Browsing by Author "Christopher Garimoi Orach"

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    Prediction of Preeclampsia Using Routinely Available Care: A Review of Literature
    (Journal of African Interdisciplinary Studies, 2022-01) Silvia Awor; Rosemary Byanyima; Benard Abola; Annettee Nakimuli; Christopher Garimoi Orach; Paul Kiondo; Dan Kaye; Jasper Ogwal-Okeng
    Women of Afro-Caribbean racial origin are at increased risks of adverse pregnancy outcomes including preeclampsia. This is probably related to low socio-economic status among these communities. With limited resources allocated for health care, there has been a growing need to predict preeclampsia to enable frequent follow up of those at risk, for early diagnosis and treatment to minimize adverse outcomes. Risk prediction models have been developed in some parts of Africa, using maternal history and physical examination, uterine artery Doppler sonography, maternal full haemogram, liver and renal function tests with at least 50% accuracy and 70% AUC. The study concludes that routine prediction of preeclampsia in Africa is limited, although with a potential to save lives.
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    Prediction of stillbirth low resource setting in Northern Uganda
    (BMC, 2022-11-19) Silvia Awor; Rosemary Byanyima; Benard Abola; Paul Kiondo; Christopher Garimoi Orach; Jasper Ogwal‑Okeng; Dan Kaye; Annettee Nakimuli
    Background: Women of Afro-Caribbean and Asian origin are more at risk of stillbirths. However, there are limited tools built for risk-prediction models for stillbirth within sub-Saharan Africa. Therefore, we examined the predictors for stillbirth in low resource setting in Northern Uganda. Methods: Prospective cohort study at St. Mary’s hospital Lacor in Northern Uganda. Using Yamane’s 1967 formula for calculating sample size for cohort studies using finite population size, the required sample size was 379 mothers. We doubled the number (to>758) to cater for loss to follow up, miscarriages, and clients opting out of the study dur‑ ing the follow-up period. Recruited 1,285 pregnant mothers at 16–24 weeks, excluded those with lethal congenital anomalies diagnosed on ultrasound. Their history, physical findings, blood tests and uterine artery Doppler indices were taken, and the mothers were encouraged to continue with routine prenatal care until the time for delivery. While in the delivery ward, they were followed up in labour until delivery by the research team. The primary outcome was stillbirth 24+weeks with no signs of life. Built models in RStudio. Since the data was imbalanced with low stillbirth rate, used ROSE package to over-sample stillbirths and under-sample live-births to balance the data. We cross-vali‑ dated the models with the ROSE-derived data using K (10)-fold cross-validation and obtained the area under curve (AUC) with accuracy, sensitivity and specificity. Results: The incidence of stillbirth was 2.5%. Predictors of stillbirth were history of abortion (aOR=3.07, 95% CI 1.11—8.05, p=0.0243), bilateral end-diastolic notch (aOR=3.51, 95% CI 1.13—9.92, p=0.0209), personal history of preeclampsia (aOR=5.18, 95% CI 0.60—30.66, p=0.0916), and haemoglobin 9.5 – 12.1 g/dL (aOR=0.33, 95% CI 0.11—0.93, p=0.0375). The models’ AUC was 75.0% with 68.1% accuracy, 69.1% sensitivity and 67.1% specificity. Conclusion: Risk factors for stillbirth include history of abortion and bilateral end-diastolic notch, while haemoglobin of 9.5—12.1 g/dL is protective.