Background. Premature rupture of membranes (PROM) is a common condition in developed and developing countries and poses a serious threat to the maternal and fetal well-being if not properly managed. This study delineated the prevalence and predictors of PROM in the western part of Uganda so as to guide specific preventive measures. Methods. A cross-sectional study design was conducted in the months of September 2019 to November 2019. A total of 334 pregnant women above 28 weeks of gestation admitted at the maternity ward of KIU-TH were consecutively enrolled. Interviewer-administered questionnaires were used to obtain the data. Descriptive statistics followed by binary logistic regression were conducted. All data analyses were conducted using STATA 14.2. Results. Of the 334 pregnant women enrolled, the prevalence of PROM was found to be 13.8%. The significant independent predictors associated with lower odds of PROM were no history of urinary tract infection (UTI) in the month preceding enrollment into the study (aOR = 0:5, 95% CI: 0.22-0.69, p = 0:038) and gestational age of 37 weeks or more (aOR = 0:3, 95% CI: 0.14-0.71, p = 0:01) while history of 3 or more abortions (aOR = 13:1, 95% CI: 1.12-153.62, p = 0:05) was associated with higher likelihood of PROM. Conclusions. Majorly urinary tract infections, low gestational age, and abortions influence premature rupture of membranes among women. There is a great need for continuous screening and prompt treatment of pregnant women for UTI especially those with history of 3 or more abortions at less than 34 weeks of gestation.

BackgroundVerbal autopsy (VA) procedures can be used to estimate cause of death in settings with inadequate vital registries. However, the sensitivity of VA for determining malaria-specific mortality may be low, and may vary with transmission intensity. We assessed the diagnostic accuracy of VA procedures as compared to hospital medical records for determining cause of death in children under five in three different malaria transmission settings in Uganda, including Tororo (high), Kampala (medium), and Kisoro (low).Methods and FindingsCaretakers of children who died in participating hospitals were interviewed using a standardized World Health Organization questionnaire. Medical records from the child's hospitalization were also reviewed. Causes of death based on the VA questionnaires and the medical records were assigned independently by physician reviewers and then compared. A total of 719 cases were included in the final analysis, 67 in Tororo, 600 in Kampala, and 52 in Kisoro. Malaria was classified as the underlying or contributory cause of death by review of medical records in 33 deaths in Tororo, 60 in Kampala, and 0 in Kisoro. The sensitivity of VA procedures for determining malaria deaths in Tororo was 61% (95% CI 44–78%) and 50% in Kampala (95% CI 37–63%). Specificity for determining malaria deaths in Tororo and Kampala was high (>88%), but positive predictive value varied widely, from 83% in Tororo to 34% in Kampala (difference 49%, 95% CI 31–67, p<0.001). The difference between the cause-specific mortality fraction for malaria as determined by VA procedures and medical records was −11% in Tororo, +5% in Kampala, and +14% in Kisoro.ConclusionsOur results suggest that these VA methods have an acceptable level of diagnostic accuracy for determining malaria deaths at the population level in high and medium transmission areas, but not in low transmission areas.

Background: Thrombocytopenia is a serious threat both to the mother and the fetus world over. We established the prevalence and associated immediate maternal complications of thrombocytopenia among women delivering at Kampala International University Teaching Hospital (KIUTH) so as to help us draw a platform for provision of appropriate interventions.Methods: A prospective cross-sectional study involving 386 women was conducted in the months of May 2019 to August 2019. Questionnaires and laboratory result forms were used to obtain the data. Data analyses were conducted using STATA version 14.2.Results: The prevalence of thrombocytopenia was 15.8%. Significant immediate maternal outcomes were placenta abruption which was higher among women with thrombocytopenia (44.3%) than those with no thrombocytopenia (2.2%; p<0.001) and postpartum haemorrhage which was higher among those with thrombocytopenia (45.9%) than those with no thrombocytopenia (6.8%; p<0.001).Conclusions: Thrombocytopenia is a serious obstetric issue worth paying extra attention at this facility.

