Abdullah Ali Halage

Occupational Health Hazards among Healthcare Workers in Kampala, Uganda

Objective. To assess the occupational health hazards faced by healthcare workers and the mitigation measures. Methods. We conducted a cross-sectional study utilizing quantitative data collection methods among 200 respondents who worked in 8 major health facilities in Kampala. Results. Overall, 50.0% of respondents reported experiencing an occupational health hazard. Among these, 39.5% experienced biological hazards while 31.5% experienced nonbiological hazards. Predictors for experiencing hazards included not wearing the necessary personal protective equipment (PPE), working overtime, job related pressures, and working in multiple health facilities. Control measures to mitigate hazards were availing separate areas and containers to store medical waste and provision of safety tools and equipment. Conclusion. Healthcare workers in this setting experience several hazards in their workplaces. Associated factors include not wearing all necessary protective equipment, working overtime, experiencing work related pressures, and working in multiple facilities. Interventions should be instituted to mitigate the hazards. Specifically PPE supply gaps, job related pressures, and complacence in adhering to mitigation measures should be addressed.

Prevalence and risk factors associated with tungiasis in Mayuge district, Eastern Uganda.

Introduction Tungiasis is an endemic but neglected health problem in Uganda especially in resource poor communities. It is largely affecting rural communities in the Eastern, West Nile and Central regions. This study assessed prevalence and risk factors associated with tungiasis in Mayuge district, Eastern Uganda. Methods This was a cross sectional study that used a semi-structured questionnaire and observational checklist to collect quantitative data from 422 households in 12 villages. Prevalence of tungiasis was defined as presence of Tunga penetrans in the skin of any household member at the time of data collection. Results The prevalence of tungiasis was 22.5%. However, a big percentage 41.5% of households were reported to have had T. penetrans in the previous month while 49.5% had T. penetrans for more than one month. Majority (90.5%)of the participants used a pin, needle, or thorn to remove sand flea from infected body parts. Having dirty feet (AOR 3.86, CI (1.76-8.34)), dirty clothes (AOR 3.46, CI (2.00-5.97)), cracked house floor (AOR =6.28, CI (3.28-12.03)), dirty floor (AOR 3.21, CI (1.38-7.46)), littered compounds (AOR= 2.95, CI (1.66-5.26)) and rearing cattle (AOR 2.38, CI (1.28-4.45)) were associated with tungiasis. However, practicing preventive measures (AOR 0.51, CI (0.29-0.90)) was found protective for disease. Conclusion Tungiasis is still a prevalent health problem in rural communities in Eastern Uganda due to a number of individual (host) and environmental factors. There is need to increase awareness regarding improvement in sanitation and hygiene to enable communities’ implements interventions for prevention of T. penetrans.

The role of environmental health in One Health: A Uganda perspective

Background One Health is the integrative effort of multiple disciplines working locally, nationally and globally to attain optimal health for people, animals and the environment. As the human population continues to increase across the world, the interface of people, animals and the environment becomes more significant and impactful. For the past few years, the One Health concept has brought together experts in the areas of animal and human health. It has provided a new synthesis for public health and veterinary communities across the world. One Health initiatives have majorly focused on veterinarians, medical doctors and public health professionals. However, the Environmental Health profession has a major role to play in One Health activities based on Ugandas experiences. Contribution of environmental health to One Health In Uganda, Environmental Health Practitioners (EHPs) carry out several duties that contribute towards One Health. These include: inspection of animals before slaughter (antemortem) and meat in abattoirs (postmortem); inspection of meat in butcheries; destruction of condemned meat; disease surveillance; outbreak investigation and control of zoonoses; control of vectors and vermin such as rats, fleas, mosquitoes and monkeys; health education on pertinent issues such as vaccination of dogs; and food safety including meat and milk. EHPs also play an important role in prevention, detection and abatement of microbial and chemical pollution of land, air and water sources that have created new threats to the health of both animals and humans. EHPs carry out house to house inspections on water, sanitation and hygiene hence involved in abating nuisances at households that could pose a threat to public health. Such threats could be emerging from the environment including animals. Enforcement of public health legislation is also a key contribution of EHPs to One Health in Uganda. Conclusion EHPs play an important role in disease surveillance, prevention and control. Therefore, Environmental Health professionals should be involved as stakeholders in local, national and global One Health initiatives.

Bacteriological and physical quality of locally packaged drinking water in Kampala, Uganda.

