Nelson Ssewante
@mak.ac.ug
Makerere University
Ssewante Nelson is a medical doctor who completed his undergraduate degree in Bachelor of Medicine and Bachelor of Surgery (MBChB) from the College of Health Sciences, Makerere University. He is a passionate clinician and an early career researcher who aims to create a positive impact in society through collaboration, and mentorship. His work focuses mainly on infectious diseases most especially malaria, mental health, emergency medicine and medical education.
He aspires to champion for malaria elimination through advocacy, collaborative engagements with stakeholders and research. He is the founder of Malarialess, Uganda an initiative aimed at creating a conducive environment where the youths are empowered to generate local ideas that can be nurtured to emanate into feasible solutions towards malaria elimination. He's also a founding member of the Malaria Youth Army, Uganda a project part of the African Leaders Malaria Alliance (ALMA) among other activities.
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Edwin Kigozi, Livingstone Kamoga, Nelson Ssewante, Patrick Banadda, Faith Atai, Lydia Kabiri, and Scovia Nalugo Mbalinda
Elsevier BV
Edward J. M. Monk, Timothy P. W. Jones, Felix Bongomin, Winnie Kibone, Yakobo Nsubuga, Nelson Ssewante, Innocent Muleya, Lauryn Nsenga, V. Bhargavi Rao, and Kevin van Zandvoort
Public Library of Science (PLoS)
Antimicrobial resistance (AMR) is a major global threat and AMR-attributable mortality is particularly high in Central, Eastern, Southern and Western Africa. The burden of clinically infected wounds, skin and soft tissue infections (SSTI) and surgical site infections (SSI) in these regions is substantial. This systematic review reports the extent of AMR from sampling of these infections in Africa, to guide treatment. It also highlights gaps in microbiological diagnostic capacity. PubMed, MEDLINE and Embase were searched for studies reporting the prevalence of Staphylococcus aureus, Eschericheria coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii in clinically infected wounds, SSTI and SSI in Central, Eastern, Southern or Western Africa, and studies reporting AMR from such clinical isolates. Estimates for proportions were pooled in meta-analyses, to estimate the isolation prevalence of each bacterial species and the proportion of resistance observed to each antibiotic class. The search (15th August 2022) identified 601 articles: 59 studies met our inclusion criteria. S. aureus was isolated in 29% (95% confidence interval [CI] 25% to 34%) of samples, E. coli in 14% (CI 11% to 18%), K. pneumoniae in 11% (CI 8% to 13%), P. aeruginosa in 14% (CI 11% to 18%) and A. baumannii in 8% (CI 5% to 12%). AMR was high across all five species. S. aureus was resistant to methicillin (MRSA) in >40% of isolates. E. coli and K. pneumoniae were both resistant to amoxicillin-clavulanic acid in ≥80% of isolates and resistant to aminoglycosides in 51% and 38% of isolates respectively. P. aeruginosa and A. baumannii were both resistant to anti-pseudomonal carbapenems (imipenem or meropenem) in ≥20% of isolates. This systematic review found that a large proportion of the organisms isolated from infected wounds, SSTI and SSI in Africa displayed resistance patterns of World Health Organisation (WHO) priority pathogens for critical or urgent antimicrobial development.
Blaise Kiyimba, Linda Atulinda, Racheal Nalunkuma, Ignatius Asasira, Jonathan Kabunga, Davis Banturaki, Anastacia Ssebbowa Nabyonga, Rachel Nakiganda, Rachael Ndyabawe, Jonathan Nkalubo,et al.
