Antibiotics in Uganda are controlled drugs or Prescription Only Medicine (POM) and should be obtained only with a prescription from duly qualified and registered medical practitioners such as doctor, nurse, or midwife (MOH, 2014). Irrational use of Medicines is a global phenomenon (WHO, 2015). The study was based on specific objectives that included; social demographic, personal and health related factors associated with irrational use of antibiotics among community members in Shuuku Sub County Sheema District. The study used a descriptive and cross sectional research design with a sample size of 108 respondents who were household caretakers selected by simple random sampling. The study found out that the significant social demographic factors associated with irrational antibiotic use were gender at (p=0.000) and marital status at (P=0.0164). Personal factors were the prices of drugs at (P=0.0000) and the importance of seeking medical care at (P=0.0132). Then the health facility related factors were asking patients to pay for medication at (P=0.0000) and adequacy of health workers at (P=0.0022). In conclusion the study found out that, gender and marital status were highly associated with irrational antibiotic use because females were inferior in the community both socially and financially so they could allow using any medicine brought by anyone or their superiors. Also the negative patients‘ attitude derailed them to think that there were few health workers and that some patients are told to buy some medicines that may be out of stock at the health facilities made them to develop a thinking that they were cheated since all services are meant to be free of charge and thus would rather practice irrational antibiotic use. The researcher therefore recommends that, more females should be encouraged to go to school, get jobs and improve their social status. It is important to sensitize both married couples regarding the dangers of irrational antibiotics use so that both understand and comply accordingly, should be sensitized about the effects of irrational use of antibiotics on minor illnesses, should enforce the sale of antibiotics in Sheema only on the basis of prescription. Government should sensitize people in Sheema that government facilities have got enough health workers for positive attitude in the community about government health centres. Government should implement health insurance policy.

Background: The number of persons suffering from type II diabetes mellitus continues to rise worldwide and causes significant morbidity and mortality, especially in the developing world. behavior change and adoption of healthy lifestyle habits help to prevent or manage the disease. however, the knowledge and practice of healthy lifestyles in many diabetic patients are inadequate. Purpose: This study aimed at establishing the knowledge, attitude and practice regarding lifestyle modification amongst type II diabetic patients in Mubende. Study Setting: the study was carried out at the diabetic clinic of Mubende regional referral hospital Methods: A cross-sectional study was done using a structured questionnaire amongst 100 type II diabetic patients seen at the diabetic clinic of Mubende regional referral hospital. baseline characteristics of the participants were obtained and their knowledge, attitude and practice regarding lifestyle modification were assessed. Results: In this study, majority (81)81% of the respondents had knowledge about lifestyle modification as they were able to mention adherence to diabetic drugs 37%, low sugar consumption 25%, healthy and nutritious diet by 20%, regular exercise 11% and weight management/reduction mentioned by only 7% of the respondents. 62% of the respondents said that Lsms keep blood sugar levels in normal or near normal ranges and 34% said Lsms help to reduce or normalize blood sugar levels. In the study more than (92)92% of the respondents demonstrated good (positive)attitude towards lifestyle modification in the management of diabetes mellitus typeII. in the study, 53% of the respondents do not practice lifestyle modifications/measures to control diabetes mellitus type ii and only 47% 0f the respondents do practice Lsms in the management of type II diabetes mellitus Conclusion: Despite the knowledge and positive attitudes of respondents toward healthy lifestyle modifications, practice of lifestyle modifications amongst type II diabetes mellitus patients at the diabetic clinic in Mubende is generally very low/poor. good knowledge and attitude towards lifestyle modification in the management of type II diabetes mellitus does not necessarily guarantee practice.

