Health
New Uganda study shows Oxygen Access increase among neonates & children in Hospitals
A new study in Uganda has shown a significant increase in oxygen access and pulse oximetry among neonates and children in health facilities.
Preliminary findings published in The Lancet, the world’s highest-impact medical and academic journal show the positive impact of a diverse oxygen systems strengthening intervention on diagnosis, oxygen therapy use, and mortality rates.
Titled; “Improving Effective Coverage of Medical Oxygen Services for Neonates and Children in Health Facilities in Uganda: A Before-After Interventional Study,” the study shows that large-scale improvements in hospital oxygen services are achievable in a relatively short timeframe and have great potential for impact.
The study was led by Dr. Freddie Ssengooba, an Associate Professor of Health Policy Planning and Management, at the School of Public Health and Dr. Freddy Eric Kitutu, a Senior Lecturer of Health Systems Pharmacy both co-chairs of the Lancet Global Health Commission on Medical Security. Other researchers on the study include Hamish Graham from the University of Melbourne, Yewande Kamuntu, Blasio Kunihira, Santa Engol, Jasmine Miller, Absolom Zisanhi, Dorcas Kemigisha, Lorraine Kabunga and Felix Lam all from Clinton Health Access Initiative, Dr. Charles Olaro from Uganda’s Ministry of Health and Dr. Harriet Ajilong from the Uganda Paediatric Association.
From June 2020 to June 2022, an intervention study assessed neonates and children at 31 government health facilities in Uganda’s Busoga and North Buganda regions, located at altitudes of 1100-1400 meters. The primary outcome measured the proportion of patients with documented pulse oximetry on admission.
Secondary outcomes included patients with severe hypoxaemia (SpO2 < 90%) receiving oxygen, overall oxygen usage, and appropriate oxygen usage. The study’s primary effectiveness analysis compared pulse oximetry coverage before and after the intervention, incorporating a 4-month washout period. The analysis utilized mixed-effects logistic regression, adjusting for clustering at individual facilities, age (child versus neonate), and sex (male versus female).
Researchers analyzed 64,562 patients (25% neonates) and observed a significant rise in pulse oximetry coverage during the intervention period, increasing from 24% to 88% with an adjusted odds ratio of 40.1 (95% confidence interval: 37.4 to 42.9).
They also observed better oxygen coverage for children and neonates with low oxygen levels, increasing from 40% to 71%, with an adjusted odds ratio of 3.81 (95% confidence interval: 3.26 to 4.46).
Additionally, there was a slight increase in overall oxygen usage, rising from 8% to 11%, with an adjusted odds ratio of 1.95 (95% confidence interval: 1.79 to 2.13).
“Improvements were relatively greater in smaller facilities and for children (versus neonates). We estimated additional patients served and lives saved in the post-intervention period using observed effect estimates in this and other studies,” reads the study.
With these findings, researchers are calling on governments in low-income and middle-income countries to create oxygen plans and invest in proven solutions, like incorporating pulse oximetry in regular hospital care, and providing clinical as well as biomedical mentorship and support.
For all age groups, medical oxygen is essential for both acute and chronic health problems. Scientific evidence suggests access to medical oxygen services that are safe, economical, and appropriate is essential for improving overall health and achieving Sustainable Development Goals. Unfortunately, inadequate or inconsistent oxygen supplies present challenges for many low- and middle-income nations, particularly for small medical facilities in underserved areas.
Disruptions in the oxygen supply during the COVID-19 pandemic caused excessive deaths, which predominantly affected countries with low to middle incomes. According to a 2021 study, half of the COVID-19 patients who died in 64 critical care units across ten African countries did not receive the required medical oxygen.
The study was funded by a grant from the Bill and Melinda Gates Foundation (BMGF) and ELMA Philanthropies to the Clinton Health Access Initiative (CHAI) and approval from Makerere University School of Health Sciences Research and Ethics Committee, and the Uganda National Council of Science and Technology.
Available at SSRN: https://ssrn.com/abstract=4676954 or http://dx.doi.org/10.2139/ssrn.4676954
Agriculture & Environment
Makerere Hosts Inaugural Falling Walls Lab Competition as Innovators Pitch Solutions to National Challenges
Students and researchers from Makerere University and other institutions pitched 12 innovations addressing challenges in healthcare, clean energy, agriculture, waste management and community resilience during the inaugural Falling Walls Lab Kampala, held at the School of Public Health Auditorium, Makerere University.
The competition brought together emerging innovators to present solutions to practical challenges through a three minute pitch, followed by questions from a panel of judges.
Modelled on the Falling Walls format that originated in Berlin, the event required each participant to identify a “wall” a problem or barrier, and demonstrate how their innovation seeks to break it down.
Mudhasi wins with newborn jaundice screening device
Andrew Mudhasi of Makerere University emerged as the overall winner with a score of 90 per cent for a low cost medical device designed to improve newborn jaundice screening across different skin tones.
Mudhasi explained that the device uses optical sensor technology and a skin tone targeting algorithm to provide a rapid reading, with the aim of helping nurses and clinicians identify jaundice more efficiently.
During questions from the jury, Mudhasi said the device had not yet been tested on actual babies but had undergone laboratory testing using simulated skin tones.
He reported an accuracy rate of 94 per cent when the device was compared with laboratory spectrophotometers.
The innovation is intended initially for use in clinics and hospitals, with Mudhasi saying the team is also considering a version that could eventually allow mothers to screen babies at home.
