Challenges with accessing health care for young children presumed to have malaria in the rural district of Butaleja, Uganda: a qualitative study

OBJECTIVE: A qualitative study was conducted to gain insight into challenges reported by Butaleja households during a previous household survey. Specifically, this paper discusses heads of households' and caregivers' perceptions of challenges they face when seeking care for their very young children with fever presumed to be malaria. METHODS: Eleven focus groups (FGs) were carried out with household members (five with heads of households and six with household caregivers) residing in five sub-counties located across the district. Purposive sampling was used to ensure the sample represented the religious diversity and geographical distance from the peri-urban center of the district. Each FG consisted of five to six participants. The FGs were conducted at a community centre by two pairs of researchers residing in the district and who were fluent in both English and the local dialect of Lunyole. The discussions were recorded, translated, and transcribed. Transcripts were reviewed and coded with the assistance of QDA Miner (version 4.0) qualitative data management software, and analyzed using thematic content analysis. RESULTS: The FG discussions identified four major areas of challenges when managing acute febrile illness in their child under the age of five with presumed malaria: (1) difficulties with getting to public health facilities due to long geographical distances and lack of affordable transportation; (2) poor service once at a public health facility, including denial of care, delay in treatment, and negative experiences with the staff; (3) difficulties with managing the child's illness at home, including challenges with keeping home-stock medicines and administering medicines as prescribed; and (4) constrained to use private outlets despite their shortcomings. CONCLUSIONS: Future interventions may need to look beyond the public health system to improve case management of childhood malaria at the community level in rural districts such as Butaleja. Given the difficulties with accessing quality private health outlets, there is a need to partner with the private sector to explore feasible models of community-based health insurance programs and expand the role of informal private providers

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Bolita de nieve / Little snow ball

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Prevalencia y factores de riesgo de la disfunción eréctil y los síntomas de deficiencia de testosterona en una población rural de uganda / Prevalence and risk factors of erectile dysfunction and testosterone deficiency symptoms in a rural population in Uganda

OBJETIVO: Determinar prevalencia y factores de riesgo de disfunción eréctil (DE) y prevalencia de síntomas de hipogonadismo en Buluba, una población rural en Uganda. MÉTODOS: Estudio prospectivo, consecutivo y transversal entre septiembre y diciembre 2010. Se incluyeron 902 hombres atendidos en consultas externas del Hospital Saint Francis de Buluba. De estos 902 hombres, 204 eran VIH+ y seguían controles en el consultorio de VIH del mismo centro. Se recogieron prospectivamente las variables edad, peso, altura, consumo de tabaco y alcohol, Erection Hardness Score y Aging Male Symptoms Scale (AMSS), así como hipertensión, diabetes, dislipemia, problemas respiratorios, úlcera péptica, sintomatología urinaria y VIH. Se realizó análisis multivariante para analizar las variables relacionadas con la función eréctil y AMSS. RESULTADOS: Edad media 39±11,8 años. Tasa DE 47,8% (DE leve 28,8%; moderada 14%; severa 5%). En el análisis multivariante, se relacionaron las variables edad (Odds ratio (OR) 1,032), VIH+ (OR 11,280), AMSS (OR 1,138) y AMSS≥50 (OR 1,164) con DE. Al excluir la población VIH+, el 36,6% de los hombres sufren DE (leve 23%; moderada 10,2%; severa 3,6%). 5,7% de los hombres tenían síntomas severos (≥50) de hipogonadismo según AMSS. Ninguna variable clínica se relacionó con la presencia de AMSS≥50 en el análisis multivariante. CONCLUSIONES: La tasa de DE en un entorno rural de Uganda es elevado. Las variables edad, AMSS, AMSS≥50 y VIH+ se relacionaron con la presencia de DE. La prevalencia de AMSS≥50 fue del 5,7%. Ninguna de las variables de estudio estuvo en relación con la presencia de AMSS (AU)

OBJECTIVES: To determine the prevalence and risk factors of ED and the prevalence of hypogonadism symptoms in Buluba, a rural population in Uganda. METHODS: Prospective, consecutive, cross-sectional study was conducted between September and Decempaber2010. 902 men attending the outpatient clinic of Saint Francis Hospital in Buluba were enrolled. From these 902 men, 204 had been previously diagnosed as HIV+ followed in a specific HIV outpatient clinic in the same centre. Variables age, weight, height, tobacco use and drinking habits, Erection Hardness Score and Aging Male Symptoms Scale (AMSS), as well as Hypertension, Diabetes, Dyslipidemia, lung diseases, peptic ulcer, urinary symptoms and HIV were prospectively recorded. A multivariate analysis was used to analyze the variables related to erectile function and AMSS. RESULTS: Mean age was 39±11,8 years. ED rate was 47,8% (Mild ED 28,8%; Moderate 14%; Severe 5%). In the multivariate analysis, variables age (Odds ratio (OR) 1,032), HIV+ (OR 11,280), AMSS (OR 1,138) and AMSS≥50 (OR 1,164) were related to ED. When excluding HIV+ population, 36,8% of men suffered ED (Mild ED 23%; Moderate 10,2%; Severe 3,6%). 5,7% of men had severe symptoms (≥50) of hypogonadism according to AMSS. No clinical variable was related to the presence of AMSS≥50 in the multivariate analysis. CONCLUSIONS: The rate of ED in a rural milieu in Uganda is high. Variables age, AMSS and AMSS ≥50 and HIV+ were related to ED. The rate of AMSS≥50 was 5,7%. No variable was found to be related to AMSS (AU)

Brote de Fiebre Hemorrágica por el virus del Ébola en Uganda / Hemorrhagic Fever outbreak due to Ebola virus in Uganda

En Uganda se está llevando a cabo la Misión de la Unión Europea (EUTM) Somalia, en la que participan efectivos de las Fuerzas Armadas españolas. En mayo de 2011 el Ministerio de Sanidad de Uganda notificó un brote de fiebre hemorrágica por el virus del bola a 70 km de distancia de Kampala. El caso índice y único caso confirmado, fue una niña de 12 años que falleció. La investigación epidemiológica se llevó a cabo por un equipo internacional que incluyó personal del Ministerio de Sanidad de Uganda y de la OMS. Tras mantener la vigilancia del brote durante un tiempo igual a dos veces el periodo de incubación y no confirmar otros casos, fue declarado finalizado el brote el 17 de junio de 2011. Se distribuyó información sobre el brote y recomendaciones de actuación tanto a profesionales de la salud como a la población general (AU)

The European Mission (EUTM) Somalia is being conducted in Uganda. Military personnel of the Spanish Armed Forces participate in that mission. On 13 May 2011, The Ministry of Health of Uganda notified a case of Ebola hemorrhagic fever in a district 70 kilometers far from Kampala. The index case and only confirmed case, was a 12-year-old girl who finally died. Epidemiologic surveillance was conducted by an international team including representatives of the Ugandan Ministry of Health and WHO. The Ministry of Health of Uganda declared the end of the outbreak on the 17 June 2011, since the epidemiological investigations, including twofold the incubation period surveillance, did not confirm new cases. Guidelines to control the outbreak and information on the disease were distributed to health professionals and general population (AU)

Últimas historias ugandesas o el triunfo de Mamadi / Last Ugandan stories or Mamadi’s triumph

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Los sellos de Rose / Rose’s stamps

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Sofía se cayó de la bicicleta y yo me tomaré pronto un descanso / Sofia fell off her bicycle and I will take a break soon

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