Springer Science and Business Media LLC
Abstract Background Involvement of undergraduate health professions students (HPS) in research will facilitate evidence-based clinical practice among future healthcare practitioners. This study aimed to assess research involvement among undergraduate HPS students and associated factors in Uganda. Methods A cross-sectional study was conducted using an online assessment tool sent through WhatsApp groups and E-mail addresses of HPS in 12 medical schools in Uganda between 20th September and 5th October 2021. Results We enrolled 398 participants with a mean age of 23.9 ± 3.7 years. Of this, 267 (67.1%) were male. One hundred twenty (30.2%) participants previously participated in a research activity: 90 (58.4%) as research assistants, 39 (25.3%) published as first authors, and 25 (16.2%) as co-authors. Training on the conduct of research was received by 242 (65.8%) participants, and 326 (81.9%) had intentions of conducting research in the future. Factors influencing participation in research activities were, age ≥ 25 years (adjusted odds ratio (aOR): 1.9, 95% confidence interval (95% CI): 1.2–3.2, p = 0.012), being male (aOR: 2.1, 95%CI: 1.2–3.6, p = 0.008), and being in a clinical year i.e., year 3 (aOR: 3.2, 95% CI: 1.1–9.3, p = 0.033), year 4 (aOR: 3.3, 95% CI: 1.1–9.5, p = 0.028) and year 5(aOR: 11.6, 95% CI: 3.2–42.1, p < 0.001). Lack of funds (79.6%), and mentorship (63.3%) were reported as major barriers to research. Conclusions Despite a high proportion of HPS showing interest in getting involved in research, less than one-third reported previous involvement. Addressing barriers such as funding could potentially improve research involvement and output among undergraduate HPS in resource-limited settings.
Nelson Ssewante, Godfrey Wekha, Angelique Iradukunda, Phillip Musoke, Andrew Marvin Kanyike, Germinah Nabukeera, Nicholas Kisaakye Wamala, Wilson Zziwa, Lauben Kamuhangire, Jonathan Kajjimu,et al.
Springer Science and Business Media LLC
Abstract Background Uganda continues to depend on a health system without a well-defined emergency response system. This is in the face of the rising cases of out-of-hospital cardiac arrest contributed largely to the high incidence of road traffic accidents. Non-communicable diseases are also on the rise further increasing the incidence of cardiac arrest. Medical students are key players in the bid to strengthen the health system which warrants an assessment of their knowledge and attitude towards BLS inclusion in their study curriculum. Methods A descriptive cross-sectional study was conducted in 2021 among undergraduate medical students across eight public and private universities in Uganda. An online-based questionnaire was developed using Google forms and distributed via identified WhatsApp groups. Chi-square or Fisher’s exact test and logistic regression were performed in STATA 15 to assess the association between knowledge of BLS and demographics. P < 0.05 was considered statistically significant. Results Out of the total 354 entries obtained, 351 were analyzed after eligibility screening. Of these, (n = 250, 71.2%) were male less than 25 years (n = 273, 77.8%). Less than half (n = 150, 42.7%) participants had undergone formal BLS training. Less than a third of participants (n = 103, 29.3%) had good knowledge (≥ 50%) with an overall score of 42.3 ± 12.4%. Age (p = 0.045), level of academic progress (p = 0.001), and prior BLS training (p = 0.033) were associated with good knowledge. Participants with prior training were more likely to have more BLS knowledge (aOR: 1.7, 95% CI: 1.1–2.7, p = 0.009). The majority (n = 348, 99.1%) believed that BLS was necessary and would wish (n = 343, 97.7%) to have it included in their curriculum. Conclusions Undergraduate medical students have poor BLS knowledge but understand its importance. Institutions need to adopt practical teaching methods such as clinical exposures, field experience in collaboration with local implementers, and participating in community health promotion campaigns.
Brandy Nantaayi, Rodney Kato Ndawula, Phillip Musoke, Nelson Ssewante, Lourita Nakyagaba, Joyce Nakiganda Wamala, Emmanuel Arthur Makai, Babrah Wannyana, Nicholas Kisaakye Wamala, Andrew Marvin Kanyike,et al.