Mudhasi’s innovation has previously received recognition at the African Business Concept Challenge and the iF Design Student Award, according to his presentation.
Rhonda’s innovation tackles diaper waste
Rhoda John of the University of Nairobi emerged in second place with 89.6 per cent for an innovation addressing the problem of used diaper waste.
Under the theme “Breaking the wall of diaper waste and drug soils,” Rhonda explained that her team extracts sodium polyacrylate, the absorbent polymer found in diapers, and replaces the sodium with potassium.
The resulting potassium based superabsorbent material is designed to act as a “water battery” in soil by absorbing and retaining water for plants during dry periods.
John said testing showed a 99 per cent increase in germination and a 23 per cent increase in drought resistance.
The innovation also seeks to reduce the amount of used diapers ending up in landfills and the environmental effects associated with their decomposition.
During the question and answer session, John explained that her team was working with government environmental officials in Nairobi on a pilot collection system to address the challenge of gathering used diapers at scale.
Mahera takes third place with herbal peptic ulcer treatment
Stuart Mahera of Makerere University finished third with 86.2 per cent for a herbal formulation targeting peptic ulcers.
Presenting under the theme “Breaking the wall of Nature and Modern Medicine,” Mahera argued that conventional treatment for peptic ulcers can involve multiple medicines and may be associated with side effects and antimicrobial resistance.
His proposed formulation, MARAC capsules, is intended as a monotherapy, combining properties required for peptic-ulcer treatment in a single capsule.
Mahera said his team had carried out quality control work, including characterisation and dose quantification, and had conducted preclinical trials on laboratory mice.
He also told the jury that an application had been submitted to the National Drug Authority as the team awaits the next stage of the regulatory process.
According to Mahera, the proposed seven day treatment would cost about Shs21,000, compared with the existing 14 day treatment approach.
Innovators present solutions to practical challenges
The remaining presentations covered a wide range of challenges.
Esther Nakungu of Utamu University presented Agri-Track, a digital record keeping solution intended to improve visibility, accountability and management of farm operations and financial information.
Dr. Jimmy Chachiga, a Makerere University participant, presented a solar photovoltaic cooker with a heat storage system designed to provide a cleaner and more reliable cooking option during both sunny and non sunny periods.
His presentation focused on reducing dependence on biomass fuels and addressing the challenges associated with intermittent solar energy.
Abdul Noor Luttamaguzi, a PhD student and senior government fisheries officer, presented a mobile application aimed at helping fish farmers and extension officers report, track and manage disease outbreaks.
Henry Duke Tamale presented a herbal cream targeting antibiotic resistant biofilm infections associated with diabetic foot ulcers.
Marvin Seruwu proposed adapting existing near infrared brain monitoring technology to help detect extra-axial brain bleeds in health facilities where access to CT and MRI equipment is limited.
His proposal seeks to repurpose existing technology towards a diagnostic need that could be particularly important in settings where advanced imaging facilities are not readily available.
Kennedy Kisame presented a poultry alert and diagnosis system combining satellite weather information with computer vision disease detection. The proposed system could be accessed through a smartphone application, SMS or USSD, making it potentially usable by farmers with limited internet access.
Frank Atwiine proposed a solar powered mobile diagnostic van designed to bring ultrasound and other diagnostic services closer to rural communities.
Johnson Makmot, a software and blockchain developer, presented a platform that combines GPS tracking and blockchain-based tokens to incentivise and verify plastic-waste collection in Kampala.
Dr. Nelson Ndugu, from a partner university, presented an artificial intelligence tool designed to translate agricultural research publications into local Ugandan languages and generate voice notes for radio-based extension delivery.
The final presentation came from Dr. Juliet Akola, a Ugandan post doctoral researcher at Mangosuthu University of Technology in South Africa.
Akola presented a community digital resilience initiative focused on mapping risks in Kampala’s informal settlements, including flooding, fire, poor sanitation, waste management and inadequate infrastructure.
Her proposal seeks to combine local community knowledge with geographical information systems and link identified risks to action plans involving municipalities and other stakeholders.
Nawangwe calls for more investment in innovation
Closing the event, Prof. Nawangwe congratulated all the participants and described their presentations as an important beginning for Makerere University, Uganda and the wider region.
Drawing on his experience attending the Falling Walls conference in Berlin, the Vice Chancellor said initiatives of this nature are important because innovation will play a major role in determining the future of countries.
He encouraged participants to make their pitches more precise by clearly identifying the problem they are addressing, explaining their proposed solution and demonstrating what they have already achieved.
Prof. Nawangwe also welcomed the participation of innovators from other universities and countries, noting that the Kampala event had attracted participants beyond Makerere.
He thanked the Africa Office of the Falling Walls Foundation for its role in bringing the initiative to Makerere and encouraged continued support for innovation.
The Vice Chancellor further linked innovation to Uganda’s growing youth population and the need to develop home-grown solutions to address challenges such as youth unemployment.
The inaugural Falling Walls Lab Kampala ultimately provided a platform for innovators to move ideas beyond the classroom and laboratory and demonstrate how research, technology and creativity can be applied to challenges affecting communities.
| Position | Winner | Institution | Score |
| 1st | Andrew Mudhasi | Makerere University | 90% |
| 2nd | Rhoda John | University of Nairobi | 89.6% |
| 3rd | Stuart Mahera | Makerere University | 86.2% |
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