PubMed Health⌕ Search

Biomedical subjects

C G Orach

Publications and source records attributed to C G Orach.

3 recordsLinked to original sources
PubMed2000

Maternal mortality estimated using the Sisterhood method in Gulu district, Uganda.

A community-based retrospective maternal mortality study using the Sisterhood method was conducted in Gulu district between February and March 1996. The objectives were to estimate the magnitude of and identify factors associated with maternal mortality in the district. A total of 5522 adult respondents, randomly selected from 27 parishes, of the five counties in the district were interviewed. Between 1960-1996 324 maternal deaths occurred in the sisterhood sample. The maternal mortality rate (MMR) was estimated to be 662 per 100,000 deliveries [95% confidence interval (CI) 421-839 per 100 deliveries]. The leading causes of maternal death were: haemorrhage 45.1%; obstructed labour 26.2%; puerperal sepsis 9.6%; anaemia 2.2%; AIDS 2.2%; and gunshot wounds (GSW) 1.0%. Factors associated with maternal mortality included: age--31.8% of the mothers who died were below 20 years; education--57.1% had no formal education; 65% of the mothers had delivered at home, 50.6% had been attended to by untrained traditional birth attendants (TBAs), while 37.8% were attended to by relatives. The MMR was found to be 1.3 times higher than the estimated national MMR of 500 per 100,000 deliveries. Most maternal deaths (80.9%) were due to preventable causes, being related to low socioeconomic status and low-level education of women in the district. The intractable civil war in the district was a major underlying and contributory factor to the high maternal mortality in the area. A multifaceted approach to reduce maternal mortality in the district should target improving the socioeconomic conditions in the district with special emphasis on encouraging and supporting female education. Intensive education on maternal healthcare in antenatal clinics be conducted targeting husbands/spouses and relatives who care for the prenatal/pregnant and postnatal mothers. There is need for more trained TBAs per village who should be given effective support supervision. Ambulance transport services, motor and bicycle be made available at the district and community levels. At a national level the security situation should be improved in the district.

Adolescent↗
PubMed1999

Morbidity and mortality amongst southern Sudanese in Koboko refugee camps, Arua District, Uganda.

OBJECTIVE: To determine the causes of morbidity, mortality and assess the nutritional status of children under five years, in Koboko refugee camps, Arua District, Uganda. DESIGN: Review and analysis of refugee treatment records between 1992 and 1994 from Maracha and Koboko hospitals and cross sectional nutritional survey of children under five years in camps. SETTING: Between June 1992 and March 1994, an estimated 70,000 Sudanese refugees were encamped in five transit camps in Koboko county, Arua district. Koboko field hospital was immediately established and Maracha hospital designated the referral hospital for refugees. PARTICIPANTS: Hospitalised refugees between 1992 and 1994 in Koboko and Maracha hospitals and children under five years in the camps formed the study populations. INTERVENTIONS: Health facilities and therapeutic nutrition centres were established in the camps. Fortnightly general food distribution and therapeutic feeding programmes were instituted. Severe medical and surgical conditions were referred to Maracha hospital. MAIN OUTCOME MEASURES: Outcome variables considered were morbidity, mortality, case fatality rates; weight/height, weight/age and height/age. RESULTS: Out of 1476 refugees hospitalised in Koboko and Maracha hospitals, 267 died giving a case fatality rate of 18%. The leading causes of morbidity were diarrhoeal diseases (26.9%), ARI (13.6%), malaria (10.2%), trauma (7.6%) and malnutrition (5.0%). The main causes of mortality were similar, that is, diarrhoeal diseases (35.9%), ARI (23.9%), anaemia (7.2%) and HIV/AIDS (6.8%). Conditions associated with high overall case fatality rates were ARI (31.3%), HIV/AIDS (30.0%) and cardiac failure (29.3%) respectively. Nearly half of the children (48.6%), H/A -2SD were stunted, over a third (36.7%), W/A -2SD were underweight and (8.5%), W/H -2SD wasted. CONCLUSION: Communicable diseases are the predominant causes of morbidity and mortality during the emergency phase of encampment. Timely and effective management of communicable diseases including malnutrition and trauma are crucial to avoid high mortality amongst refugees, coupled with the provision of essential requirements and services such as water, sanitation, food, shelter and immunisation.

Adolescent↗