Interventions Improving Neurosurgery Patient Outcomes in Uganda (2017-2018)

Since 2007, Duke’s Division of Global Neurosurgery and Neuroscience (DGNN) has been collaborating with Mulago National Referral Hospital (MNRH) and Makere University College of Health Science in Kampala, Uganda, to improve neurosurgical care for patients throughout Uganda.

Operating within the larger framework of DGNN, this project team has been working since 2016 to conduct research to evaluate interventions directed at impacting neurosurgical patient outcomes.

In 2017-18, the team focused their work on developing and testing the impact of interventions aimed at three pre- and post-operative management issues that DGNN identified as a critical areas in need of improvement: infection control, patient-family education and medication management.

Team members split into three subgroups based on these foundational areas, with each group conducting research around a discrete intervention question.

Infection control: Will an infection control clinical practice guideline help build upon the infection control success following the improved hand hygiene practices?

Medication management: Will a specialized “pill box” provided to neurosurgical patients to store their medications improve medication adherence?

Patient family education: Will a multiplatform educational intervention aid in the education of patients’ families?

The team's research yielded new data points that were added to DGNN’s Uganda database as well as three manuscripts to be submitted to peer-reviewed journals.

The team also established a partnership with Saraya, a company in Uganda that produces hand sanitizer. This partnership has allowed the neurosurgery ward to be continuously and sustainably supplied with hand sanitizer – an important intervention identified, implemented and evaluated by the infection control subgroup.

Timing

Summer 2017 – Spring 2018

Team Outputs

Evaluating the Influence of Caretaker Health Literacy on Delays in Care for Traumatic Brain Injury Patients in Mulago Hospital Neurosurgical Ward (MNRH), Uganda (poster by Chinemerem Nwosu, Anthony Fuller, Charles Pate, Deborah Gold, Gary Bennett, Michael Haglund, presented at Bass Connections Showcase, Duke University, April 17, 2019)

Improving Hand Hygiene through Accessibility in an LMIC Neurosurgical Ward (poster by Samantha Sadler, Bruno Valan, Praruj Pant, Akash D. Patel, Kelsey Graywill, Margaret Lund, Joao Ricardo Nickenig Vissoci, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Michael M. Haglund, Anthony Fuller, presented at Bass Connections Showcase, Duke University, April 17, 2019)

Interventions to Improve Medication Adherence Among Neurosurgical Patients at Mulago National Referral Hospital (poster by Suzanna Joseph, Jonah Sinclair, Sarah Rapaport, Garrett Holmes, Hyun Keun Ahn, Raahina Malik, Winnie Nambatya, Michael Muhumuza, Michael Haglund, Anthony Fuller, presented at Bass Connections Showcase, Duke University, April 17, 2019)

Evaluating the Feasibility of Multi-Modal Educational Interventions to Improve Patient-Caretakers’ Health Literacy in Mulago Hospital Neurosurgical Ward, Uganda (poster by Chinemerem Nwosu, Sherry Yang, Sandra Batakana, Joao Ricardo Vissoci, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Anthony Fuller, Michael Haglund); Judges’ Selection Runner-up at Bass Connections Showcase, April 18, 2018

Interventions to Improve Medication Adherence Among Neurosurgical Patients at Mulago National Referral Hospital (poster by Sarah Rapaport, Garrett Holmes, Hyun Keun Ahn, Raahina Malik, Anthony Fuller, Winnie Nambatya, Michael Haglund), presented at Bass Connections Showcase, April 18, 2018

Improving Hand Hygiene through Accessibility in an LMIC Neurosurgical Ward (poster by Anthony Fuller, Akash D. Patel, Kelsey Graywill, Samantha Sadler, Margaret Lund, Joao Ricardo Nickenig Vissoci, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Michael M. Haglund), presented at Bass Connections Showcase, April 18, 2018

Physical Activity in the Neurosurgical Ward of Mulago National Referral Hospital: Preliminary Results of a Mixed-Methods Study (poster by Kira G. Battle, Anthony Fuller, Richard Kasiita, Joao Vissoci, Sarah Jean Barton, Amy Pastva, Michel Landry, Michael Haglund), presented at Bass Connections Showcase, April 18, 2018

