James Ditai
A5061734887- Global Maternal and Child Health
- Ethics in Clinical Research
- Child Nutrition and Water Access
- Maternal and Perinatal Health Interventions
- Maternal and fetal healthcare
- HIV/AIDS Research and Interventions
- Cardiac, Anesthesia and Surgical Outcomes
- Vaccine Coverage and Hesitancy
- Surgical site infection prevention
- HIV/AIDS drug development and treatment
- Patient-Provider Communication in Healthcare
- Reproductive Health and Contraception
- Health Systems, Economic Evaluations, Quality of Life
- Global Health and Surgery
- Infant Development and Preterm Care
- HIV-related health complications and treatments
- Blood donation and transfusion practices
- Infant Nutrition and Health
- Emergency and Acute Care Studies
- Neonatal Respiratory Health Research
- Health Policy Implementation Science
- Infection Control in Healthcare
- Preterm Birth and Chorioamnionitis
- Neonatal and Maternal Infections
- Gestational Diabetes Research and Management
Sanyu Africa Research Institute
2015-2022
Busitema University
2019-2021
Liverpool Women's Hospital
2015-2021
University of Liverpool
2013-2021
Mbale Hospital
2015-2021
Liverpool Womens NHS Foundation Trust
2019
University of Birmingham
2019
Jawaharlal Nehru Medical College
2019
University of Zimbabwe
2019
King's College London
2019
Neonatal sepsis is a major cause of mortality worldwide, with most deaths occurring in low-income countries. The World Health Organisation (WHO) '5 Moments for Hand Hygiene' poster has been used to reduce hospital-acquired infections, but there no similar tool prevent community-acquired newborn infections low-resource settings. This assessment, part the BabyGel Pilot study, evaluated acceptability 'Newborn Hygiene Home' poster. was an educational which aimed remind mothers rural Uganda clean...
Cross-resistance after first-line antiretroviral therapy (ART) failure is expected to impair activity of nucleoside reverse-transcriptase inhibitors (NRTIs) in second-line for patients with HIV, but evidence the effect cross-resistance on virological outcomes limited. We aimed assess association between activity, predicted by resistance testing, NRTIs used and treatment infected HIV.We did an observational analysis additional data from a published open-label, randomised trial ART (EARNEST)...
In 2015, an estimated 303 000 women died in pregnancy and childbirth. Obstetric haemorrhage, sepsis, hypertensive disorders of account for more than 50% maternal deaths worldwide. There are effective treatments these complications, but they require early detection by measurement vital signs timely administration to save lives. The primary aim this trial was determine whether implementation the CRADLE Vital Sign Alert education package into community facility maternity care low-resource...
Although the advantages of early infant HIV diagnosis and treatment initiation are well established, children often present late to programs in resource-limited settings. We aimed assess factors related timing among HIV-infected attending three clinical sites Uganda. Clinical demographic determinants associated with disease (WHO stages 1-2) or (stages 3-4) stage at presentation were assessed using multilevel logistic regression. Additionally, semistructured interviews caregivers health...
Millions of HIV-infected people worldwide receive antiretroviral therapy (ART) in programmes using WHO-recommended standardised regimens. Recent WHO guidelines recommend a boosted protease inhibitor plus raltegravir as an alternative second-line combination. We assessed whether this treatment option offers any advantage over the standard two nucleoside reverse-transcriptase inhibitors (NRTIs) combination after 144 weeks follow-up typical programme settings.
Abstract Background Human milk is the best nutrition for all infants. When mother’s own not available, World Health Organization recommends use of donated human and banking neonates born prematurely or with medical problems. Donor rarely available in low-resource settings where both rates preterm birth neonatal mortality are highest. The potential to reduce through one that yet be fully explored African setting. For introduction any new health intervention successful, determining barriers...
Good hand hygiene (HH) practice is crucial to reducing healthcare associated infections (HAIs). Use of alcohol-based rub (ABHR) at health facilities strongly recommended but it limited in Uganda. Data on the HH and incidence HAIs sparse resource-limited settings. We conducted a quasi-experimental study evaluate practices care providers (HCPs) utilizing locally made ABHR HAIs. compliance among HCPs were assessed Mbale Regional Referral Hospital, teaching hospital rural Inpatients from...
Surgical intervention is needed in some cases of spontaneous abortion to remove retained products conception. Antibiotic prophylaxis may reduce the risk pelvic infection, which an important complication this surgery, particularly low-resource countries.
600 mcg of oral misoprostol reduces the incidence postpartum haemorrhage (PPH), but in previous research this medication has been administered by health workers. It is unclear whether it also safe and effective when self-administered women. This placebo-controlled, double-blind randomised trial enrolled consenting women at least 34 weeks gestation, recruited over a 2-month period Mbale District, Eastern Uganda. Participants had their haemoglobin measured antenatally were given either 600mcg...
