https://dr.ur.ac.rw/handle/123456789/26 Research works from students of the College of Medicine and Health Sciences 2026-04-23T19:40:14Z https://dr.ur.ac.rw/handle/123456789/2738 Prevalence of stunting and associated factors among children of under five years with disabilities in Bugesera district, Eastern province of Rwanda NKURUNZIZA, Emmanuel Background: There are nearly 240 million children with disabilities globally among numerous challenges they face nutrition difficulties are very common and this leads to inadequate nutrition which seriously affects disabled children in terms of thriving, brain development, physical growth and prone to diseases. Stunting is still a public health problem among the general population in LMIC. The burden doubles among children with disabilities due to inadequate or excess dietary intake which worsens their nutrition status and deterioration of their conditions. The aim of this study was to assess prevalence of stunting and associated factor among disabled children under five years in Bugesera district. Method: This was a cross-sectional descriptive study with the main objective of assessing prevalence of stunting and associated factors among children under the age of five years with disabilities in Bugesera District. Multistage sampling technique was applied where 8 sectors have been randomly selected and from each sector probability proportion to size sampling (PPS) was applied to identify the study participants in each sector. Weight was obtained using standard electronic balance scale, height was measured using wooden height board and children less than 24 months lengths were obtained in recumbent position. Height for age was classified according WHO z-score standards. Socioeconomic factors and sociodemographic were obtained through an administered questionnaire. Description of independent variables was done through Percentages and frequency tables. Height for age(haz) was obtained by zscore06 stata function, bivariate analysis was obtained with chi-square (X2 ) test to determine the associated factors among children with disabilities. Logistic regression was used for multivariate analysis to test the strength of association of multiple factors. Results: In total 265 children were recruited and the majority were aged between 25-59 months. The high attained level of education by the parents was primary school 51.70% and 53.96% father and mother respectively. The most occupation for both parents was farming. Prevalence of stunting among disabled children under the age of five in Bugesera district was 44.91%. A positive association of being stunted was found in: age 25-59 months (aOR = 4.18 [95% CI: 1.71 - 10.23]), incomplete child immunization (aOR = 4.4 [95% CI: 1.16 - 16.69]) and rural residence (aOR = 3.08 [95% CI: 1.05 - 8.99] and parents education. Conclusion: The prevalence of stunting among under five children with disabilities is high and being in preschool age, incompletely immunized, living in rural and no formally educated parents are associated with high risk of stunting among these children. There is a need to address stunting among disabled children through a strong program on parental education about nutritional guidance and support, quality healthcare including child full immunization. Further studies on magnitude of stunting among disabled children on national level are also needed. Master's Dissertation 2023-08-01T00:00:00Z https://dr.ur.ac.rw/handle/123456789/2737 Factors associated with mortality in TB patients on first-line treatment in Rwanda: from July 2019 to June 2022 NSHIMIYIMANA, Kizito Introduction: Tuberculosis (TB) is a significant cause of mortality worldwide, and Rwanda is no exception. Although the availability of effective treatment, the mortality rate in TB patients remains high. This study aimed to identify factors associated with mortality in TB patients receiving first-line treatment in Rwanda. Methods: A retrospective cross-sectional study was conducted among adult TB patients aged 15 and above, including those engaged in first-line therapy and registered in health facilities' National electronic individual records (e-TB) between July 2019 and June 2022. Multivariate logistic regression analysis was used to identify significant independent variables retained in an unadjusted model. Results: Of the 14,451 patients included in the study, 1,262 (8.7%) died during treatment. Death rates were higher in the cohorts of clinically diagnosed (17.1%), and TB/HIV co-infected (16.9%) Several factors were significantly associated with mortality. The risk was higher in patients who were underweight at initial treatment (aOR=1.78, 95% CI: 1.39-2.28), clinically diagnosed with TB (aOR=1.72, 95% CI: 1.27-2.34), not currently on ART (aOR=9.22, 95% CI: 6.39-13.29). Being managed in referral hospitals (aOR=2.58, 95% CI: 1.77-3.76) or district hospitals (aOR=2.18, 95% CI: 1.58-3.01), and not followed up by CHWs (aOR=2.68, 95% CI: 1.92-3.74). Interestingly, being an inmate was found to be a protective factor, with a lower risk of dying from TB compared to those who were not in prison (aOR=0.35, 95% CI: 0.16-0.78). Conclusion: This study highlights the importance of early diagnosis and treatment of TB, as well as the need