Background Traumatic brain injury (TBI) is a major cause of long‐term disability and economic loss to society. The aim of this study was to assess the factors affecting mortality after TBI in a resource‐poor setting. Methods Chart review was performed for randomly selected patients who presented with TBI between 2013 and 2017 at St Mary's Hospital, Lacor, northern Uganda. Data collected included demographic details, time from injury to presentation, and vital signs on arrival. In‐hospital management and mortality were recorded. Severe head injury was defined as a Glasgow Coma Scale score below 9. Results A total of 194 patient charts were reviewed. Median age at time of injury was 27 (i.q.r. 2–68) years. The majority of patients were male (M : F ratio 4·9 : 1). Some 30·9 per cent of patients had severe head injury, and an associated skull fracture was observed in 8·8 per cent. Treatment was mainly conservative in 94·8 per cent of patients; three patients (1·5 per cent) had burr‐holes, four (2·1 per cent) had a craniotomy, and three (1·5 per cent) had skull fracture elevation. The mortality rate was 33·0 per cent; 46 (72 per cent) of the 64 patients who died had severe head injury. Of the ten surgically treated patients, seven died, including all three patients who had a burr‐hole. In multivariable analysis, factors associated with mortality were mean arterial pressure (P = 0·012), referral status (P = 0·001), respiratory distress (P = 0·040), severe head injury (P = 0·011) and pupil reactivity (P = 0·011). Conclusion TBI in a resource‐poor setting remains a major challenge and affects mainly young males. Decisions concerning surgical intervention are compromised by the lack of both CT and intracranial pressure monitoring, with consequent poor outcomes.

Background: To protect health workers (HCWs) from risky occupation exposure, CDC developed the universal precautions (Ups) including Personal Protective Equipment (PPEs). However compliance to it by HCWs has remained poor even in high-risk clinical situation . The objective of this study was to identify and describe the factors that influence a HCWs' decision to wear PPEs and the barriers that exist in preventing their use Methods: A cross-sectional survey was carried out in the St. Mary's Hospital Lacor in all the wards to collected quantitative information as well as qualitative and observational data on PPE use Results: Out of the total 59 respondents, 2% do not know the purpose of PPE, 23.7% do not know how to don and doff PPEs, 13.6% do not use PPE even when indicated and 10% are not using an appropriate PPE. The main barriers relates to poor fitting and weak domestic gloves, few of aprons, frequent stock out and inadequate PPE as well as lack of training in PPE Conclusion: This study provides a baseline for measuring the effectiveness of interventions to improve compliance.

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Introduction: The aim of this study was to evaluate the profile of esophagogastroduodenal (EGDS) diseases diagnosed by upper endoscopy in a rural area of Uganda in a retro-protective study of 605 patients. Results: The mean age of patients with digestive symptoms was 39.7yrs (SD +/-16.11) and female gender predominated by 60% compared to the male (P value 0.000). Peasant farmers were the commonest group with GI symptoms requiring EGDS compared to the rest 72.1% v 27.9%. Epigastric pain was the commonest indication (58%) for EGDS, followed by chest pain (11%), abdominal pain (8.8%), dyspahgia (7.6%) and hematemesis (7.3%). The commonest endoscopy finding was gastritis (47.9%) followed by esophagitis (14.4%), cancer esophagus (5.1%), esophageal varicose (4%), PUD (2.3%), gastric cancer (1%). However 19.5% of patients had normal EGDS. There was a significant correlation between the outpatient diagnosis and Original Research Article

Background: Awareness of residual disabilities amongst people living in countries recovering from prolonged armed conflicts and their socio-economic consequences is increasing. Robust data on the prevalence of such disabilities are important for planning cost effective health services. This study outlines the first community-based prevalence study of Major Limb Loss (MLL) in the Acholi sub region of Northern Uganda. The generic lessons learnt are relevant to many other postconflict societies in Asia and Africa. Methods:A cross sectional survey using random cluster sampling was conducted across 8,000 households in eight districts, of which 7,864 were suitable for analysis. The households were sampled randomly using a high-resolution population model generated using a combination of census data and artificial intelligence. Data were collected using semi-structured questionnaires administered by trained staff, and results were statistically analysed to identify patterns.Results: Data obtained from 7,864 households demonstrated that 47.9% (3,763) of households contained people with disabilities, and 3.0%, (237) of households contained people living with MLL. Of those exhibiting disabilities, the most common types were physical disabilities affecting mobility and other conditions limiting vision or hearing. Our analysis suggests that MLL sufferers are disproportionately male, older and less well educated than the general population. Using the identified prevalence rate of MLL (0.6%) and an estimated population value for the Acholi Sub-Region of 1.9 million, we estimate that there are approximately 11,400 MLL sufferers in the region who require long-term rehabilitation services.Conclusions: This is the first large scale study on the prevalence of MLL following the Ugandan civil war -known for extreme forms of violence, cruelty and mutilation. Our study demonstrates the magnitude of the problem still faced by the affected people, almost 15 years after the end of large scale combat, and the relative paucity of rehabilitation services to meet their needs. Suitable alternative health policy frameworks are required to address these relatively invisible needs.