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Research findings show that Iron levels of blood donors in Uganda are low

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Makerere University researchers have released research findings showing that some blood donors in Uganda have low iron levels,low iron stores are common in blood donors, and that the donors who are deferred for low blood levels have limited insight into their situation. The findings were presented at a research dissemination workshop held on the 15th November 2022 at Makerere University College of Health Sciences.

In his remarks, Dr. Aggrey Dhabangi, Principal Investigator (PI) of the study explained that lack of iron may result in anaemia, which in turn makes blood donors ineligible to donate. ‘Other complications arising from low iron include, fatigue, low energy, and depression’, he added.

Statistics show that Uganda collects about 300,000 blood donations per year which is below the WHO recommended target of one donation per 100 population per year. As such, more donations are needed to increase blood supply. However, 10% of potential donors are turned away (deferred), 25% of these are due to low blood levels (anaemia); these missed donations may further exacerbate blood shortages in the country. Thresholds for eligibility to donate are 12.5g/dL and 13.5 g/dL for women and men respectively.

A total of 500 donors were involved in the cross-sectional study conducted within the central region blood collection sites of the Uganda Blood Transfusion Services (UBTS). The key findings of the study included:

  • The results showed that, of all potential donors screened to donate, 20.6 % had low iron stores. Among donors with blood levels acceptable to donate, 11.5% had low iron stores, while among those already turned away from donating for low blood levels, 61.5% also had had low iron.
  • The prevalence of low iron stores was higher among females (33.0%) compared to males (2.5%), but even higher among younger females i.e., 24 years and below (35.4%).
  • Further analysis revealed that, NOT eating an“iron-rich” diet was a major factor linked to low storesamong blood donors.
  • Interviews with donors turned away from donating for low blood levels revealed that many did not receive sufficient explanations as to why they were turned away, and what they were told was sometimes confusing to them.
  • Although the majority were surprised to be found with low blood levels and seemed frustrated for being turned away; deferral for low blood levels was generally poorly understood. Some interpreted it to mean, they had just ‘enough blood for themselves, but not enough to donate’. Others took the issue very lightly, yet their iron measurements have shown that 61.5% of these individuals besides being low on blood, they also had low iron.

The researchers gave the following recommendations:

  • Dietary (Iron-rich diet):Action – The population should be encouraged to adopt healthy eating lifestyle/diet which is iron-rich.Foods like leafy greens (bbugga, dodo, nakati), liver, beef, beans among others should be included in diets.
  • Behavioural change communicationon nutrition should be instituted to get the populations to change their diets and eating habits.
  • Consider Iron supplements for the population to repleteiron stores. The UBTS/Ministry of Health can offer iron pills to the affected donors. In the past this was done.
  • Identify donors at risk of Iron Deficiency through screening to identify affected persons early enough for interventions.
  • Improved communication is necessary for better handling of blood donors; the capacity of UBTS staff should be built; produce IEC materials for deferred donors: anaemia treatment, and prevention
  • Referral – to physicians for work-up and further management of anaemia

This study was made possible through collaboration between Makerere University College of Health Sciences and Uganda Blood Transfusion Services. Funding support was provided by the Government of the Republic of Uganda, through the Makerere University Research and Innovations Fund (Mak-RIF) – Round 3, financial year 2021/22.

Research Team: Dr. Aggrey Dhabangi (Principal Investigator (PI) and Co-PIs Dr. Godfrey Siu, Dr. Ronald Ssenyonga, Dr. Susan Acan, Mrs. Dorothy Kyeyune, and Dr. Imelda Bates.

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Researchers call for interventions to support HIV/AIDS prevention among University Students

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Group photo of Study team and Participants at the Dissemination meeting.

Researchers at Makerere University College of Health Sciences have given recommendations on how the education and health sectors can support HIV/AIDS prevention among students.

The researchers advised that the health sector should develop communication strategies and materials specific to university students and increase support to provide youth-friendly HIV prevention services at universities. The education sector working with University management should include: life skill programs during orientation of new students; HIVST delivery through peers and freshman orientations; Increase sensitization & access to PEP/PrEP by high-risk students; and update and disseminate institutional HIV policies.

The recommendations were made at a dissemination meeting for a study titled ‘HIV risk and factors associated with use of novel prevention interventions among female students at Makerere Universityheld on the 30th September 2022 at the Food Science & Technology Hall, Makerere University Campus.The study funded by Government of Uganda through the Makerere University Research & Innovations Fund (MakRIF) was conducted by Dr. Lorraine Oriokot (Principal Investigator), Dr. Ivan Segawa, Dr. Sabrina Bakeera-Kitaka, Dr. Andrew Mujugira and Ms. Sharon Okello.

The objectives of the study were: to know the percentage of female students at risk of HIV; and to know the characteristics of students that have used the newer HIV prevention methods, which are HIV self-testing; Pre-exposure prophylaxis; and Post-exposure prophylaxis.

