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Acceptability of pre-exposure prophylaxis and associated factors among HIV-negative young men in Kagwara fishing community-Serere district, Uganda: A cross-sectional study
No full textAbbreviations: AGYW, adolescent girls
and young women; AIDS, Acquired
Immunodeficiency Syndrome; AVERT, Aid
Virus Education and Research Trust; AYFRHS,
Adolescent and Youth Friendly Reproductive
Health Care Services; CDC, Centers for Disease
Control and Prevention; DHIS2, District Health
Information System Software version 2; HIV,
Human Immunodeficiency Virus; HMIS, Health
Management Information System; MSM, Men
who have sex with Men; MSMW, Men who have
Sex with Men and Women; NRTIs, Nucleotide
Reverse Transcriptase Inhibitors; PrEP, pre-
exposure prophylaxis; PWID, People Who Inject
Drugs; PWUD, People Who Use Drugs; STD,
Sexually Transmitted Disease (s); UN, United
Nations; UNAIDS, United Nations Joint Program
on HIV; UNFPA, United Nations Fund for
Population Activities; UNICEF, United Nations
International Children’s Emergency Fund; WHO,
World Health OrganizationBackground
Despite the potential efficacy of Pre-Exposure Prophylaxis (PrEP) in reducing HIV
risk, Oral PrEP acceptability remains strikingly varied by populations and locations.
We assessed PrEP acceptability and associated factors among at-risk HIV-negative
young men.
Methods
A cross-sectional analytical study design was used. Data were collected among
409 at-risk HIV-negative young men aged 15–24 years living in Kagwara fishing
community- Serere district, Uganda between August and October 2023. Quantitative
data were collected on socio-demographic characteristics, sexual risk behaviors
and concerns about PrEP. Data was analyzed using Stata version 15.0 statistical
software. Summary statistics were computed and presented as tables, frequencies
and proportions. Bivariate analysis was conducted using binary logistic regression to
identify independent factors associated with PrEP acceptability. All factors that had
p < 0.10 at the bivariate analysis and confounders were entered into the final logistic
regression model. All factors with p < 0.05 were considered significantly associated
with the primary outcome
Results
The average age of 409 respondents was 21.8 (Standard Deviation [SD]=1.9) years.
Majority, (97.8%, n = 393) had unprotected penetrative sex. PrEP acceptability was high as majority of the participants accepted to use PrEP based on the six constructs
of acceptability (93.6%, n = 383). Participants with perceived risk of getting HIV
infection had higher odds of PrEP acceptability, (adjusted odds ratio [aOR]=4.23,
95%CI = 1.05–17.04). Participants who knew their partner’s HIV status (aOR=0.25,
95%CI = 0.07–0.88), those who felt embarrassed to ask for PrEP from the facility
(aOR=0.12, 95%CI = 0.04–0.39), and those who had stigma associated with use of
PrEP (aOR=0.13, 95%CI = 0.04–0.41) had reduced odds of PrEP acceptability.
Conclusion
We found a high level of PrEP acceptability among young men at risk of HIV acqui
sition in Kagwara fishing community. Improving access to PrEP services among
high risk young men in the fishing communities may increase PrEP uptake in this
population and across similar settings. The Ministry of health needs to use multiple
approaches to provide PrEP such as peer-led models, drug distribution points, short
message reminders for refills, pharmacies and retail drug shops.he author(s) received no specific funding for this work
Return to care of children and adolescents living with HIV who missed their clinic visits or were lost to follow- up: a continuous quality improvement study in Uganda
No full textThis is an open access article distributed in accordance with the
Creative Commons Attribution Non Commercial (CC BY- NC 4.0) license, which
permits others to distribute, remix, adapt, build upon this work non- commercially,
and license their derivative works on different terms, provided the original work is
properly cited, appropriate credit is given, any changes made indicated, and the use
is non- commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.Background While the UNAIDS 95- 95- 95 targets
have been met among adults, those for children and
adolescents remain suboptimal. This study aimed to
improve the return- to- care rates among children and
adolescents living with HIV (CALHIV) who missed clinic
appointments at a county- level rural health facility in
eastern Uganda.