Background: Immunization is a proven tool for controlling and eliminating life-threatening infectious diseases and has been estimated to save more than three million lives in 2015 (WHO, 2015). The study assessed the knowledge, attitude and practices of caretakers towards immunization uptake in Katikamwe parish, Kyabugimbi trading center and Kyamutiganzi Villages, Bushenyi District. Method: A descriptive cross sectional and quantitative study design was used with a sample size of 195 respondents who were caretakers selected by simple random sampling. Data was collected through interviews. Results: Regarding knowledge on immunization uptake, all respondents had ever heard about immunization from health workers and could correctly define it. 175(90%) thought training about immunization was necessary, routine immunization prevented children from some infectious diseases, boosted a child‟s immunity 111(56.9%), were aware that multi-doses of the same vaccine given at intervals boosted immunity, knew that most immunizable diseases occurred before the first birth day. However they had inadequate facts about immunization, where; 92 (47.2%) did not know the right number of times a child should be immunized and when to receive the first vaccine, did not know that lack of immunization could cause serious sickness to children and were unaware of the immunizable diseases. Had generally poor attitudes where 82 (42.1%) never perceived it necessary to always seek medical care a child falls sick, thought some vaccines were unsafe 78 (40%), associated immunization with side effects, believed that a child can be infected after immunization with the disease/s against which he/she was vaccinated, did not believe that completion of immunization schedule was important and believed that local herbs were better than modern medicine. They also had poor practices where; they did not immunize on the exact date indicated for the next immunization schedule 102 (62.6%), started immunization late, never had immunization records, never immunized sick children and did not complete immunization despite getting information over the media. This provided ground for high prevalence of immunizable diseases in the area. Conclusions and recommendations: Had fair awareness about immunization because apart from knowing what it is, 147 (75%) they did not know; when to immunize, the number of times to immunize and effect of immunization. They had poor attitude since they believed that vaccines were unsafe and a child could be infected with the disease he or she was immunized against. They also had poor practices where; they did not meet the immunization schedule, started immunization late, never had records while other never completed the schedule. The researcher suggests that; more education and sensitization about immunization should be done by all stakeholders; caretaker should always start immunization from birth, keep the records and complete the schedule.

Introduction: In Uganda adolescents have an average of 1.8 sexual partners and only 54% use condomsdespite extensive voluntary counseling and testing strategies all over the country to prevent STIs (Renzaho, et al., 2017). This puts the youth at risk of getting sexually transmitted infections. Therefore a study on the level of knowledge, attitude and practices towards the prevention of sexually transmitted infections among the youths in Bidi Bidi Refugee Camp was carried out. Methods:A descriptive and cross sectional research design using qualitative method of data collection were used to carry out this study. A sample size of 420 respondents who were youth at Youth Centre was used. Data was collected using a face to face structured and semi structured interviews.And presented as a descriptive data using frequency tables and pie chart. Results: Respondents had moderate knowledge towards the prevention of STIs as all 420 (100%) had ever heard of prevention of STIs, 302 (79%) understood it as safe sexual intercourse and avoid body and blood contact, 267 (64%) knew HIV and gonorrhoea as the commonest STIs, 187 (61%) knew condoms as a preventive measure while 176 (42%) reported painful urination and itching as the major signs and symptoms of STIs.Respondents generally had negative attitude towards the prevention of STIs as290(69%) not freely seek STIs VCT services, 319 (76%) felt not at risk of STIs infection,345 (82%) marry any partner regardless of their sex history and 328 (78%) would not regularly use a condom. The practices towards prevention of STIs were generally poor as 265 (63%) were not married but 184 (47%) had two partners and more, 353 (84%) had been in more than one sexual relationship of recent, 322 (77%) had never used condoms, 298 (71%) had ever used drugs before and during sex intercourse. Majority 244 (58%) had never undergone STIs VCT services and 386 (92%) never first tested for STIs before sexual intercourse with new sexual partner. Conclusions and recommendations:In conclusion respondents had moderate knowledge about prevention of STIs but had negative attitude and poor practices towards STIs prevention. The study recommends that, youth are counselled about better ways of STIs prevention through behavioural change of regular condom use, being faithful and abstain from sex.