A total of 534 female students with an average age of 22years completed the survey. The results and findings of the study were:

  • Behavioural characteristics (12% of the respondents were in multiple sexual relationships; 21% of the respondents had a partner ≥ 10 years from their age; 29% of the respondents used emergency contraceptive (in the past 6 months); 21% of the respondents had never tested for HIV; and 10% of the respondents believed that they were at high risk for HIV)
  • The study considered a person was high risk if they: Had a partner who was HIV positive; Had multiple sexual relationships, anal or transactional sex; Used drugs especially injectable drugs; Had 2 or more sexually transmitted episodes in one year; Were pregnant or breast feeding; Were or had partners who sex workers, fishermen, long-distance truck driver, boda-boda rider, or army officers
  • Overall, 21% students were deemed high risk for HIV; 19% of students had ever used HIV self-test kits; 64% had ever heard of oral HIVST; 93% were willing to use HIVST; HIVST was more likely to be used by older students; HIVST can bridge the HIV testing gaps among students
  • 80% had ever tested for HIV far below the global targets of 95%; Self-test kits are freely available at the University Hospital; Test kits can be purchased over-the-counter in pharmacies
  • For PEP it was found that:3% of students had ever used PEP; 9% among those eligible for PEP; 70% had ever heard of PEP; 65% were willing to use PEP; PEP use was linked to having a partner and high-self risk perception; PEP is currently the only way to reduce the risk of HIV infection in an individual who has been exposed to HIV; PEP is available at Makerere University Hospital at no cost
  • For PreP it was found that:1% of students had ever used PrEP; 2% among high-risk students; 45% had ever heard of PrEP; 52% were willing to use PrEP; PrEP has been linked with decreased new infections of HIV; PreP is currently available as oral tablets. Vaginal rings and injectable forms are being tested for wide roll out; and PrEP is available at KCCA health facilities and facilities offering HIV care.

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METS Newsletter October 2022

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Mabel from METS takes Biostatisticians through eCBSS during the DHIS2 training. Photo: MakSPH METS.

The Monitoring and Evaluation Technical Support (METS) Program is a 5-year CDC-supported collaboration of Makerere University School of Public Health (MakSPH), the University of California San Francisco (UCSF) and Health Information Systems Program (HISP Uganda).

Highlights of the METS August 2022 Newsletter

  • Advancing health information security, privacy and confidentially
    • With support from the Makerere University School of Public Health (MakSPH) – METS Program and other partners, the MoH has developed the national Health Information Exchange (HIE) and Interoperability guidelines that will guide the implementation of HIE initiatives within the health sector.
  • Inaugural HIV Recency Testing Data Quality Assessment
    • The inaugural HIV Recency Testing Data Quality Assessment (DQA) was conducted from 28th August – 10th September 2022, with an aim of designing interventions for improving data quality for public health action.
    • The DQA was carried out in a representative sample of 170 facilities geographically distributed across the country by 15 teams of members from MoH, METS, UCSF, implementing partners (IPs) and districts health teams.
  • Case Based Surveillance Learning Exchange in Kenya
    • The main objective of the learning visit was to benchmark the Kenyan CBS program with the aim of harnessing the implementation modalities, lessons learned, and best practices that will guide program improvements in Uganda.
    • The key lessons learnt for implementation of the CBS program in Uganda will require key steps including; strong leadership, coordination and involvement by MoH and partners, alignment of funding priorities with national needs; clear documentation of policies and guidelines; adoption of a unique identifier to manage de-duplication of patients across the health sector; strengthening communities of practice within the workforce capable of maintaining and extending the CBS implementation and development of a national data warehouse for surveillance.
  • Milestones in equipping health facilities to track commodities
    • UgandaEMR is an electronic medical records system that is currently in use in over 1,400 health facilities in Uganda. UgandaEMR currently supports the following service areas such as HIV, TB, MCH, Laboratory, SMC, and Cervical Cancer, among others. Since 2015, the MakSPH-METS program has been supporting the Ministry of Health in the design and development of UgandaEMR.
    • One of the latest modules added to UgandaEMR by MaKSPH-METS is the stock management and dispensing (SMD) module that supports the documentation of essential medical supplies distributed and/or received at health facilities from the national medical warehouses.

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37 Makerere University students & faculty complete 2-month Erasmus + exchange programme at NTU, UK

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Makerere University and NTU staff pose for a photo with NTU Pro Vice Chancellor International, Professor Cillian Ryan (in white shirt) at the Connecting Globally Conference.

