Our PhD studies will improve health sector

Dr Geoffrey Erem (PhD in Diagnostic Radiology)
Dr Erem conducted a study to determine the first adult Diagnostic Reference Levels for Computed Tomography Examinations in Uganda.

This study found that examination, reference and total mAs had a significant positive association with the patient characteristics across the facilities.

He recommends training of CT scan radiographers on optimising the CT scan acquisition parameters. The study also recommends continuous dose audits for all new CT scan equipment’s in Uganda or after every three years to ensure that CT radiation doses are optimised. 

Dr Hussein Kafeero Mukasa  (PhD in  Immunology and Medical Microbiology)
Dr Mukasa investigated the factors responsible for the difference in the burden of hepatitis B virus (HBV) in Uganda.

He collected samples from Kibuku (low endemic) and Kitgum (high endemic) districts. He found out that many people were silently infected with HBV infection (occult Hepatitis), eligible for treatment using TREAT-B algorithm and, infected with strains D and A but, with a conserved tumor necrosis factor alpha gene at positions 863 and 1031T.

Strain D and silent infections were more common in the high endemic region. Since D presents with a more aggressive disease, this can potentially explain the difference in burden of HBV. He recommends comprehensively evaluation of HBV infection to establish silent infections, infecting strains and treatment eligibility. 

Dr Martin Mbonye (PhD in Social Anthropology)
Dr Mbonye explored how masculinity influences the uptake of HIV services by men in relationships with female sex workers (FSW) in Kampala, Uganda.

Martin concluded that two marginalised groups can effectively harness and combine existing opportunities in their relationships to produce positive health behaviours, thereby crafting respectability from positions of marginality.  

Dr Beatrice Odongkara (PhD in Medicine)
Dr Odongkara conducted a cohort study to estimate the burden and risk factors for small-newborns and neonatal hypoglycaemia; and a cluster-randomized trial of innovative teaching method to improve frontline healthcare workers’ competence in post-conflict Northern Uganda.

Her study highlights the vulnerability of small newborns, providing guidance for healthcare workers and policymakers in resource-limited settings for SGD 3.2 of <12 neonatal deaths per 1,000 live births by 2030. 

Dr Nicholas Nanyeenya (PhD in  Public Health)
Dr Nanyeenya investigated the non-suppression risk, perceptions, and the effectiveness of intensive adherence counselling (IAC) among people living with HIV (PLHIV) on antiretroviral therapy, having low-level viraemia, LLV (greater than or equal to 50 to less than 1,000 copies/ml) in Uganda.

The results showed that PLHIV with LLV had 4.1 times higher risk of non-suppression (greater than1000 copies), as compared to PLHIV with less than 50 copies/ml. Qualitative data showed that PLHIV were unaware about LLV.  

IAC doubled the likelihood of PLHIV with LLV to achieve a viral load less than50 copies/ml in the intervention arm, as compared to the control arm. This project contributed to the reduction of the suppression threshold from 1,000 to 200 and 400 copies/ml for plasma and dried blood spot samples respectively in Uganda. 

Dr James Muleme (PhD in Public Health)
Dr Muleme investigated the global health threat of extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-Ec) and antimicrobial resistance (AMR) in Wakiso, Central Uganda. Significant multi-drug resistance was observed, particularly in intensively husbandry-practising households.

Molecular analyses identified prevalent ESBL genes and shared replicons among isolates from different sources. Cultural norms and human-animal interactions were identified as key drivers of AMR spillover, thus broader dissemination and undetected transmission of ESBL-Ec.

Dr Charles Ssemugabo  (PhD in Public Health)
Dr Ssemugabo investigated dietary exposure to pesticide residues in fruits and vegetables, and potential health risks among consumers, using the “Farm-to-Fork” principle.

Findings demonstrated presence of pesticides in commonly consumed fruits and vegetables in the Kampala Metropolitan Area, including chemicals that are banned for use in agriculture with some having concentrations above the CODEX Alimentarius maximum residue limits.

The detected concentrations were attributed to pre and post-harvest application of pesticides intended to increase shelf life and marketability.

Further, children especially those aged under 5 years had higher health risks from exposure to pesticide residues.

The study also revealed that consumers relied on washing, peeling and boiling or a combination to reduce exposure to pesticides. The findings demonstrate the need to enforce national guidelines on proper use of pesticides for food production and post-harvest handling.

Dr Frederick Oporia (PhD in Drowning Prevention)
Dr Oporia developed and evaluated a peer-to-peer training program to improve lifejacket wear among occupational boaters on Lake Albert, Uganda.

Despite being among the oldest occupations in human history, water-related boating activities like fishing and water transport remain the most affected by drowning.

More than 95 percent of individuals who drown from boat-related activities in Uganda are not wearing lifejackets at the time of the incident.

The intervention was piloted for six months and evaluated.

At baseline, lifejacket wear was influenced by insufficient knowledge about its benefits. At end-line, self-reported lifejacket wear increased markedly from 30.8 percent to 65.1 percent in the intervention arm than in the non-intervention arm which rose from 29.9 percent to 43.2 percent. 

Dr Eva Wodeya Wanyenze  (PhD in Health Sciences)
Dr Wanyenze investigate health human resources problem in Uganda. Such shortages jeopardize midwives’ ability, availability to offer support to women during childbirth. Birth companions could mitigate this crisis.

There were no significant differences in mode of delivery, length of labor, and Apgar scores. Women reported a higher self-efficacy and contented with care.

Birth companions provide emotional, physical support, and advocate for women’s needs. Companion disrespect hinders coping.

Midwife-provided orientation of birth companions lowers maternal anxiety and improves coping and maternal satisfaction. Birth companion orientation enhanced women’s self-efficacy, promoted respectful, compassionate intrapartum care. Guided birth companionship is a low-cost intervention pivotal in respectful maternity care. 

Dr Samuel  Kyobe (PhD in  Human Genetics)
Dr Kyobe studied human leukocyte antigen (HLA) Class I and Paediatric HIV Disease Progression in Botswana and Uganda. Examining HLA class I alleles in LTNP children unveiled novel associations, including the protective HLA-C*03:02 allele. This allele, along with others (HLA-B*57:03 & HLA-B*58:01), accounts for 16.5 percent of LTNP variability.

Further exploration elucidated that HLA-C*03:02 presents HIV peptides, particularly Gag GY9, shaping immune responses crucial for viral control.

The findings provide a foundation for developing targeted HIV vaccines and immunotherapies, underscoring the importance of genetic factors in understanding HIV pathogenesis. 

Dr Andrew  Ssemata Sentoogo (PhD in Clinical Neuropsychology)
Dr Sentoogo explored the effect of severe anaemia and ferrous sulphate therapy on neuropsychological function among children below five years in Uganda.

He found that the various forms of malaria, iron deficiency and severe anaemia affect cognitive and behavioural function among Ugandan children in the short and long-term. These deficits significantly impact children’s lives preventing them from achieving their full potential.

Additionally, he found that although delaying administration of ferrous sulphate therapy by 28 days has clinical significance, it does not make changes to the cognitive and behavioural outcomes among children under five years surviving severe malaria.

The information generated informs the timing and prioritisation of ferrous sulphate administration in a malaria endemic region. 

Compiled by Dorothy Nagitta.
Photos/Frank Baguma
Sub Editor: Eva Kyomugisha