Methods Between January 2023 and January 2024, we
conducted a continuous quality improvement (CQI) study.
A CQI committee was established through entry meetings
and training, and quality of care gaps were identified
through data reviews. We prioritised one gap for CQI
through ranking, performed a root- cause analysis using a
f
ishbone diagram, and developed and ranked improvement
changes using the impact- effort matrix. The improvement
changes were implemented using Plan- Do- Study- Act
cycles. The changes included (1) line listing CALHIV with
missed appointments and following up via phone calls; (2)
weekly data reviews to harmonise missed appointments
and (3) assigning community health workers (CHWs) to
trace and return CALHIV to care. We tracked and plotted
the proportion of CALHIV returning to care over time to
assess improvements.
Results Before the implementation of CQI initiatives
(August 2022–January 2023), the average return- to- care
rate was 35% (baseline). Following the initiation of CQI in
February 2023, the average return- to- care rate increased
to 59% from February to May 2023 with the introduction
of line listing (phase 1), to 69% from June to September
2023 with the implementation of weekly data reviews
(phase 2), and to 88% from October 2023 to January
2024 with the involvement of CHWs (phase 3), ultimately
reaching a peak of 100% in January 2024.
Conclusion The CQI approach improved the return to
care of CALHIV who missed clinic appointments, allowing
access to optimal care and better health outcomes.
These findings should serve as preliminary data for larger
randomised studies.The authors have not declared a specific grant for this research from any
funding agency in the public, commercial or not- for- profit sectors
Prevalence, factors associated, and negative outcomes of "probable PTSD" among HIV infected children and adolescents: CHAKA study 2014-2017
No full textThis study was conducted in Uganda under the authorization H-S 1601 approved by the Science and Ethical Committee of the Uganda Virus Research Institute and the Uganda National Council of Science and Technology. Consent to participate in this study was obtained from care-givers and assent from children and adolescents.The aim of this study was to determine the prevalence of “probable post-traumatic stress disorder (PTSD),” factors associated with probable P-T-S-DPTSD, and its relationship with clinical and behavioral problems among children and adolescents with H-I-V/A-I-D-S (CA-HIV). A random sample of 1,339 C-A-H-I-V (aged 5–18 years, living with H-I-VHIV) whose caregivers completed an extensive battery of measures. The caregivers evaluated psychiatric symptom severity using a standardized D-S-MDSM-5-referenced psychiatric rating scale, the Child and Adolescent Symptom Inventory-5. The prevalence of “probable P-T-S-DPTSD” was estimated with 95% confidence intervals (95% C-ICI). Logistic and ordinal regression models were fitted to determine factors associated with probable P-T-S-D P-T-S-D , including study site, sex of the child, age of the child, caregiver religion, caregiver psychological distress, any anxiety and any attention-deficit/hyperactivity disorder (ADHD). Logistic and ordinal regression models were fitted to determine factors associated with probable P-T-S-D
and to evaluate the relationship between probable P-T-S-D and clinical and behavioral outcomes. The overall prevalence of “probable P-T-S-DPTSD” was 19.6%. C-A-H-I-V with “probable P-T-S-DPTSD” were more likely to have had their sexual debut (a-o-r = 2.78; 95% C-I 1.12–6.55; P = 0.02). “Probable P-T-S-DPTSD” was marginally associated with poor adherence to H-I-V medication (a-o-r = 0.13, 95% C-I 0.02–0.97; P = 0.05).The study identified a high prevalence of “probable P-T-S-DPTSD” among C-A-H-I-V HIV, with significant associations with caregiver psychological distress, anxiety, and A-D-H-D . These findings underscore the need for targeted mental health interventions tailored to the unique needs of C-A-H-I-V in Uganda. Furthermore, integrating mental health services into routine H-I-V care could address the significant burden of P-T-S-D and its comorbidities in this vulnerable population in Uganda.This study was funded by an M-R-C/D-f-I-D grant awarded to Professor Eugene Kinyanda after winning an African Leadership Award; M-R-C African Research Leaders MR/ L004623/1—Mental health among H-I-V infected CHildren and Adolescents in KAmpala, Uganda (CHAKA)
Ikoja Odongo, J. R. (2024). Information Needs and Uses of the Informal Sector Entrepreneurs: A Conceptual, Contextual and Historiographic Review.
