Browsing by Author "Wanyama, Ronald"

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    Are Women In Low Income Setting Gaining Adequate Gestational Weight? A Prospective Cross Sectional Study In Urban Uganda
    (School of Biological Sciences, 2016) Wanyama, Ronald; Obai, Gerald; Odongo, Pancras; Kagawa, Mike N.; Baingana, Rhona K.
    Introduction: Pre-pregnancy weight and weight gained during pregnancy significantly influence maternal and infant health. Little information is available regarding prevalence of optimal GWG in relation to pre-pregnancy body mass index (BMI) in Uganda. This study aimed at determining the prevalence of inadequate, adequate and excessive GWG in women pregnant for the first and second time. Methods: The study was prospective cross sectional by design and involved HIV negative women pregnant for the first or second time. It was conducted in a health centre IV and recruitment women at ≤18 weeks of gestation. Follow up measurements were done at 26 and 36 weeks gestation age. Maternal height and weight were measured and used to calculate BMI. Depending on BMI category, GWG was categorized as inadequate, adequate and excessive based on the Uganda Ministry of Health guidelines. Results: The participants’ mean±standard deviation (Sd) age was 20.9±2.7 years and mean±Sd BMI was 21.40±2.73kg/m2. None of the participants was obese and 68.8% (n=132) were primigravidae. The mean±Sd GWG at time of delivery was 10.58±2.44kg. Inadequate GWG was recorded in 62.5% (n=120/192) while only 3.1% (n=6/192) of the participants gained excessive gestational weight. Conclusion: About 62% of primigravidae and secundigravidae in low income urban Kampala do not gain adequate gestational weight
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    Effect of maternal Helicobacter Pylori infection on gestational weight gain in an urban community of Uganda
    (The Pan African Medical Journal, 2017) Wanyama, Ronald; Obai, Gerald; Odongo, Pancras; Kagawa, Michael; Baingana, Rhona
    Introduction: Maternal Helicobacter pylori (H. pylori) infection has been associated with undesirable effects during pregnancy such as; hyperemesis gravidarum, anemia, intrauterine fetal growth restriction and miscarriage. Our aim was to document the effect of H. pylori infection on gestational weight gain (GWG) in a low-income urban setting in Uganda. Methods: This was a prospective cohort study conducted in Kampala between May 2012 and May 2013. The participants were HIV negative, H. pylori positive and H. pylori negative primigravidae and secundigravidae. Recruitment was at gestation age of eighteen or less weeks and follow up assessments were carried out at 26 and 36 weeks gestation age. H. pylori infection was determined using H. pylori stool antigen test. Maternal weight and height were measured, and body mass index (BMI) and rates of GWG were calculated. Results: The participants’ mean±standard deviation (sd) age was 20.9±2.7 years. Primigravidae were 68.8% (n = 132) and 57.3% (n = 110) of the participants were positive for H. pylori infection. Low pre-women pregnancy BMI (< 18.5 kg/m2) was recorded in 14.6% (n = 28). The mean±sd rate of GWG during second and third trimesters was 300.5±79.7 grams/week. The mean±sd weight gained by 36 weeks of gestation was 9.6±2.2 kg while gestation age at delivery was 39.4±1.0 weeks. Factors independently associated with the rates of GWG during the second and third trimesters were parity (P=0.023), H. pylori infection (P = 0.006), pre-pregnancy BMI (P = 0.037), height (P = 0.022) and household income (P = 0.003). Conclusion: H. pylori infection is associated with low rates of GWG among primigravidae and secundigravidae.
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    Health seeking behaviour of small income market vendors: Diabetes primary care in Gulu Municipality, northern Uganda
    (South Sudan Medical Journal, 2020) Loum, Constantine S.L.; Wanyama, Ronald; Anywar, Denis; Odongkara, Beatrice M.; Odongo, Pancras
    Introduction: Uganda faces a serious threat of non-communicable diseases including type 2 diabetes; sedentary lifestyles predispose people to these diseases. Objective: To understand the diabetes health seeking behaviour of market vendors at the main market, Gulu Municipality. Method: This cross-sectional study used quantitative and qualitative methods to understand experiences of market vendors on health seeking behaviour. After general sensitization and mobilisation in the market, 400 participants were enrolled for the study, however quantitative analysis was done only on data from 375 participants (316 women and 59 men); 25 participants had missing data; 30 of these 375 were interviewed and the qualitative analyses of their responses offered further insight on health seeking – and is reported here. The qualitative data will be reported later. Results: Mixed responses were obtained from these 30 market vendors about their health seeking behaviour for diabetes. The factors were responsible for their overall health seeking behaviour included crowded hospitals and low frequency of clinic days; lack of accurate knowledge, and uninformed beliefs on diabetes, and poor work-life balance. Major impediments to health seeking were the fear of losing work time and money, and feeling healthy and hence seeing no need for health check-ups or medical care. Conclusion: Awareness of diabetes and the need to seek health care exists, but market vendors are not well informed on tests and care. We recommend that more comprehensive simple-message sensitisation is undertaken to change health seeking behaviour and prevent escalation of non-communicable diseases in northern Uganda and beyond.
