Shared-decision-making and communication in paediatric palliative care within Uganda.

The first palliative care services were started in Uganda 30 years ago with services continuing to develop since then. The Ministry of Health and the Palliative Care Association of Uganda have played key roles in the development of paediatric palliative care in the country. There are a range of paediatric palliative care service providers in Uganda, and these have developed alongside educational programmes and research in PPC. Care is provided across the Uganda health system and across the age range from neonates through to adolescents and young adults. Whilst recognising the importance of shared decision-making there is little literature with regards to this in the Ugandan context. However, a variety of factors have been shown to influence decision-making, along with the challenges and recommendations for the future. Uganda has made significant strides in the provision of paediatric palliative care although there is still a way to go before all children with palliative care needs, and their families, can access palliative care.

Predictors of treatment failure among pulmonary tuberculosis patients in Mulago hospital, Uganda.

INTRODUCTION: Early identification of Tuberculosis (TB) treatment failure using cost effective means is urgently needed in developing nations. The study set out to describe affordable predictors of TB treatment failure in an African setting. OBJECTIVE: To determine the predictors of treatment failure among patients with sputum smear positive pulmonary TB at Mulago hospital. The study was carried out in the TB clinic of Mulago hospital Kampala, Uganda. This was an unmatched case control study where fifty patients with a diagnosis of TB treatment failure (cases) and 100 patients declared cured after completing anti TB treatment (controls) were recruited into the study. Cases were compared with controls to determine predictors of treatment failure. RESULTS: Significant predictors of treatment failure in this study included a positive sputum smear at 2 months of TB treatment (OR 20.63, 95%CI 5.42- 78.41) and poor adherence to anti TB treatment (OR 14.59, 95%CI 3.04-70.15). CONCLUSION: This study identified a treatment related and a simple laboratory predictor of TB treatment failure in Mulago hospital which may be used in resource limited settings for early recognition of those at risk and early intervention.