Introduction: Medical care equipment and hospital work surfaces play a major role in the accommodation of pathogenic bacteria. As such, they act as modes of transmission of these organisms among patients giving rise to nosocomial infections. Consequences of such infections include morbidity and mortality of the patients and increased antibiotic resistances amongst others. Aim of the study: This research was aimed at determining the microbial contaminants present on medical items and work surfaces in the post-operative surgical ward at Kawolo general hospital and their susceptibility patterns to antibiotics. Methodology: A cross sectional and laboratory based study was conducted for the research. Sterile swabs were used to collect samples from medical equipment including scissors, infusion stands, beds and work surfaces which were composed of tables, sinks and taps. The samples were processed and the antimicrobial susceptibility patterns of the identified isolates were assessed and further classified as MDR, XDR and PDR. Results: Out of the total 138 swabs that were collected and processed, the overall prevalence of bacterial contaminants was 44.2% (61/138). The Gram positive organisms constituted of 75.4% (46/61) while the Gram negative organisms accounted for 24.6% (15/61). All the Gram positive organisms isolated were Staphylococcus aureus, while the Gram negative bacteria isolated had Klebsiella pneumoniae with 7(11.5%), Proteus vulgaris, Enterobacter species and Serratia merscescans representing 5(8.2%), 2(3.3%) and 1(1.6%) respectively. The items that had the highest level of bacterial contaminants that were isolated were infusion stands and patient beds from which 12 swabs (19.67%) had isolates followed by tables and sinks represented by 10 (16.39%), scissors with 9 (14.75%) and light switches with 8 (13.11%). Statistically, contaminated patient beds were the most likely medical care equipment that were capable of transmitting organisms to the patients with OR: 20.1 and p value 0.0008. Antibiot ic susceptibility patterns for Gram positive isolated revealed that vancomycin was the most effective antibiotic with 100% while ciprofloxacin and ceftriaxone were the most effective antibiotics for Gram negative isolates both with 80% sensitivity. MDR for Staphylococcus aureus accounted for 52% (24/46) with 4% (1/24) classified as a possible XDR. Gram negat ive isolates had 27% (4/15) MDR strains out of which 50 %( 2/4) were classified as possible PDR. Conclusion: The high prevalence of bacteria present on the medical equipment at Kawolo hospital is an indicator of ineffective decontamination. A microbiology unit should be put in place for routine isolation and susceptibility testing of bacteria before antibiotic treatment to combat increasing drug resistance trends together with an infection control surveillance system.

Background of the study: Food is an important basic necessity which is essential for health and wellbeing of humans and so if the proper food handling and preparation proceses are not followed it might pose health risks to the consumer.Pupils in schools can be be exposed to infections and possible complications; gastroenteritis can impair digestion and absorption of nutrients and the perception or fear about poor food hygiene practices might result in pupils rejecting food. Objective: The overall objective of this study was to establish knowledge levels and practices of food safety among food handlers in selected primary schools in Makindye division, Kampala Methodology: A descriptive cross sectional study was carried out in Makindye division, 10 primary schools involving 103 food handlers. Schools were selected using a simple random selection so as to get equal respondents.An interviewer administered questionnaire and key informant interview guide were used to collect qualitative and quantitative data which was entered in SPSS for descriptive, bivariate and multivariate analysis. Results: Safe food was found to be at 20.4% among the food handlers in the selected schools in Makindye division.Three independent factors were found to be significantly associated with food safety; formal training (p=0.00), level of knowledge (p=0.00) and use of protective coverings (p=0.00). Conclusion: The safety of food in Makindye divison is at stake with only 20.4% safe food among primary schools. This implies that pupils in these schools are at risk of contracting food borne diseases. The low percentage of safe food is attributed to lack of formal training among food handlers regarding food safety, lack of adequate knowledge on best practices of food and failure to wear protective clothings while conducting food processes

Background; Population growth is a major challenge in most developing countries, and Uganda is no exception to this. In Uganda, the rate of population growth is 3.2% (UBOS, 2012), which can be attributed partly to an imbalance between infant mortality and fertility. Short birth intervals are associated with an increased risk of adverse health outcomes, including infant, child and maternal mortality. Short birth intervals (< 2 years) can lead to maternal depletion syndrome, milk diminution and competition between siblings close in age for food and other resources. Objective; The objective of this study was to assess the actual and preferred birth intervals of the women in Mbale regional referral hospital Methods; This study adopted a cross-sectional study design. This design was chosen because it could collect data to make inferences about a population of interest (women attending ANC) at one point in time. The study population included women who were attending both antenatal clinics and post natal clinics in outpatient departments who had had at least two children prior to the current pregnancy or had already two children respectively. Data was collected from the women using a variety of methods including interviews and tools. Results; Socio economic factors such as education of the mother/husband, occupation of the mother, transport costs to the hospital, paying some extra fee (bribe) to health workers before getting the service, affordability of services offered by the health centers, whose decision to have the current pregnancy, cultural influence to have shorter or long birth intervals, showed a statistical significance with actual and preferred birth intervals with p values 0.000 (p<0.05). Socio demographic factors like residence, age of mother, and age at first pregnancy were found to be significantly related to the birth spacing where as for community factors, breast feeding of the previous last child, duration of breast feeding, whether they exclusively breastfed their children, community perception on the use of family planning methods and community preferences on the gender of children to birth to showed a statistical significance with actual and preferred birth intervals. Conclusion; Socio economic and demographic factors of the women play a major role in determining birth intervals. Recommendations; Policy makers need to consider the potential for lengthening birth intervals in Uganda where the median birth interval is close to 3 years (2.88 years). Data from other African countries suggests that even in situations when women wish to increase spacing it is by no more than six months (Rafalimanana and Westoff, 2001). It has been found that women who are educated tend to have longer birth intervals, therefore girl child education should be further boosted to increase their literacy rates.