No full textThis is a book chapter published in a book titled Information, Knowledge, and Technology for Teaching and Research in Africa: Information Behavior in Knowledge and Economy, 23-52.This chapter reviews extant literature on information needs and uses of the informal sector entrepreneurs of Uganda. The review is based on the study conducted from 1999 to 2002. By this time, studies on information needs were already forty years old since the early writing and exposition by Taylor in 1962, 1968. Motivation to the study is that the informal sector whose entrepreneurs were studied, had during this time relatively few studies of information needs and uses undertaken in developing Africa and within Uganda there was no empirical evidence to rely on to the size, nature, range, and activities of the sector. There is also a wide information gap in government, NGOs and other stakeholders on the sector regarding what they do and yet the sector contributes to the national economy. However the sector is part of the Ugandan economy that is deeply rooted in the history, customs and culture of the country. It is the second economy that has demonstrated remarkable ability to survive and expand in recent years. To understand the information needs and uses of entrepreneurs, their demographic and business characteristics are highlighted and empirically tested. Qualitative research methodologies, applying critical incidence technique for interviews of informal entrepreneurs from various trades was employed. Observations of entrepreneurs’ work environments and historical methods were engaged. Results suggest modern/exotic models of information transfer based on textual media and ICT, exhibit less impact on the entrepreneurs’ information needs and use at macro levels because of illiteracy, low levels of education and poor information infrastructure. Most ‘elite’ models share a platform with information behavior of entrepreneurs at the micro levels. The conclusion is drawn that an appropriate model for information behavior for information poor communities like the informal entrepreneurs must be grounded on oral traditions and indigenous knowledge and should be sensitive to poverty, infrastructure and illiteracy. There is need for information repackaging and use of appropriate media for information provision.Non
Uptake and Completion of Human Papilloma Virus Vaccination by Adolescent Girls Attending Primary Healthcare Facilities in Soroti City, Northeastern Uganda; A Cross Sectional Study
No full textAcknowledgement
We would like to acknowledge the contribution of the Departments
of Nursing and Public Health, School of Health Sciences, Soroti
University which provided guidance throughout the process of
proposal development, protocol approval, data collection and
report writing. In addition, we acknowledge Associate Professor
Fred Kirya, the Dean School of Health Sciences who facilitated
the faculty members to oversee and supervise this research project.Introduction: Uganda adopted and implemented Human Papilloma Virus (HPV) vaccination since 2015 for adolescent girls aged
9-13 years for primary prevention of cervical cancer. However, the vaccine uptake and dose completion have remained relatively
low national wide. Therefore, this study aimed at determining the uptake and dose completion of HPV vaccination and associated
factors in Soroti city, Northeastern Uganda.
Methodology: This was a cross-sectional study that employed quantitative methods of data collection and analysis. A sample
of 287 adolescent girls aged 10-19 years were selected consecutively from four health centers in Soroti City between March
and April 2024. Data was analyzed using Stata statistical software, version 15.0. Descriptive statistical analysis was performed
to determine the level of HPV vaccine uptake and dose completion. Bivariate and multivariate analyzes were performed using
modified Poisson regression with robust error estimates to determine association between independent factors and uptake and
dose completion. Results were reported with a 95% confidence interval (CI) and factors whose P-Values were less than 0.05 were
considered statistically significant.
Results: Of the 287 adolescent girls, their mean age was 14 years (SD=2.9). Most of the participants were in school, 231(80.5%).