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    Impaired renal function and associated risk factors in newly diagnosed HIV-infected adults in Gulu Hospital, Northern Uganda
    (BMC nephrology, 2015) Odongo, Pancras; Wanyama, Ronald; Obol, James Henry; Apiyo, Paska; Byakika-Kibwika, Pauline
    Background: Screening for renal diseases should be performed at the time of diagnosis of human immunodeficiency virus (HIV) infection. Despite the high prevalence of HIV/AIDS in Northern Uganda, little is known about the status of renal function and its correlates in the newly diagnosed HIV-infected individuals in this resource limited region. We aimed to determine the status of renal function and factors associated with impaired renal function in newly diagnosed HIV-infected adults in Northern Uganda. Methods: This was a seven month cross-sectional hospital-based study, involving newly diagnosed HIV-infected patients, 18 years and older. Patients with history of diabetes mellitus, hypertension and renal disease were excluded. Estimated glomerular filtration rate (eGFR) was calculated using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula (Table one). Factors associated with impaired renal function (eGFR < 60 ml/min/1.73 m2) were thus sought. Results: We enrolled 361 participants (230, 63.7% female) with Mean ± standard deviation age of 31.4 ± 9.5 years. 52, (14.4%) had impaired renal function (eGFR <60 mL/min/1.73 m2) and of this 37 (71.2%) moderate renal impairment (eGFR 30–59.9 mL/min/1.73 m2) while 15 (28.8%) had severe renal impairment (eGFR <30 mL/min/1.73 m2). Proteinuria was recorded in 189 (52.4%) participants. Of these, 154 (81.5%) had mild (1+) while 8 (4.2%) had severe (3+) proteinuria. Using logistic regression, age, CD4 cell count, and proteinuria were significantly associated with impaired renal function; age >34 years (OR 2.8, 95% CI 1.3 – 5.9; P =0.009), CD4 count <350 cells/μL (OR 2.4, 95% CI 1.0-4.7; P =0.039) and proteinuria (OR 9.6, 95% CI 5.2–17.9; P < 0.001). Conclusion: The prevalence of impaired renal function was high in new HIV-infected individuals in this region with limited resources. So, screening for renal disease in HIV is recommended at the time of HIV diagnosis
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    Prevalence of anaemia and associated risk factors among pregnant women attending antenatal care in Gulu and Hoima Regional Hospitals in Uganda: A cross sectional study
    (BMC pregnancy and childbirth, 2016) Obai, Gerald; Odongo, Pancras; Wanyama, Ronald
    Background: Anaemia is a public health problem affecting over 1.62 billion people globally. It affects all age groups of people and is particularly more prevalent in pregnant women. Africa carries a high burden of anaemia; in Uganda 24 % of women of child bearing age have anaemia. Pregnant women living in poverty are at greater risk of developing iron deficiency anaemia. The objective of this study was to determine the prevalence of anaemia and the associated risk factors in pregnant women attending antenatal care at Gulu and Hoima Regional Hospitals in Northern and Western Uganda respectively. Methods: We conducted a cross sectional study in Gulu and Hoima Regional Hospitals from July to October 2012. Our study participants were pregnant women attending antenatal care. Socio-demographic data were collected using structured questionnaires and blood samples were collected for haemoglobin estimation. Haemoglobin concentration was determined using an automated analyzer closed mode of blood sampling. Data were analysed using Stata version 12. Odds ratio was used as a measure of association, with 95 % confidence interval; and independent risk factors for anaemia were investigated using logistic regression analyses. Ethical approval was obtained from Gulu University Research Ethics Committee and written informed consent was obtained from each study participant. Results: The overall prevalence of anaemia was 22.1 %; higher in Gulu (32.9 %) than in Hoima (12.1 %), p < 0.001. In Gulu, the prevalence of mild anaemia was 23 %, moderate anaemia was 9 %, and severe anaemia was 0.8 %, while in Hoima, the prevalence of mild anaemia was 9 %, moderate anaemia was 2.5 %, and severe anaemia was 0.5 %. Independent risk factors for anaemia were: being a housewife [Adjusted Odds Ratio (AOR) = 1.7, 95 % CI: 1.05–2.68]; and being a resident in Gulu (AOR = 3.6, 95 % CI: 2.41–5.58). Conclusion: The prevalence of anaemia in pregnant women in Gulu is higher than in Hoima. Amongst pregnancy women, being a housewife is an independent risk factor for anaemia. Greater efforts are required to encourage early antenatal attendance from women in these at risk groups. This would allow iron and folic acid supplementation during pregnancy, which would potentially reduce the prevalence of anaemia.