Frontiers Media SA
BackgroundLockdown is an important public health approach aimed at curbing the raging effect of the coronavirus disease-2019 (COVID-19). This study aimed at determining the impact of prolonged lockdown on mental health and access to mental health services among undergraduate students in Uganda.MethodsAn online cross-sectional study was conducted anonymously among undergraduates across 10 universities in Uganda. The Distress Questionnaire-5 (DQ-5) and the Patient Health Questionnaire-2 (PHQ-2) were used. Logistic regression analysis was conducted to determine factors associated with psychological distress.ResultsWe enrolled 366 participants with a mean age of 24.5 ± 4.6 years. The prevalence of psychological distress was 40.2% (n = 147) (cut off 14/25 based on DQ-5) while depression stood at 25.7% (n = 94; cut off 3/6 based on PHQ-2) with mean scores of 12.1 ± 4.6 and 1.7 ± 1.6 respectively. Female gender (aOR: 1.6, 95%CI: 1.0–2.6, p = 0.032), pursuing a non-medical program (aOR: 2.2, 95%CI: 1.3–3.7, p = 0.005) were factors associated with psychological distress while non-medical program (aOR: 2.2, 95%CI: 1.3–3.7, p = 0.005) was associated with increased depression. Access to mental health services was associated with both reduced distress (aOR: 0.5, 95%CI: 0.3–0.8, p = 0.005) and depression (aOR: 0.6, 95%CI: 0.3–0.9, p = 0.034). A majority (65.3%) of the participants reported knowing how to access mental health care and 188 (51.4%) reported having needed emotional support but, only 67 (18.3%) ever sought care from a mental health professional. Of those who had access, only 10 (7%), and 13 (9%) accessed a counselor or a mental health unit, respectively. The barriers to accessibility of mental health care included financial limitations (49.5%), lack of awareness (32.5%), lack of mental health professionals (28.4%), and stigma (13.9%).ConclusionAmong university students in Uganda during the COVID- 19 lockdown, the burden of psychological distress and depression was substantial. However, access to mental health services was limited by several factors.
Nelson Ssewante, Godfrey Wekha, Moureen Namusoke, Bereta Sanyu, Ayub Nkwanga, Racheal Nalunkuma, Ronald Olum, Lawrence Katumba Ssentongo, Rachel Ahabwe, Sharon Esther Kalembe,et al.
Elsevier BV
Racheal Nalunkuma, Derrick Bary Abila, Nelson Ssewante, Blaise Kiyimba, Edwin Kigozi, Ruth Ketty Kisuza, Fulugensio Kasekende, Jonathan Nkalubo, Sam Kalungi, Winters Muttamba,et al.
Informa UK Limited
Introduction The second wave of COVID-19 greatly affected the health care and education systems in Uganda, due to the infection itself and the lockdowns instituted. Double masking has been suggested as a safe alternative to double-layered masks, where the quality of the latter may not be guaranteed. This study aimed to determine patterns of double mask use among undergraduate medical students at Makerere University, Uganda. Methods We conducted a descriptive cross-sectional study using an online questionnaire. All students enrolled at the College of Health Sciences; Makerere University received the link to this questionnaire to participate. Logistic regression analysis was used to assess factors associated with double mask use. Results A total of 348 participants were enrolled. The majority (61.8%) were male; the median age was 23 (range: 32) years. Up to 10.3%, 42%, and 4.3% reported past COVID-19 positive test, history of COVID-19 symptoms, and having comorbidities, respectively. Up to 40.8% had been vaccinated against COVID-19. More than half (68.7%) believed double masking was superior to single masking for COVID-19 IPC, but only 20.5% reported double masking. Participants with a past COVID-19 positive test [aOR: 2.5; 95% CI: 1.1–5.8, p = 0.026] and participants who believed double masks had a superior protective advantage [aOR: 20; 95% CI: 4.9–86.2, p < 0.001] were more likely to double mask. Lack of trust in the quality of masks (46.5%) was the most frequent motivation for double masking, while excessive sweating (68.4%), high cost of masks (66.4%), and difficulty in breathing (66.1%) were the major barriers. Conclusion Very few medical students practice double masking to prevent COVID-19. Coupled with inconsistencies in the availability of the recommended four-layered masks in Uganda and increased exposure in lecture rooms and clinical rotations, medical students may be at risk of contracting COVID-19.