Majority, 79 % (n=228) had never heard about HPV Vaccination. HPV Vaccination uptake among the study participants was
suboptimal as only 58.8% (n=166) had received at least one dose whereas only 30% (n=86) had completed the two doses of the
vaccine. The factors that were significantly associated with vaccination uptake were school enrollment status (P=0.022), religion
(P=0.010), and awareness about HPV vaccine (P<0.001), while factors that were significantly associated with completion of HPV
vaccination were: School enrollment status (P=0.046) and awareness about HPV vaccine (P=0.007).
Conclusion: The uptake and completion of HPV vaccination in Soroti was suboptimal compared to WHO target of 90%. School
enrollment status and awareness about HPV vaccine were factors significantly associated with HPV uptake and dose completion.
Strengthening the school-based HPV vaccination program and creating awareness about HPV vaccination, in schools, at the
health facilities and in the community may significantly improve the HPV vaccination and dose completion in the region.Non
Factors Associated with Cervical Cancer Screening Uptake Among Women Attending Outpatient Department in a Rural District Hospital in Uganda. A Cross-Sectional Study
No full text© 2025 Ekinu et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.
php and incorporate the Creative Commons Attribution – Non Commercial (unported, v4.0) License (http://creativecommons.org/licenses/by-nc/4.0/). By accessing the
work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).Background: Sub-Saharan Africa (SSA) faces persistently low cervical cancer screening uptake, averaging only 13% over the past
five years, with Uganda reporting less than 5%. This study aimed to assess the factors influencing cervical cancer screening uptake in
a rural district hospital to inform targeted interventions that enhance screening coverage for the rural community.
Methods: This was a cross-sectional study conducted at Kaberamaido General Hospital (KGH) outpatient department. A total of 422
participants aged between 25 and 49 years were interviewed and data analyzed using STATA version 16.0. Bivariate and multivariate
analyses were performed using modified Poisson regression with robust error estimates to identify key factors associated with cervical
cancer screening uptake. Variables with P-value <0.05 were considered statistically significant.
Results: The average age of participants was 32 (SD ±7) years. 77.5% (n=327) of participants were married, had primary level of
education, 69.2% (n=292), and were unemployed, 89.3% (n=377). Awareness about screening was high as 85.5% (n=360) of
respondents had heard about cervical cancer screening. Cervical cancer screening uptake was low, as only 20.4% (n=86) had been
screened in the past five years. Factors significantly associated with increased screening uptake, including age older than 35 years,
adjusted Prevalence Ratio [aPR]= 1.7 (95% CI: 1.08–2.69), availability of free government screening services, aPR = 1.6 (95% CI:
1.09–2.38), provision of screening service at the nearest health facility, aPR = 2.1 (95% CI: 1.09–3.97), and a positive family history of
cervical cancer, aPR = 1.7 (95% CI: 1.14–2.65).
Conclusion: Our study confirms that cervical cancer screening uptake in Kaberamaido District remains low, highlighting the need for
enhanced awareness campaigns and improved access to screening services. Our findings emphasize the need for policies that
strengthen community outreach programs and expand cervical cancer screening services at primary healthcare facilities.
Keywords: uterine cervical neoplasms, cervical cancer screening, women, cervical cancer awarenessN/
Maternal satisfaction with intrapartum care services and its associated factors among mothers who delivered from health facilities within a city in Uganda. A descriptive cross-sectional community study
No full textNAAbstract
Background: keeping an eye on and assessing maternal satisfaction enhances the effectiveness and
quality of care during the intrapartum period and if not regularly accessed, could lead to detrimental
effects on maternal and newborn outcomes following intrapartum. Therefore this study aimed at assessing
maternal satisfaction with intrapartum care services and its associated factors among mothers who
delivered from health facilities within Soroti City
Methods: Background characteristics of participants were collected using an interviewer-administered
questionnaire was used. Data entry and analysis were performed using Statistical Package for the Social
Sciences (SPSS) version 27.0 software. A crude and adjusted odds ratio with a 95% confidence interval
(CI) was computed to identify associated factors.
