested questionnaires and partographs were used to collect maternal and perinatal variables including the outcomes. The data obtained was entered in Microsoft excel version 2010, then imported into STATA 15.0 (Statacorp, USA Texas) for analysis.
Results: Majority of participants 97.9% in misoprostol 86.7% in oxytocin delivered vaginally with mean IDI significantly less in misoprostol group (p=<0.001) 18.7±5.2 hours. The overall good maternal outcome was 80% in oxytocin and 75% in misoprostol and the significant poor outcomes included 13.3% caesarean section in oxytocin and 20.8% perineal tears occurred in misoprostol (p=0.038). Both groups had normal birth weights with the 5th minute Apgar score of >7 97.9% in misoprostol and 93.3% in oxytocin groups. Foetal distress (4.2%), meconium passage (4.2%) and NICU admissions 14.6% were more in misoprostol group while more neonatal sepsis 20% and 1 neonatal death occurred in the oxytocin group.
Conclusion: Oral misoprostol had significantly reduced mean induction to delivery interval and increased perineal tears while oxytocin had significant increase caesarean delivery. Oral misoprostol and intravenous oxytocin had equally good foetal outcomes. Oral misoprostol and oxytocin had comparable neonatal outcomes.
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Organisational Structure, Performance Monitoring, And Academic Staff Performance in Selected Private Chartered Universities in Ankole Sub Region- Uganda
(Kampala International University, 2026-02) Silaji Turyamureeba
The main purpose of the study was to investigate the types of organisational structures, performance monitoring practices, and their relationship with academic staff performance in Selected Private Chartered Universities in the Ankole Sub Region. Guided by five objectives. A convergent parallel mixed-methods design was adopted using a mixed methods approach. The study targeted 621 academic staff, from whom 330 were selected using stratified sampling for the quantitative component, while 10 Deans of Faculties participated in qualitative interviews. Quantitative data were analysed using descriptive statistics, correlation, ANOVA, and regression analysis, while qualitative data were analysed using thematic content analysis. Findings for objective one revealed that Selected Private Chartered Universities predominantly operate under mechanistic organisational structures characterised by hierarchical control, centralisation, and rigid formalisation (M = 3.94, SD = 0.90). Objective two showed that performance monitoring practices were moderately implemented (M = 3.91, SD = 1.03). For objective three, correlation analysis revealed strong positive relationships between organisational structure dimensions and academic staff performance, with an overall correlation of r = 0.65 (p < .01). ANOVA results confirmed significant differences in performance across structural forms (F = 4.97, p < .05), while regression analysis showed that organisational structure explained 38% of the variance in academic staff performance (R² = 0.38, p < .05). Findings for objective four indicated that academic staff perceived performance monitoring as irregular, opaque, and largely compliance-driven, with only 27.6% reporting receipt of structured feedback. For objective five, strong positive relationships were found between performance monitoring dimensions and academic staff performance, with an overall correlation of r = 0.66 (p < .05). Regression analysis showed that performance monitoring explained 41% of the variance in academic staff performance (R² = 0.41, p < .05), making it the stronger predictor. Qualitative results in general supported the quantitative ones, “Most of our monitoring is done to satisfy regulatory requirements”. The study concludes that both organisational structure and performance monitoring significantly influence academic staff performance. The study recommends a more decentralised organisational structures xviii alongside transparent, technology-enabled performance monitoring frameworks to improve academic productivity, student outcomes, and institutional effectiveness in line with Sustainable Development Goal 4.