The Clavien-Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by treatment provided. However, it unclear whether can be internationally studies across differing healthcare systems high- (HICs) and low- middle-income countries (LMICs).This was a secondary analysis of International Surgical Outcomes Study (ISOS), prospective observational cohort study elective surgery adults....
Abstract Background Neonatal hypoglycemia is the most common endocrine abnormality in children, which associated with increased morbidity and mortality. The burden risk factors of neonatal rural communities sub-Saharan Africa are unknown. Objective To determine prevalence for Lira District, Northern Uganda. Methods This was a community-based cross-sectional study, nested cluster randomized controlled trial designed to promote health facility births newborn care practices study recruited...
Interventions aimed at reducing maternal mortality are increasingly complex. Understanding how complex interventions delivered, to whom, and they work is key in ensuring their rapid scale-up. We delivered a vital signs triage intervention into routine maternity care eight low- middle-income countries with the aim of composite outcome morbidity mortality. This was pragmatic, hybrid effectiveness-implementation stepped-wedge randomised controlled trial. In this study, we present results...
Poor participant understanding of research information can be a problem in community interventional studies with rural African women, whose levels illiteracy are high. This study aimed to improve the informed consent process for women living eastern Uganda. We assessed impact alternative models on participants' clinical trial and their contribution The applied parallel mixed-methods design prospective comparative cohort, nested within pilot distribution an alcohol-based hand rub prevent...
Abstract Background Complications of prematurity are the leading cause neonatal mortality, and majority these deaths occur in low middle-income countries. Research settings has focused on improved outcomes for preterm infants hospital settings, however, research into continuation care home after discharge from a unit is limited. This study examines experiences perceptions caregivers during initial weeks following Uganda, views healthcare workers (HCWs) ability to cope. Methods qualitative...
Limited viral load (VL) testing in human immunodeficiency virus (HIV) treatment programs low-income countries often delays detection of failure. The impact remaining on failing protease inhibitor (PI)-containing regimens is unclear.We retrospectively tested VL 2164 stored plasma samples from 386 patients randomized to receive lopinavir monotherapy (after initial raltegravir induction) the Europe-Africa Research Network for Evaluation Second-line Therapy (EARNEST) trial. Protease genotypic...
Background: Prolonged surgical antimicrobial prophylaxis (SAP) to prevent site infection (SSI) is generally discouraged after completion of surgery. However, little known about the pattern peri-operative antibiotic use in resource-limited settings. We aimed describe its at a typical government hospital Uganda. Methods: A study was originally conducted rural Ugandan regional referral and teaching 2014 2015 improve hand hygiene practice measure impact on health-care–associated infections...
The estimated annual global burden of miscarriage is 33 million out 210 pregnancies. Many women undergoing have surgery to remove pregnancy tissues, resulting in being one the most common operations performed hospitals low-income countries. Infection a serious consequence and can result illness death. In settings, infection rate following has been reported be high. Good quality evidence on use prophylactic antibiotics for surgical management not available. Given that common, infective...
Alcohol-based hand rub (ABHR) is widely used in both health and social facilities to prevent infection, but it not known whether supplying for regular perinatal use can newborn sepsis African rural homes. Our study piloted a cluster randomised trial of providing ABHR postpartum mothers neonatal infection-related morbidity the communities. We conducted pilot parallel controlled across ten villages (clusters) Eastern Uganda. Pregnant women over 34 weeks' gestation were recruited period 3...
Abstract Background Globally, 15 million infants are born preterm each year, and 1 die due to complications of prematurity. Over 60% births occur in Sub-Saharan Africa south Asia. Care at birth for premature may be critical survival long term outcome. We conducted a prospective audit assess whether women giving could identified, describe cord clamping neonatal care hospitals Methods This livebirths was six Uganda, Kenya, India Pakistan. Births were considered if between 28 + 0 33 6 weeks...
Abstract Background Advance provision of misoprostol to women during antenatal care aims achieve broader access uterotonics for the prevention postpartum hemorrhage. Studies this community-based approach usually involve education as well timely follow-up visits confirm maternal and neonatal outcomes. The MamaMiso study in Mbale, Uganda sought assess feasibility conducting period following advance hemorrhage prevention. recruited visits. Participants were asked contact research team within 48...
Neonatal sepsis causes 0.5 million deaths annually, mostly in low resource settings. Babies born African rural homes without running water or toilet facilities are especially vulnerable. Alcohol-based hand rub (ABHR) may be used by mothers and carers as an alternative to washing with soap prevent neonatal infection. However, no definite study has established the preferred formulation of for mothers. This aimed assess effects addition bitterants perfume towards acceptability alcohol-based...
Due to their immature immune system, neonates are at high risk of infection. This vulnerability when combined with limited resources and health education in developing countries can lead sepsis, resulting global neonatal mortality rates. Many these deaths preventable. The BabyGel pilot trial tested the feasibility conducting main randomised trial, provision alcohol handgel postpartum mothers for prevention infective morbidity rural community. secondary analysis sought evaluate methods...