Results: 86.5% gave birth from government facilities while 13.5 % delivered from private facilities.
Overall 70.4% of mothers were satisfied with the intrapartum care services received from health facilities
in Soroti City. Mothers who gave birth in private facilities were more satisfied (95.2%) compared to those
in public facilities (66.5%). Type of the healthcare facility AOR(95%CI) 7.504(1.573-35.787),duration of
hospital stay before delivery AOR(95% CI)2.674(1.300-5.502),periodic updates AOR (95% CI)
0.247(0.116-0.530),plan to have the pregnancy AOR(95%CI),2.483(1.280-4.814)overall cleanness
AOR(95%CI) 0.07(0.013-0.378),delivery position of patient choice AOR(95% CI) 0.228(0.069
0.754),privacy AOR(95% CI) 0.102(0.050-0.209), and Pain management AOR (95% CI) 0.334(0.152
0.738) were significantly associated with satisfaction.
Conclusion: The overall satisfaction of mothers with intrapartum care services provided was relatively
high. Majority of the mothers gave birth from government facilities however a higher percentage of
satisfaction was reported in private facilities. Therefore, all stakeholders have to emphatically work on
those identified factors to improve maternal satisfaction with intrapartum care services
Keywords: Intrapartum care services, maternal outcome, satisfaction.N
Isoniazid preventive therapy completion between July-September 2019: A comparison across HIV differentiated service delivery models in Uganda
No full textPLOS recognizes the
benefits of transparency in the peer review
process; therefore, we enable the publication of
all of the content of peer review and author
responses alongside final, published articles. The
editorial history of this article is available here:
https://doi.org/10.1371/journal.pone.0296239Background
Tuberculosis (TB) remains the leading cause of death among people living with HIV
(PLHIV). To prevent TB among PLHIV, the Ugandan national guidelines recommend Isoniazid
Preventive Therapy (IPT) across differentiated service delivery (DSD) models, an effective
way of delivering ART. DSD models include Community Drug Distribution Point
(CDDP), Community Client-led ART Delivery (CCLAD), Facility-Based Individual Management
(FBIM), Facility-Based Group (FBG), and Fast Track Drug Refill (FTDR). Little is
known about the impact of delivering IPT through DSD.
Methods
We reviewed medical records of PLHIV who initiated IPT between June-September 2019 at
TASO Soroti (TS), Katakwi Hospital (KH) and Soroti Regional Referral Hospital (SRRH).
We defined IPT completion as completing a course of isoniazid within 6–9 months. We utilized
a modified Poisson regression to compare IPT completion across DSD models and
determine factors associated with IPT completion in each DSD model.
Results
Data from 2968 PLHIV were reviewed (SRRH: 50.2%, TS: 25.8%, KH: 24.0%); females:
60.7%; first-line ART: 91.7%; and Integrase Strand Transfer Inhibitor (INSTI)-based regimen:
61.9%. At IPT initiation, the median age and duration on ART were 41.5 (interquartile
range [IQR]; 32.3–50.2) and 6.0 (IQR: 3.7–8.6) years, respectively. IPT completion overall was 92.8% (95%CI: 91.8–93.7%); highest in CDDP (98.1%, 95%CI: 95.0–99.3%) and lowest
in FBG (85.8%, 95%CI: 79.0–90.7%). Compared to FBIM, IPT completion was significantly
higher in CDDP (adjusted rate ratio [aRR] = 1.15, 95%CI: 1.09–1.22) and CCLAD
(aRR = 1.09, 95% CI 1.02–1.16). In facility-based models, IPT completion differed between
sites (p<0.001). IPT completion increased with age for FBIM and CCLAD and was lower
among female participants in the CCLAD (aRR = 0.82, 95%CI 0.67–0.97).