Background : Post-caesarean wound sepsis is among the most common problem for patients who undergo caesarean section. It remains a common and widespread problem contributing to morbidity and mortality; this could be due to an increase in antimicrobial resistance. Determining the burden of wound sepsis and common bacterial pathogens can provide solution to prevent incidence and establish microbiological mapping. Aim: To determine prevalence, identify factors, common bacterial pathogens from post-caesarean wounds and antibacterial susceptibility pattern at Hoima Regional Referral Hospital. Methods : A cross-sectional study was conducted among post-caesarean mothers attending Hoima Regional Referral Hospital. Consecutive enrolment of 303 participants who consented to participate was done. Structured questionnaires were used to collect data on associated factors and wound swabs were done prior to bacterial culture. Antibacterial susceptibility pattern of isolated bacterial pathogens was determined by Kirby Bauer disc diffusion method. Data was analyzed using Stata 14.2. Results : The wound sepsis rate was 16.8%. Being educated, multiple vaginal examination, hygiene, previous caesarean sections and HIV seropositivity were all significantly and positively associated with post-caesarean wound sepsis (p<0.05). The most implicated bacteria was Staphylococcus aureus and was most susceptible to ciprofloxacin. Resistance was most exhibited against ciprofloxacin, gentamycin, ceftriaxone and cotrimoxazole especially by coliforms. Conclusions. The rate of caesarean wound sepsis is high at Hoima Regional Referral Hospital . Being educated, multiple vaginal examination, hygiene, previous caesarean sections and HIV seropositivity are possible risk factors for the condition. Staphylococcus aureus is the commonest organism isolated from exudates of septic wounds after caesarean section. Awareness amongst health workers and patients about these major factors is necessary so that management can be directed. Rational use of antibiotics by health workers is paramount to combat resistance in this setting.

<p><strong>Background: </strong>We aimed to establish pre-pregnancy and prenatal care risk factors for spontaneous premature delivery at Kampala international university teaching hospital (KIUTH) so as to enable us draw a platform upon which specific interventions can be formulated.</p><p><strong>Methods: </strong>This was a hospital based unmatched case-control study conducted in the months of March to June 2019. A total of 110 cases and 330 controls admitted at KIUTH maternity and postnatal units were enrolled into the study. Interviewer administered questionnaires and respondent’s medical records were used to collect data. Chi square test and multiple logistic regression analysis were performed to establish the risk factors for spontaneous premature delivery at this facility. All data analyses were done using SPSS statistics version 20.</p><p><strong>Results: </strong>Nulliparity, previous premature delivery, history of premature rupture of membranes, previous cervical procedures, history of not having received preconception care, urinary tract infections during pregnancy and maternal obesity were independently associated with spontaneous premature delivery at this hospital.</p><p><strong>Conclusions: </strong>Guided by these factors, a high index of suspicion for spontaneous premature delivery among all pregnant women attending prenatal care is vital towards ameliorating this obstetric complication at KIUTH.</p>

Background: Premature rupture of membranes (PROM) remains a great burden to mothers and their unborn children all over the world with several adverse maternal and fetal outcomes. This study aimed at determining common bacterial pathogens and their susceptibility patterns in women with PROM at Kampala International University Teaching Hospital (KIU-TH). Methods: This was a cross-sectional study conducted in the months of September 2019 to November 2019. A total of 334 pregnant mothers above 28 weeks of pregnancy admitted in maternity ward of KIU-TH were consecutively enrolled. Interviewer administered questionnaires and laboratory forms were used to collect data. Endocervical swabs were obtained from those with PROM and taken to the laboratory for culture and susceptibility tests. Descriptive statistics were used using STATA 14.2. Results: 46 (13.8%) mothers had PROM. Of these, the most common bacterial pathogens identified were S. aureus (29.6%), E. coli (25.9%) and N. gonorrhoeae (25.9%). Antibacterial susceptibility tests revealed highest sensitivity to imipenem (100%), nitrofurantoin (92.6%), cloxacillin (85.2%) and azithromycin (81.5%). Total resistance to amoxacillin, ceftriaxone and ampicillin was found. Conclusion: Women with PROM predominatly have Staphylococcus aureus, Escherichia coli and Neisseria gonorrhoeae. Imipenem, nitrofurantoin, cloxacillin and azithromycin are the most effective antibiotics among patients with PROM.