Chinemerem Nwosu ’19, Bass Connections Follow-on Student Research Award

Samantha Sadler ’19, Bass Connections Follow-on Student Research Award

Abstract accepted for GLOCAL 2018 Conference, Houston, TX, March 9-10, 2018

Improving Hand Hygiene through Accessibility in an LMIC Neurosurgical Ward (poster by Anthony Fuller, Akash D. Patel, Kelsey Graywill, Samantha Sadler, Margaret Lund, Joao Ricardo Nickenig Vissoci, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Michael Haglund), presented at Global Health Research Showcase, November 1, 2017

Evaluating the Feasibility of a Multi-Modal Educational Intervention to Improve Neurosurgical Patients’ and Caregivers’ Health Literacy (poster by Chinemerem Nwosu, Sherry Yang, Sandra Batakana, Jared Gloria, Anthony Fuller, Joao Vissoci, Michael Haglund), presented at Global Health Research Showcase, November 1, 2017

Interventions to Improve Medication Adherence among Neurosurgical Patients at Mulago National Referral Hospital (poster by Sarah Rapaport, Garrett Holmes, Hyan Keun Ahn, Raahina Malik, Anthony Fuller, Winnie Nambataya, Michael Haglund), presented at Global Health Research Showcase, November 1, 2017

Reflections

Obstacles Inspire an Alternative Approach to Infection Care in Uganda

Student Develops Health Literacy Tools to Empower Patient Caregivers

Most Meaningful Aspect of Bass Connections: Sarah Rapaport

Global Is Local: Insights from the GLOCAL 2018 Global Health Conference (Chinemerem Nwosu)

Intention Verus Impact: Reflections on the GLOCAL 2018 Global Health Conference (Sherry Yang)

Student's Research Experiences Link Curiosity about Brain Health to Commitment to International Development (Sarah Rapaport)

Urgent Care: When the Researcher Becomes the Patient (Sam Sadler)

This Team in the News

These Seniors Took Their Bass Connections Research Further and Graduated with Distinction

Student Develops Health Literacy Tools to Empower Patient Caregivers

Duke Seniors Share What Was Most Meaningful about Their Bass Connections Experiences

Bass Connections Showcase Presents Research Highlights from Durham to Malaysia

Judges’ Selection for Best Poster Goes to Team Exploring Health Needs of Refugees in Durham

Global Health Projects Featured Prominently among Bass Connections Awards

Meet the 2018 Recipients of Bass Connections Follow-on Research Awards

Student’s Research Experiences Link Curiosity about Brain Health to Commitment to International Development

Meet the Members of the 2017-18 Student Advisory Council

Creating Meaning: Undergraduate Pursues an Intellectual Question Across Boundaries

Bass Connections Students Win Poster and Photo Awards for Research in Uganda, Honduras, Nepal and Peru

Best Photos and Best Posters Announced at Showcase Event

See related teams, Evaluating Interventions Aimed at Improving Neurosurgical Patient Outcomes in Uganda (2018-2019) and Improving Neurosurgery Patient Outcomes in Uganda (2016-2017).

Uganda team collage.

Team Leaders

  • Anthony Fuller, School of Medicine-Neurosurgery
  • Michael Haglund, Duke Global Health Institute|School of Medicine-Neurosurgery

/graduate Team Members

  • Tony Fuller, Global Health - MS
  • Jared Gloria, Medicine MD Third Year
  • Charles Hedges, Bioethics and Sci Policy - AM
  • Charis Spears, Medicine MD Third Year

/undergraduate Team Members

  • Sandra Martha Batakana, Chemistry (AB)
  • Kelsey Graywill, Program II (AB)
  • Raahina Malik, Neuroscience (BS)
  • Chinemerem Nwosu, Program II (AB)
  • Akash Patel, Neuroscience (BS)
  • Sarah Rapaport, Neuroscience (BS)
  • Samantha Sadler, Neuroscience (BS), Global Health (AB2)
  • Sherry Yang, Neuroscience (BS)

/yfaculty/staff Team Members

  • Shem Opolot, School of Medicine-Neurosurgery
  • Joao Vissoci, School of Medicine-Surgery: Emergency Medicine

/zcommunity Team Members

  • Alex Mugalu, Department of Neurosurgery, Mulago Hospital (Uganda)
  • Michael Muhumuza, Department of Neurosurgery, Mulago Hospital (Uganda)
  • Juliet Ssekabunga, Department of Neurosurgery, Mulago Hospital (Uganda)