Imelda Namagembe

Case Western Reserve University School of Medicine , Cleveland, Ohio, United States

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Publications (4)4.4 Total impact

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    ABSTRACT: The purpose of this study was to summarise the current state of healthcare quality improvement literature focusing on sub-Saharan Africa. Conventional methods of searching the literature were quickly found to be inadequate or inappropriate, given the different needs of practitioners in sub-Saharan Africa, and the inaccessibility of the literature. The group derived a core list of what were deemed exemplary quality improvement articles, based on consensus and a search into the "grey" literature of quality improvement. Quality improvement articles from sub-Saharan Africa are difficult to find, and suffer from a lack of centrality and organisation of literature. Efforts to address this are critical to fostering the growth of quality improvement literature in developing country settings.
    Quality and Safety in Health Care 10/2010; 19(5):416-9. · 2.16 Impact Factor
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    ABSTRACT: The World Health Organization estimated alcohol consumption in Uganda to be one of the highest in the world. We examined alcohol consumption among Ugandan women prior to and after learning of pregnancy. We developed a screening algorithm using factors that predicted alcohol consumption in this study. In 2006, we surveyed 610 women attending antenatal care at the national referral hospital in Kampala, Uganda about consumption of traditional and commercial alcoholic beverages before and after learning of pregnancy. Predictors of alcohol consumption during pregnancy were examined and a practical screening algorithm was developed for use in antenatal clinics. One hundred eighty women (30%) drank alcohol at least monthly before learning of their pregnancy. Among these women, almost one-third reported usual consumption of at least one beverage type at quantities that equal binging levels for women. Overall, 151 women (25%) consumed alcohol after learning of pregnancy. Commercial beverages, particularly beer, were consumed more often than traditional drinks. A two-stage screening algorithm asking women about their religion, male partner or friends' drinking, and any lifetime drinking predicted self-reported consumption of alcohol during pregnancy with 97% sensitivity and 89% specificity. Alcohol consumption among pregnant Ugandan women attending antenatal care is high. A feasible screening algorithm can help providers target education and counseling to women who are likely drinking during pregnancy. Given the preference for commercial alcoholic beverages, it is recommended that labels be placed prominently on bottled alcoholic beverages warning of the adverse effects of consuming alcohol during pregnancy.
    Maternal and Child Health Journal 08/2009; 14(4):492-500. · 2.24 Impact Factor
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    ABSTRACT: Antenatal care (ANC) prevents adverse pregnancy outcomes by providing women with interventions like HIV testing that is vital to the baby's or maternal health. Low birth weight (LBW ;< 2500g) is a public health problem associated with infant morbidity, mortality and high costs. In Uganda, few studies have examined the relationship between ANC attendance and pregnancy outcomes; therefore, the purpose of this research was to describe this association. A cross-sectional study of randomly selected medical charts of women (n=600) who delivered at Mulago Hospital, Uganda, April- May, 2006 was done. A standardized abstraction form was used for data collection. Women who delivered before arrival or delivered multiples were excluded. Chi-square tests and t-tests were used to compare outcomes among those who sought ANC and those who did not. The mean (standard deviation; SD) maternal age was 22.7(5.3), 9% of women were HIV positive, and 6% had unknown HIV status. In this study, 65% (n=393) of the women attended ANC; of these 20% (n=120) made four or more visits. The mean (SD) number of ANC visits was 1.9 (1.9). There were 561 livebirths (93.5%); among these the prevalence of LBW was 7.5% (n=45), Mean (SD) Apgar score was 8.8 (2.7). Results stratified by ANC and HIV status will be shown for this presentation. Although 65% of women attended ANC, most women made less than 4 ANC visits recommended by the Uganda Ministry of Health and the World Health Organization. Effective interventions to increase the ANC attendance are needed in this population.
    136st APHA Annual Meeting and Exposition 2008; 10/2008
  • Imelda Namagembe
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    ABSTRACT: Background: Psychosocial factors are an important area to assess during pregnancy. Studies demonstrate that stress, depression, alcohol use, and lack of social support during pregnancy are commonly associated with low birth weight and perinatal mortality and morbidity. This may be more marked in communities with low social economic status. In this era of the HIV/AIDS pandemic, psychosocial problems are common among affected populations. These issues may have indirect influence through affecting antenatal care attendance, coping capacity, and adherence to medication; or directly affect the physiology of pregnancy. Methods: This was a cross-sectional analysis (n=610) of the data from a survey of pregnant women conducted in Uganda from June to October 2006. The Brief Evaluation of Perceived Stress Instrument (BEPSI), Social support ISEL-12 and Edinburgh Depression Scales were translated into Luganda and used. Descriptive and correlation statistics are reported. Reliability and factor analysis were utilized to assess instrument psychometrics. Results: Demographics of the study population are described. Nearly 9% were HIV positive. There was a significant difference between HIV positive and negative participants on age, educational, marital status and religion (p<0.05). 34.4% of the participants had a history of alcohol consumption prior to pregnancy. HIV positive participants had significantly higher odds of ever used alcohol (OR 2.21). The Edinburgh scale and BEPSI scale had good internal reliability in the Ugandan setting with Cronbach's alpha of 0.76 and 0.81 respectively. The ISEL-12 scale for social support had a Cronbach's alpha of 0.60. The prevalence of depressive symptoms was 31%. Being HIV positive was significantly associated with depression (OR 2.64, 95%CI 1.4, 4.84) The HIV positive participants reported higher stress than the HIV negative participants (p<0.001). Social support was not associated with HIV status. Stress and depression were highly correlated (r=0.49, p< 0.001). The relationship between stress, depression, and alcohol use will also be examined. Conclusion: Psychosocial problems in pregnant women were common and associated with HIV status. This research has important implications for women and health care providers in Uganda. Education and counseling prior to and during pregnancy may have an effect on pregnancy outcomes.
    135st APHA Annual Meeting and Exposition 2007; 11/2007

Publication Stats

12 Citations
4.40 Total Impact Points

Institutions

  • 2009
    • Case Western Reserve University School of Medicine
      • Department of Epidemiology and Biostatistics
      Cleveland, Ohio, United States
  • 2007–2009
    • Case Western Reserve University
      • Department of Epidemiology and Biostatistics
      Cleveland, OH, United States