Angelique Iradukunda, Shallon Kembabazi, Nelson Ssewante, Andrew Kazibwe, and Jean Damascene Kabakambira
Informa UK Limited
Introduction Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia resulting from defects in insulin production, insulin action, or both. Despite advances in DM diagnosis and management, the incidence of DM-related complications remains high. This study aimed to determine patterns of common complications and associated factors among hospitalized patients in Rwanda. Methods A cross-sectional study, with retrospective chart review, was conducted at CHUK from July to August, 2021. Charts for DM patients admitted from January 2016 to December 2020 were considered while those inaccessible at the time of data collection were excluded. Linear regression model was used to assess the relationship between dependent and independent variables with a p < 0.05 considered statistically significant. Results A total of 246 charts were reviewed. The median age was 56 years (IQR: 14–90). More than half of participants (n = 135; 54.9%) were females; majority from the Central region (n = 138; 56.7%). Recorded DM risk factors included alcohol intake (n = 81; 48.5%); smoking (n = 40; 24.2%), obesity (n = 43; 52.4%), and family history of DM (n = 27; 56.3%). Majority (n = 153; 84.5%) had type 2 DM and (n = 147; 69%) had known their diagnosis for at least 6 years. Hypertension (n = 124, 50.4%), acute hyperglycemic state (n = 59, 24%), nephropathy (n = 58, 23.6%), and stroke (n = 38, 15.4%) were frequently reported complications. Nearly all participants (n = 81, 95.2%) with complications had poor glycemic control. Alcohol intake, age ≥45 years, and T1DM were associated with higher odds of DM complications (aOR = 8, 95% CI = 2–32.6, p = 0.003, aOR = 6.2, 95% CI = 1.4–27.6, p = 0.016 and aOR = 14.1, 95% CI = 1.2–161.5, p = 0.034, respectively). Duration of DM (p = 0.001) was significant at bivariate analysis. Conclusion DM complications were prevalent among the studied population with poor glycemic control mainly influenced by alcohol consumption and duration of DM. Expansion of integrated DM and hypertension screening services to lower-level centers is needed to reduce the associated morbidity and mortality.
Godfrey Wekha, Nelson Ssewante, Angelique Iradukunda, Micheal Jurua, Shadia Nalwoga, Sharon Lanyero, Ronald Olum, and Felix Bongomin
Informa UK Limited
Introduction Colorectal cancer (CRC) is the most common type of gastrointestinal malignancies and the third leading cause of cancer-related deaths for both sexes worldwide. Although the burden of CRC is highest in developed countries, reports are indicating a rise in the incidence of early-onset CRC in developing countries. In this study, we aimed to determine the prevalence of CRC among patients hospitalized with lower gastrointestinal complaints at a tertiary health facility in Uganda. Methods We conducted a 10-year retrospective chart review of patients admitted to Mulago National Referral Hospital in Kampala, Uganda, between 1st January 2010 and 31st December 2020. We reviewed all charts of patients admitted to the lower gastrointestinal tract (GIT) ward. Charts with grossly missing data, pediatric patients, and those from other non-lower GIT specialties were excluded. Results Data of 1476 unique eligible patients were analyzed. Of these,138 had a diagnosis of CRC (prevalence: 9.3%, 95% confidence interval (95% CI): 6.5–11.7%). Among patients with CRC, the female:male ratio was 1:1. The most common site for CRC was the rectum (59.8%, n= 79). For the 138 participants with CRC, 44 had staging data with 72.8% (n=32) having advanced disease, that is, stage 3 or 4. Factors independently associated with CRC were age ≥50 years (adjusted odds ratio (aOR): 4.3, 95% CI: 2.6–7.1, p < 0.001), female sex (aOR: 1.8, 95% CI: 1.2 −2.8, p = 0.005), being widowed (aOR: 2.5, 95% CI: 1.3–5.0, p = 0.006), and presence of any risk factor for CRC (aOR: 5.3, 95% CI: 2.9–9.9, p < 0.001). Conclusion CRC is relatively common among patients hospitalized with lower GIT complaints, particularly among women and those with known risk factors for CRC. Awareness creation and screening programs should be instituted to allow early diagnosis of CRC in our setting.