Objective. To assess the bacteriological and physical quality of locally packaged drinking water sold for public consumption. Methods. This was cross-sectional study where a total of 60 samples of bottled water from 10 brands and 30 samples of sachet water from 15 brands purchased randomly were analyzed for bacteriological contamination (total coliform and faecal coliform per 100 mL) using membrane filtrate method and reported in terms of cfu/100 mL. Results. Both bottled water and sachet water were not contaminated with faecal coliform. Majority (70%, 21/30) of the sachet water analyzed exceeded acceptable limits of 0 total coliforms per 100 mL set by WHO and the national drinking water standards. The physical quality (turbidity and pH) of all the packaged water brands analyzed was within the acceptable limits. There was statistically significant difference between the median count of total coliform in both sachet water and bottled water brands (U(24) = 37.0, p = 0.027). Conclusion. Both bottled water and sachet water were not contaminated with faecal coliforms; majority of sachet water was contaminated with total coliform above acceptable limits. Government and other stakeholders should consider intensifying surveillance activities and enforcing strict hygienic measures in this rapidly expanding industry to improve packaged water quality.

Practices, Concerns, and Willingness to Participate in Solid Waste Management in Two Urban Slums in Central Uganda

Poor solid waste management is among the major challenges facing urban slums in developing countries including Uganda. Understanding community concerns and willingness towards involvement in solid waste management improvement initiatives is critical for informing interventions in slums. Methods. We used a cross-sectional study to collect quantitative data from 435 residents in two urban slums in central Uganda. A semistructured questionnaire was used which assessed waste collection practices, separation and disposal methods, concerns regarding solid wastes, and willingness to participate in waste separation and composting. Data was analysed using STATA 12. Results. Food remains (38%) and plastics (37%) formed the biggest proportion of wastes generated in households. Most households (35.9%) disposed of general wastes by open dumping while 27% disposed of plastics by burning. Only 8.8% of households conducted composting while 55% carried out separation for some decomposable wastes. Separation was carried out for only banana peelings and leftover foods for feeding animals. Respondents expressed high willingness to separate (76.6%) and compost (54.9%) solid wastes. Conclusion. Practices in waste disposal and separation were poor despite high willingness to participate in initiatives to improve waste management, highlighting a need for authorities to engage residents of slums to improve their practices.

Prevalence, Circumstances, and Management of Acute Pesticide Poisoning in Hospitals in Kampala City, Uganda

This study was aimed at assessing prevalence, circumstance, and management of acute pesticide poisoning in hospitals in Kampala. It was a retrospective cross-sectional study that involved reviewing of 739 poisoning patient records from 5 hospitals in Kampala. Of the 739 patients, 212 were due to pesticide poisoning resulting in a prevalence of 28.8%. About 91.4% (191/210) of the cases were due to organophosphate poisoning, 63.3% (133/210) were intentional, and 98.1% (206/210) were exposed through ingestion. Diagnosis was majorly based on poisoning history 91.2% (187/205), and clinical features such as airways, breathing, and circulation examination 48.0% (95/198); nausea and vomiting 42.9% (91/212); muscle weakness 29.7% (63/212); excessive salivation 23.1% (49/212); and confusion 20.3% (43/212). More than half of the patients admitted were treated using atropine 52.3% (113/212). The prevalence of acute pesticide poisoning was high with most managed based on physical and clinical examination.

An analysis of trends and distribution of the burden of road traffic injuries in Uganda, 2011 to 2015: a retrospective study

Introduction Gobally, 1.3 million people die from road traffic injuries every year. Over 90% of these deaths occur in low-and-middle-income countries. In Uganda, between 2012 and 2014, about 53,147 road traffic injuries were reported by the police, out of which 8,906 people died. Temporal and regional distribution of these injuries is not known, hence hindering targeted interventions. We described the trends and distribution of health facility reported road traffic injuries in Uganda from 2011 to 2015. Methods We obtained monthly data on road traffic injuries, from 112 districts from the Ministry of Health Uganda. We analyzed the data retrospectively to generate descriptive statistics. Results A total of 645,805 road traffic injuries were reported from January 2011 through December 2015 and 2,807 deaths reported from 2011 through 2014. Injuries increased from 37,219 in 2011 to 222,267 in 2014 and sharply dropped in December 2015 to 57,149. Kampala region had the highest number of injuries and deaths (18.3% (117,950/645,805) and 22.6% (634/2807)) respectively whereas Karamoja had the lowest injuries and deaths (1.7% (10,823/645,805) and 0.8% (21/2807)) respectively. Children aged 0-4 years accounted for 21.9% (615/2807) deaths; mostly females 81% (498/615) were affected. Conclusion Road traffic injuries increased during 2011-2014. Injuries and deaths were highest in Kampala and lowest in Karamoja region. It was noted that health facilities mostly received serious injuries. It is likely that the burden is higher but under reported. Concerted efforts are needed to increase road safety campaigns in Kampala and surrounding regions and to link pre-hospital deaths so as to understand the burden of road traffic crashes and recommend appropriate interventions.

