Department of Surgery

Permanent URI for this community

https://ir2.lirauni.ac.ug/handle/123456789/374

Browse

Browsing Department of Surgery by Author "Campion, Alice"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Major limb loss (MLL): An overview of etiology, outcomes, experiences and challenges faced by amputees and service providers in the post-conflict period in Northern Uganda
    (Journal of Global Health Reports, 2019) Okello, Tom Richard; Magada, Samuel M; Atim, Pamela; Ezati, Daniel; Campion, Alice; Moro, Emmanuel B; Huck, Jonathon; Byrne, Ged; Redmond, Anthony; Nirmalan, Mahesh
    Background Trauma is a leading cause for major limb loss (MLL) during war. As societies transition into peace other factors become important. The voluntary sector plays a diminishing role in service delivery as countries transition towards peace. Methods We undertook a retrospective review of 141 inpatient case notes at two hospitals in Northern Uganda to study the etiology of MLL. Focus group discussions, a literature search and key informant interviews were undertaken to ascertain patients’ experience and the state of current services. Results The most common indication for amputation was malignancy (36%), followed by gangrene and complications from diabetes. Trauma was the 5th most common cause. The mean (standard deviation, SD) age of this cohort was 43 (22.2) years and the mean (SD) distance from their homes to the closest rehabilitation service unit was 91 (75) km. Less than 1% of patients were formally referred to rehabilitation services. Patients described experiences of stigma and marginalization impacting relationship and/or employability. Rehabilitation services were limited/ unaffordable and inaccessible. Unpreparedness of government agencies in taking over rehabilitation services was evident. Conclusions Non-communicable diseases account for the majority of MLL in this region now. These new cohorts of patients join an existing large pool of war-related amputees. Chronic dependence on the voluntary sector has rendered a state of unpreparedness amongst the local health providers.
  • Thumbnail Image
    Item
    Major Limb Loss and Prosthesis Use in the Post Conflict era in Acholi Sub-Region, Northern Uganda
    (International Journal of Science Academic Research, 2022) Okello, Tom Richard; Magada, Samuel Moses; Atim, Pamela; Campion, Alice; Moro, Emmanuel Ben; Jonathan, Hucks; Mahesan, Nirmalan
    Introduction: This study assessed amputees’ residual limb stump in the post war era of Acholi sub-region for suitability of prosthetic fit use and associated challenges with their current prosthesis and psycho-socio emotional experiences. Methods: A cross-sectional clinical assessment of amputees living within the communities in Acholi sub-region was done between September 2018 to August 2019 by a team of Surgical Consultants, orthopaedic technician and prosthetic therapist. Result: The biggest proportion of amputees living in the Acholi communities were adults of 35-65yrs (mean of 43.36yrs, SD+/- 15.694) and more male were affected than females (73.4%:26.6% respectively). The negative predictors of prosthetic fit and use were advancing age, gender, increased duration of disability, high percentage of disability, but stump length and power were positive predictor. Lower limb amputees tend to suffer more psycho-socio emotional disorder like pain sensation, stress, mood and anxiety disorders, as well as sexual discrimination. Lower limb amputee experiences more prosthesis complication like excessive sweating, extremely bothersome sound, terrible fit,and terrible appearance than upper limb. Conclusion: Residual stump length and power are the most important predictor of prosthesis fit. For proper prosthetic adherence, mental health and socio-emotional support need to be included in a comprehensive rehabilitation of amputees