To determine factors influencing the uptake of male medical circumcision services among male adults attending Mukono and Ntenjeru health centre IV‟s in Mukono district to provide information relevant to improve MMC services‟ programming at the health centers.

Background: Shortened coagulation tests (Thrombophilia) are a marker of hypercoagulability observed in pregnancy and immediate postpartum period. While this is beneficial for preventing maternal hemorrhage, at the same time also predisposes the women for multiple complications. This study determined the prevalence of thrombophilia, the associated socio-demographic factors among pregnant women attending antenatal care clinic at Mpigi Health Center IV. Methods: This was a cross sectional study in which adult consented pregnant women attending Mpigi Health Centre IV were enrolled. Four milliliters of citrated blood were taken off, and spun to obtain hemolysis free plasma which was later analyzed for coagulation tests of prothrombin time (PT), activated partial thromboplastin time (aPTT) and thrombin time (TT). In addition, socio-demographic characteristics of the participant were recorded using a questionnaire. Data were analyzed, and presented as tables and a pie-chart. Logistic regression was used to establish the associated factors of thrombophilia, and variables with a p-value ≤ to 0.05 was considered statistically significant. Results: The study enrolled 136 pregnant women, their mean age was 29.7 years (range; 18 to 39 years). Most (50.9%, N=69) of the women were in different relationships, and a single participant (0.74%) reported a history of thrombophilia. The coagulation parameters of the participants varied by gestation period. The mean PT was 9.27 seconds with SD of ±1.13, while the mean a PTT was 35.59 ± 4.95 seconds. The mean TT was 27.51± 3.78 seconds. Thrombophilia was observed in 17 out of 136, giving a prevalence of 12.5% (95% confidence interval: 9.10 – 14.92). Age category, gestation period and history of thrombophilia showed a significant association (p<0.05). Conclusion: This study has found a high prevalence of thrombophilia, and there cases were typically characterized by delayed diagnosis. This necessitates the need to establish early diagnosis and establish the need for anticoagulation therapy to prevent adverse pregnancy outcomes.

Objective: To establish factors contributing to non adherence to antiretroviral therapy (ART) among HIV in-fected clients attending care at Uganda cares Soroti health care center in Soroti regional referral hos-pital. Method: This was a descriptive cross sectional study design involving 133 HIV infected respondents on ART. Respondents were sampled via systematic random method after acquisition of verbal consent. Data was collected using a semi structured and pre-coded researcher administered questionnaire. Data was entered in Epi-data v3.1 and then exported to Epi-Info v3.3.1 for statistical analysis at 95% confi-dence level using chi-square tests, fisher‟s exact test and logistic regression analysis. Results were presented in a tabular and graphical form. Probability values less than 0.05 were considered statisti-cally important Results: 53.4% of the respondents were females, 52.6% were of the age group 40-59 years, 50.4% were mar-ried, and 37.6 % had attained primary level of education. Only 63% of the respondents‟ were adhe-rent to the prescribed ARVs. The most commonly cited factors for non adherence to ART by the respondents were: long waiting hours in the clinic 14.3%, patient health worker relationship 9.1%, financial constrains, distance, & transport cost 8.3%, loosing appointment card 5.3%, 4.5% side ef-fects of the drugs and patient health worker ratio. At bivariate level of analysis, tendency for respon-dents to forget medication swallowing (p<0,001), ARV related side effects (p=0.002), service pro-vider attitude (p=0.004) and routine HIV counseling (p=0.008) were significantly correlated with adherence. However, via multiple logistic regression analysis, forgetting to take ARVs (adjusted OR=42, 95%CI: 5-348, p<0.001) and experience of ARV related side effects (adjusted OR=4, 95%CI: 1-12, p=0.01) were powerfully and significantly associated with non adherence to ART. Conclusion: ARV related toxicities/side effects and patient tendency to forget medication swallowing remarkably accounted for non adherence to ART among clients seeking comprehensive HIV care at Uganda Cares in Soroti Regional Referral Hospital. Recommendation: Early detection, diagnosis and appropriate management of patient related ART side effects in com-bination with new treatment reminder strategies are highly required for patient ART adherence