for comprehensive healthcare services and follow-up, particularly for patients who are underweight, being not on ART. Additionally, the study provides insight into the potential benefits of prison healthcare systems in managing TB. These findings could inform public health policies and interventions aimed at reducing mortality rates in TB patients in Rwanda and other similar settings. Master's Dissertation 2023-07-01T00:00:00Z https://dr.ur.ac.rw/handle/123456789/2735 Factors associated with abnormal lung function among university students in Kigali-Rwanda, case of UR-CMHS MVUYEKURE, Leonidas Background: Determinants of abnormal lung function among students living in hostels have not been evaluated. University students commonly come into contact with residential pollution and others different factors in their dorms, which are known to increase the risk of respiratory illnesses including Chronic Obstructive Pulmonary Diseases (COPD). COPD are estimated to have contributed to 3 million deaths worldwide which is 5% of all fatalities; and over 90% of these deaths occurred in low- and middle- income countries (LMICs), with a global prevalence of 10.3%. The recent study in Rwanda found COPD prevalence of 4.5%. This study aims to find the “Factors associated with abnormal lung function among university students in Kigali-Rwanda”. Methods: The minimum sample size were 220 subjects after the exclusion criterion to be used in this study. Validated questions were used to assess self-reported physical health status like, cough, fatigue, respiratory problems. Spirometry for lung function tests was used to identify abnormalities as the measurement of outcome variable. A typical statistical data analysis method, descriptive, bivariate and multivariate analysis were employed to assess the degree to which a dependent variable and one or even more independent variables have a linear relationship. Results: The analysis of this study showed that 119(54.09%) participants were female while 101(45.91%) were male, and the prevalence of abnormal lung function were 20.9%. Risk factors for abnormal lung function were found to be building characteristics such as frequency of window opening, freshness of air in the room, and physical wellbeing (OR:4.5; CI: 1.771744-11.45793, P=0.002) were 4.5 times of having abnormal lung function for those who reported poor compared with those who said excellent within specified period before the survey. Conclusion: This is the first research on abnormal lung function conducted in a Rwandan university residence. The prevalence of abnormal lung function showed that, it is the problems for public health which needed a great consideration for the associated factors mainly in the enclosed microenvironment like in the university campuses where students spend much of their time to alleviate the proportion of abnormal lung function. Master's Dissertation 2023-08-01T00:00:00Z https://dr.ur.ac.rw/handle/123456789/2734 Piloting adapted informed health choices school resources in out of school context Mukobwawase, Ingrid Marie Background Every day, in our life we face a variety of circumstances in which we must make health-care decisions that affect our health. Such decisions can have a negative impact on our lives if they do not respond to our health needs, and to respond to them, one must have information, understand all the options, risks, and finally be able to make the right choices. Youth especially out of schools, are frequently exposed to unreliable and untruthful information. Giving them the ability to think critically so they can make responsible choices about their health is the best way to eliminate health misinformation in their minds. Methods This was a mixed methods study that employed both qualitative and quantitative approaches. We used cross sectional study design and conducted one facility survey of 32 YEGO centers staff using a questionnaire to know the status of the YEGO centers. Using semi structured interviews, two focus group discussions were conducted with 8-10 participants each. We used purposive sampling. We used thematic analysis to explore the context in which we can teach critical thinking about health to out of school youth by using the adapted and translated digital learning resources in two YEGO centers. Results Two YEGO centers, with a total of 80 out of school youth participated in the study along with youth centers facilitators. IHC lessons were taught to the selected youth and we were able to explore the knowledge gained before teaching and after teaching. 71% of the youth, on average, learned more after using the IHC materials. Overall, on how youth experienced learning resources., out of school youth were interested in, and were able to apply the content of the lessons. The results on usefulness, usability, understandability, and desirability of youth revealed that the IHC-adapted resources were very useful. The negative perceptions included understandability and usability. Conclusion Overall, it appears that IHC-adapted resources are feasible in the out-of-school context. This pilot demonstrated that the YEGO center is an enabling environment for teaching critical thinking outside of the classroom. Master's Dissertation 2023-10-01T00:00:00Z