Phillip Musoke, Jerom Okot, Vivien Nanfuka, Pius Rwamafa, Joseph Masajjage, Ivan Kisuule, Brandy Nantaayi, Nelson Ssewante, and Felix Bongomin
Informa UK Limited
Introduction Herbal medication use among patients with COVID-19 imposes a significant risk of drug-herbal interactions and adverse events. This study aimed to assess the prevalence and factors associated with herbal medicine use among patients hospitalized with COVID-19 attending two large COVID-19 Treatment Units (CTU) in Uganda. Methods A hospital-based descriptive cross-sectional study was conducted recruiting patients with COVID-19 hospitalized at the Mulago National Referral Hospital and Namboole Stadium CTUs. Chi-square or Fishers’ exact test for categorical and Mann–Whitney U-test for numerical were used to determine the association between dependent and independent variables. Results The study was terminated early because of significant reduction in the number of patients hospitalized with COVID-19 and the closure of Namboole CTU. Of the anticipated 422 participants, we recruited 108 (25.6%). Of this, 58 (53.7%) were female, with a median age of 38 (range: 20–75) years. Forty-nine (45.4%) had received at least one dose of the COVID-19 vaccine. Fifty-eight (57.3%) of the participants had ever used herbal medicine and the majority had used them in the past 12 months (71.9%, n = 41) either before the diagnosis of COVID-19 (85.4%, n = 35) or after (36.6%, n = 15). Being vaccinated for COVID-19 (adjusted odds ratio (aOR): 3.1, 95% confidence interval (CI): 1.4–6.8, p = 0.005) and having attained tertiary level of education (aOR: 6.2, 95% CI: 1.7–23.1, p = 0.006), as well as the accessibility to herbalists (aOR: 31.2, 95% CI: 3.7–263.2, p = 0.002) were significantly associated with herbal medication use. The majority of participants reported some improvement after using herbal medicine (80.7%, n = 46) and their doctors or nurses asked almost half of the participants about herbal medicine use (49.5%, n = 53). Conclusion The use of herbal medicines to treat or prevent COVID-19 among hospitalized patients is a widespread practice in Uganda amidst unpublished evidence of their safety and efficacy.
Phillip Musoke, Brandy Nantaayi, Rodney Ndawula Kato, Babrah Wannyana, Nelson Ssewante, Godfrey Wekha, Ronald Olum, Lourita Nakyagaba, Dianah Rhoda Nassozi, Germinah Nabukeera,et al.
Informa UK Limited
Background The coronavirus disease-2019 (COVID-19) pandemic has created fear in people around the world. This has led to the widespread use of various herbal remedies in its prevention and treatment regardless of the paucity of scientific evidence about their safety and efficacy. This study assessed the fear of COVID-19 and the influence of media on the use of herbal medicine to prevent or treat COVID-19 in Uganda. Methods In the first 2 weeks of July 2021, a descriptive online cross-sectional study was carried out anonymously in the general population in Uganda. A validated questionnaire was used to collect data on herbal medicine use and the influence of media. Fear of COVID-19 was rated using the Fear of COVID-19 Scale (FCV-19S). Results We recruited 488 participants, 273 (55.9%) were female, with a median age of 25 (range: 18–73) years. Sixty-seven (57.8%) participants had a confirmed COVID-19 diagnosis. The mean FCV-19S score was 21.7 SD 5.9 with 53.3% reporting high levels of COVID-19 fear. About 57.4% of participants reported using herbal remedies either to prevent or treat COVID-19-like symptoms. Media was the main source of information, with more than 80% of the participants reporting seeing or accessing information about herbal medication use. Women (adjusted odds ratio (aOR): 1.74, 95% CI: 1.2–2.5, p=0.003) and people with a previously confirmed COVID-19 diagnosis (aOR: 3.1, 95% CI: 1.35–7.14, p=0.008) had a statistically significantly higher FCV-19S score. Being unemployed (aOR: 1.0, 95% CI: 1.1–2.3, p=0.008) and a female (aOR: 1.0, 95% CI: 1.1–2.3, p=0.012) were statistically significantly associated with herbal medicine use. Participants who used herbal remedies had a higher median FCV-19S score compared to non-users (23 versus 21, p<0.001). Conclusion The use of herbal medicines to treat or prevent COVID-19 is a widespread practice among the general population in Uganda amidst the high levels of fear of COVID-19.