Makerere University students and staff participated in a two-month exchange programme at Nottingham Trent University (NTU) in the United Kingdom (UK). This was under the Erasmus + International Credit Mobility Programme between NTU and Makerere University. Makerere University has had a partnership with NTU for more than 10 years. The partnership which was initially between Makerere University School of Public Health (MakSPH) and NTU, and later expanded to include the rest other schools in the College of Health Science and other colleges within the university. In addition to MakSPH, the partnership currently involves the College of Veterinary Medicine, Animal Resources and Biosecurity (CoVAB), College of Agricultural & Environmental Sciences (CAES) and under College of Health Sciences (CHS) the Department of Medical Microbiology, Department of Pharmacy and Department of Nursing. The exchange programme aims at enabling exchange of knowledge and skills, personal development, capacity building, fostering new research collaborations, and cross-cultural learning between Uganda and UK for both students and faculty.

Some of the Makerere University students at the global lounge at NTU.
Some of the Makerere University students at the global lounge at NTU.

This year, a total of 27 undergraduate and post graduate students from Makerere University under the support supervision of10 faculty travelled to NTU for a 2-month exchange programme. These were from various disciplines such as public health, environmental health science, pharmacy, microbiology, nursing, veterinary medicine, forestry and geography.The students and faculty arrived in the UK on 29th May2022. While at NTU, they participated in several activities such as research seminars, conferences, writing workshops, and field trips. The microbiology and pharmacy students spent most of their time at the NTU Clifton campus where they engaged in microbiology laboratory related work.Students from forestry, geography and veterinary medicine spent most of their time at the Brackenhurst campus where they carried out GIS practicals, forest walks, and animal care activities among other learning activities. The public health and nursing students participated in activities such as hospital visits, research studies and lectures at the city campus.

Makerere University Pharmacy and microbiology students taking part in a practical session at the NTU, Clifton campus.
Makerere University Pharmacy and Microbiology students taking part in a practical session at the NTU, Clifton campus.

In addition, students and faculty from all the disciplines participated in joint activities such as writing retreats and cultural exchange sessions. Some students also participated in conferences such as the Glow Nursing conference in Birmingham where Ms. Phiona Nambi, an undergraduate nursing student participated in a nurses’ competition and won the second runner up position. 10 students from various health related disciplines also presented at the10thInternational Festival of Public Health conference (IFPH) at the University of Manchester where Ms. Prossy Nakito, a Masters of Public Health Student was awarded the best oral presenter.All students attended lectures on professionalism, as well as writing retreats which enabled many of them to start or finalise with their theses and manuscripts. Faculty were involved in knowledge exchange and sharing through the different seminars and research work at NTU. Their continuous engagements with fellow faculty members at NTU created a base for establishing several research and project activities. For example, Mr. Samuel Kyobe a Lecturer in the Department of Medical Microbiology teamed up with Dr. Jody Winter and other NTU microbiology staff and wrote a grant application on antimicrobial resistance.

Makerere University students carrying out a GIS practical session at the NTU Brackenhurst campus.
Makerere University students carrying out a GIS practical session at the NTU Brackenhurst campus.

At the end of the programme, a seminar which was titled “Connecting globally” was organised for all the mobility students to reflect and share their experiences while at NTU. This seminar was attended by students and staff from, NTU, Makerere University, Mt. Kenya University and Jomo Kenyatta University from Kenya.

Makerere University Erasmus + mobility students and staff pose for a photo with NTU Pro Vice Chancellor International, Professor Cillian Ryan (in white shirt) at the Connecting Globally Conference in Nottingham.
Makerere University Erasmus + mobility students and staff pose for a photo with NTU Pro Vice Chancellor International, Professor Cillian Ryan (in white shirt) at the Connecting Globally Conference in Nottingham.

Special thanks to the partnership leads, Dr. David Musoke a Senior Lecturer in the Department of Disease Control and Environmental Health at MakSPH and Prof. Linda Gibson a Professor of Public Health,School of Social Sciences at NTU for spearheading this mobility programme.

What some students and faculty had to say:

“My time at NTU has been incredible and it will always be one of my most treasured memories. Studying while learning about various cultures was the most fruitful and enjoyable experience I’ve ever had. Most importantly, it has expanded my networks to support the development of my career. My professional, intellectual, and personal development have all benefited greatly from these priceless experiences. Mary Anne Radmacher said, I am not the same having seen the moon shine on the other side of the world.” Prossy Nakito, Masters of Public Health student

“The NTU Brackenhurst campus was a great centre for experiential learning, with fully equipped and easy to access facilities. It was a place of great comfort and bliss as we obtained hands-on experience with what we had known and didn’t know. Reptilian, rodent, feline and caprine husbandry all checked out despite some of the phobia we had to fight through. Special thanks to the volunteer program and management at the animal unit for they handled us like their own. We are certainly grateful” David Wagaba, Bachelor of Veterinary Medicine

“Through this exchange programme, I have been in position to continuously engage with other scholars at different levels as well as building peer support and networks. The academic benefits therefore are of great value in strengthening my academic career, of becoming an accomplished scholar and mentor of upcoming academics as well as establishing a platform for long term collaboration in research.” Faridah Nalwanga Ssendagire, Lecturer, School of Forestry, Environmental & Geographical Sciences

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