Analysis of a five year (2011-2015), trends and distribution of the burden of road traffic injuries in Uganda: a retrospective study

Introduction : globally, 1.25 million lives are lost to road traffic injuries every year. Over ninety percent occur in Low and Middle-Income Countries despite owning just about half of the world’s vehicles. In Uganda, between 2012 and 2014, about 53,147 road traffic injuries were reported by the Police, out of which 8,906 people died. Temporal and regional distribution of these injuries is not known, hence hindering targeted intervention. This study describes the trends and distribution of health facility reported road traffic injuries in Uganda from 2011 to 2015. Methods : monthly data on road traffic injuries, from 112 districts, obtained from Ministry of Health was analyzed retrospectively. The districts were grouped into ten sub regions as per Uganda Demographic Health Survey 2011 and analysis done to generate descriptive statistics. Results : a total of 645,805 road traffic injuries were reported between January 2011 and December 2015 and 2807 deaths reported between 2011 and 2014. Injuries increased more than five times from 37,219 in 2011 to 222,267 in 2014, and sharply dropped in 2015 to 57,149. Kampala had the highest 18.3% (117,950/645,805) injuries and deaths 22.6% (634/2807) whereas Karamoja had the lowest 1.7% (10,823/645,805) injuries and 0.8% (21/2807) deaths respectively. Under-fives accounted for 21.9% (615/2807) deaths, mostly females 81% (498/615). Conclusion : there was a more than five-fold increase of road traffic injuries in 2014 from 2011. Injuries and deaths were highest in Kampala and lowest in Karamoja region. It was noted that health facilities mostly received serious injuries, as such, it is likely that the burden of these injuries is higher but under reported. This data is only from health facilities, hence do not reflect deaths at pre-hospital. Concerted efforts are needed to link pre-hospital deaths to understand the burden of road traffic crashes and appropriate interventions.

Drinking Water Supply, Sanitation, and Hygiene Promotion Interventions in Two Slum Communities in Central Uganda

Poor water, sanitation, and hygiene (WASH) continue to contribute to the high prevalence of diarrhoeal diseases in low-income countries such as Uganda particularly in slums. We implemented a 3-year WASH project in two urban slums in Uganda with a focus on safe drinking water and improvement in sanitation. The project implemented community and school interventions in addition to capacity building initiatives. Community interventions included home improvement campaigns, clean-up exercises, water quality assessment, promotion of drinking safe water through household point-of-use chlorination, promotion of hand washing, and support towards solid waste management. In schools, the project supported health clubs and provided them with “talking compound” messages. The capacity building initiatives undertaken included training of youth and community health workers. Project evaluation revealed several improvements in WASH status of the slums including increase in piped water usage from 38% to 86%, reduction in use of unprotected water sources from 30% to 2%, reduction in indiscriminate disposal of solid waste from 18% to 2%, and increase in satisfaction with solid waste management services from 40% to 92%. Such proactive and sustainable community interventions have the potential to not only improve lives of slum inhabitants in developing countries but also create lasting impact.

Costs of unintentional injuries among children in an urban slum community in Kampala city, Uganda

Abstract Unintentional injuries cause deaths, disabilities, productivity and financial losses and disproportionately affect children in low-income settings yet their cost remains under studied. This study determined the household out-of-pocket expenditure and missed school attendance due to unintentional childhood injuries in a Ugandan slum. We used a cross-sectional household survey design. Data were collected on occurrence and associated costs of unintentional injuries during a one-year period from July 2014 to June 2015. A total of 706 (44.7%) children who had suffered from injuries were reported in the one year period. More male children (N = 415, 58.7%) suffered injuries than females (N = 291, 41.2%). The average out-of-pocket expenditure on treating an injury was US