Conclusion
IPT completion was high overall but highest in community-based models. Our findings provide
evidence that supports integration of IPT within DSD models for ART delivery in
Uganda and similar settings.This project was funded by the Ugandan
Ministry of Health and by grant # OPP1152764
from the Bill & Melinda Gates Foundation. The
funders had no role in study design, data collection
and analysis, decision to publish, or preparation of
the manuscript
A cross-sectional study Design
No full textBackground: Pneumonia continues to be the foremost cause of morbidity and mortality among
children under the age of five, resulting in the demise of 740,180 children globally and contributing
to 14% of all deaths in this age group, with 22% of deaths occurring among children aged 1 to 5
years. Most researches have been conducted to establish factors that contribute to pneumonia but
have reported inconsistent findings.
Objectives: This study assessed the prevalence of pneumonia and its associated factors in children
under-five years.
Methodology: This was a cross sectional study at the Pediatric Department of Soroti Regional
Referral Hospital, from the month of March to April 2024. The study included 385 children aged
2 to 59 months admitted to the pediatric ward. Pneumonia diagnosis was made according to the
2014 standard clinical WHO and integrated management of new born and childhood illness
classification of cases. Semi-structured questionnaires were used to collect data on socio demographic, socioeconomic, child related and facility related factors and bivariate analysis using
Chi-square in SPSS version 27 was done to assess for the factors independently associated with
pneumonia.
Results: Of the 385 children admitted in the pediatric ward, 97 (25.2%) had pneumonia. Factors
significantly associated with pneumonia included: age of the child (p= <0.001), level of maternal
education (p= <0.001), housing conditions (p= <0.001), use of wood as fuel (p= <0.001),
immunization status (p= <0.001), nutrition status (p= <0.001), exclusive breastfeeding (p=0.006),
history of ARTI (p= <0.001), Vitamin A deficiency (p= <0.001), hospital stay (p= <0.001) and
accessibility to health care services (p= <0.001).
Conclusion: The prevalence of pneumonia in children under-five years was high. Most of the
factors associated with pneumonia are modifiable; addressing these factors could reduce this
prevalence. The study recommends implementation of a comprehensive health care program at the
community level in the study area to address the factors associated with pneumonia above
Predictors of microvascular complications in patients with type 2 diabetes mellitus at regional referral hospitals in the central zone, Tanzania: a cross‑sectional study
No full textMicrovascular complications encompass a group of diseases which result from long-standing
chronic effect of diabetes mellitus (DM). We aimed to determine the prevalence of microvascular
complications and associated risk factors among patients with type 2 diabetes mellitus (T2DM).
A cross-sectional analytical hospital-based study was conducted at Singida and Dodoma regional
referral hospitals in Tanzania from December 2021 to September 2022. A total of 422 patients with
T2DM were included in the analysis by determining the prevalence of microvascular complications
and their predictors using multivariable logistic regression analysis. A two-tailed p value less than
0.05 was considered statistically significant. The prevalence of microvascular complications was
57.6% (n = 243) and diabetic retinopathy was the most common microvascular complication which
accounted for 21.1% (n = 89). Having irregular physical activity (AOR = 7.27, 95% CI = 2.98–17.71,
p < 0.001), never having physical activity (AOR = 2.38, 95% CI = 1.4–4.01, p = 0.013), being hypertensive
(AOR = 5.0, 95% CI = 2.14–11.68, p = 0.030), having T2DM for more than 5 years (AOR = 2.74, 95% CI =
1.42–5.26, p = 0.025), being obese (AOR = 2.63, 95% CI = 1.22–5.68, p = 0.010), and taking anti-diabetic
drugs irregularly (AOR = 1.94, 95% CI = 0.15–0.77, p < 0.001) were the predictors of microvascular
complications. This study has revealed a significant proportion of microvascular complications in a
cohort of patients with T2DM. Lack of regular physical activity, being obese, taking anti-diabetic drugs
irregularly, presence of hypertension, and long-standing duration of the disease, were significantly
associated with microvascular complications