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Prevalence, Factors and Earlyoutcomesassociated with Elevated Serum Creatinine Among Inpatients with Community Acquired Pneumonia at Mubende Regional Referral Hospital
(Kampala International University, 2025-09) David Elia Saria
Community acquired pneumonia is one of the leading causes of mortality globally. Emerging evidence highlights a strong relationship between renal function and pneumonia outcomes. However, there is a clear gap in data from Sub-Saharan Africa, particularly Uganda. The prevalence of renal impairment, the associated clinical factors, and the early outcomes among pneumonia patients remain largely undocumented. Understanding the burden and predictors of elevated creatinine in community acquired pneumonia patients would support timely diagnosis of renal injury, improve risk stratification, and inform clinical decisions about fluid management, antibiotic dosing, and monitoring intensity. This study determined the proportion, early outcomes and factors associated with elevated creatinine among inpatients admitted with community acquired pneumonia (CAP) at Mubende Regional Referral Hospital (MRRH). Methods This was a hospital-based cross-sectional study with a short-term longitudinal extension. All adult patients managed for CAP at MRRH were enrolled following consent. A blood sample was taken to measure the serum creatinine and urea. The longitudinal extension involved tracking of early outcomes such as in-hospital mortality and length of hospital stay. Logistic regression in SPSS was done to determine the significant factors. P<0.05 was considered significant. Results We enrolled 184 patients with CAP of whom 26.1 were young adults, 31% middle aged and 42.9% elderly. There were slightly more males (51.1%) than females (48.9%). Elevated creatinine was found in 47 (25.5%), with a corresponding 95% confidence interval of 19.0-32.1%. The independent factors associated with elevated creatinine among inpatients admitted with CAP at MRRH were: being elderly, hypotension, low peripheral oxygen saturation and higher pneumonia severity according to CURB-65 (P<0.05 for all). The overall mortality was significantly higher in the group that had elevated creatinine compared to those with normal creatinine (21.3% versus 8.8%, P=0.035). The median length of hospital stay was significantly higher among the patients that had elevated creatinine compared to those with normal creatinine (6 days versus 4 days, P<0.001). The details area shown in table 4 below. Conclusion The proportion of creatinine elevation was high, seen in about 3 in every 10 patients. All patients with CAP should be routinely screened for creatinine, since elevated creatinine was common and its elevation associated with both increased mortality and prolonged hospital stay.
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Prevalence and Factors Associated with Acute Otitis Media in Febrile Children aged 1-59 months Attending Outpatient Unit in Jinja Regional Referral Hospital
(Kampala International University; Faculty of Cinical Medicine and Dentistry, 2024-03) Amatarahman Ibrahim Said
Background: Otitis media is still a great public health challenge among children especially under 5 years with more than half of the children suffering at least one episode by their third birthday (Hounkpatin et al., 2016). It’s the leading cause of antibiotic prescription and is associated with hearing loss, decreased capability and low educational achievement (Jamal et al,2022). This study aimed to determine the prevalence of acute otitis media and to establish factors associated with acute otitis media among febrile children aged 1-59 month attending outpatient unit in Jinja Regional Referral Hospital.
Methodology: This was a hospital based cross sectional descriptive and analytical study which enrolled 312 febrile children aged 1-59months in Jinja Regional Referral Hospital. Consecutive enrollment was conducted and diagnosis of AOM was conducted by otoscopy. Informed consent was obtained from individual participants and ethical clearance obtained from Bishop Stuart university institutional research and ethics committee with registration number - BSU- REC-2023-148. Data was obtained using structured questionnaire, entered in excel software and imported to STATA version 18 for analysis.
Results: The prevalence of Acute otitis media was 12.5% with 95% CI ( 0.090-0.167).Female gender ( aOR 3.260, 95% CI (1.470-7.2288), p=0.004), family history of AOM (aOR 3.597,95% CI (1.436-9.009) p=0.006), prematurity (aOR 2.471,95% CI (1.051-5.814)
p=0.038), wasting (aOR 5.956, 95% CI (1.862-19.048) p=0.003), and stunting (aOR 7.746,
95% CI (2.675-22.432) p=<0.001) were independently associated with AOM. The commonest clinical features of acute otitis media were nonspecific and included runny nose, cough, vomiting and ear itching.
Conclusion: The prevalence of acute otitis media was high. Female gender, family history of AOM, prematurity and under nutrition were significantly associated with AOM. The commonest clinical feature among febrile children with AOM was runny nose followed by cough ,vomiting and ear itching.