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Community‑based ART distribution system can effectively facilitate long‑term program retention and low‑rates of death and virologic failure in rural Uganda
Get PDFThis study was focused on Community-drug distribution point is a care model for stable patients in the community designed to make ART delivery more efficient for the health system and provide appropriate support to encourage long-term retention of patients.Background: Community-drug distribution point is a care model for stable patients in the community designed to make ART delivery more efficient for the health system and provide appropriate support to encourage long-term retention of patients. We examined program retention among ART program participants in rural Uganda, which has used a community-based distribution model of ART delivery since 2004.
Methods: We analyzed data of all patients >18 years who initiated ART in Jinja, Ugandan site of The AIDS Support Organization between January 1, 2004 and July 31, 2009. Participants attended clinic or outreach visits every 2–3 months and had CD4 cell counts measured every 6 months. Retention to care was defined as any patient with at least one visit in the 6 months before June 1, 2013. We then identified participants with at least one visit in the6 months before June 1, 2013 and examined associations with mortality and lost-to-follow-up (LTFU). Participants with >4 years of follow up during August, 2012 to May, 2013 had viral load conducted, since no routine viral load testing was available.
Results: A total of 3345 participants began ART during 2004–2009. The median time on ART in June 2013 was 5.69 years. A total of 1335 (40 %) were residents of Jinja district and 2005 (60 %) resided in outlying districts. Of these, 2322 (69 %) were retained in care, 577 (17 %) died, 161 (5 %) transferred out and 285 (9 %) were LTFU. Factors associated with mortality or LTFU included male gender, [Adjusted Hazard Ratio (AHR) = 1.56; 95 % CI 1.28–1.9], CD4 cell count <50 cells/μL (AHR = 4.09; 95 % CI 3.13–5.36) or 50–199 cells/μL (AHR = 1.86; 95 % CI 1.46–2.37); ART initiation and WHO stages 3 (AHR = 1.35; 95 % CI 1.1–1.66) or 4 (AHR = 1.74; 95 % CI 1.23–2.45). Residence outside of Jinja district was not associated with mortality/LTFU (p value = 0.562). Of 870 participants who had VL tests, 756 (87 %) had VLs <50 copies/mL.
Conclusion: Community-based ART distribution systems can effectively mitigate the barriers to program retention and result in good rates of Virologic suppression
Integrating Faith with Work: a ministry transformational model
Get PDFThis eBook was published by Global Globethics.net International series Focus No. 28The Integration of Faith in Work has been regarded as a ministry transformational model because today work has lost its place and meaning especially among Christian communities. Work no longer brings joy to those who engage in it. It has been so much associated with monetary benefits, that any work activity which is not worth paying is
disregarded and degraded. Many people of our time have shifted focus from the purpose for which work was created to more personal benefits such as monetary gains. There is little consideration to what positive impact it may create and leave for the people that will come after us. It is a very serious matter when it comes to Christians who know that God created and mandated us to work as His stewards in His estate and yet we do not give it its due respect. Today’s Christian work ethic has not met with the expectation of the Biblical teaching when we look around
and see what is happening among us as Christian workers. There is a lot of neglect and irresponsible management of what has been entrusted to us by God.
Elly’s concern that has led to the writing of this book is intended to call upon Christian workers both in private and public sectors, to look back and see where the work ethic was lost and revive it. He points out clearly how much Christians need to understand the Biblical teaching about work in their daily life. Although they have engaged work most of their life time, they have been influenced by unbiblical principles such as corruption, idleness, and crime of all sorts. Over the years Christians have lost the work ethic and values and this has resulted into meaningless and unproductive work
Assessment of Somali refugees’ wellbeing: the centrality of human needs.
Get PDFThis paper seeks to bridge this gap by evaluating the satisfaction of the human needs of Somali refugees in Kampala, Uganda.Presentet at Conference: Human Development and Capability Association annual conference At Georgetown University.There is a substantial body of literature on psychological wellbeing of refugees in psychology, especially in relation to refugee acculturation. However, very little research has been carried out on refugee wellbeing by assessing refugees’ objective conditions of living. This paper seeks to bridge this gap by evaluating the satisfaction of the human needs of Somali refugees in Kampala, Uganda. Drawing on data from thirty six individual in-depth interviews and seven focus group discussions with seventy Somali refugee and twenty two Ugandan study participants living in Kisenyi slum, the paper shows that the study participants assessed the satisfaction of seven objective elements. They include peace and security, housing, education, health care, financial security, food and employment. These objective elements can be seen to represent human needs when analysed in relation to Len Doyal and Ian Gough’s (1991) theory of human need formulation. Specifically the objective elements are similar in some respect to Doyal and Gough’s identified intermediate needs of physical security, nutritional food and safe water, economic security, protective housing, appropriate education, appropriate health care and a non-hazardous work environment. Doyal and Gough (1991) maintain that their identified needs equate to functionings such as being nourished, healthy, literate and numerate (educated), sheltered, clothed, etc under the capability approach.
The study participants assessed some Somali refugees as having adequate satisfaction of these objective elements while others as having inadequate satisfaction. Further, the Ugandan study participants evaluated the satisfaction of the elements more positively while the Somali refugee participants evaluated the satisfaction more negatively. In this paper I argue that this is the case because of the differences in Somali refugees’ financial resources and social support, a comparison of Somali refugees’ life situation in Kampala vis-à-vis their previous life situation in Somalia, a comparison of Ugandans’ life situation with Somali refugees’ life situation, and the non-discriminatory and accepting host environment. Refugees with more financial resources and stronger social support have their human needs such as housing, food, health care, education, employment and financial security adequately satisfied while refugees with fewer financial resources and weak social support have their needs inadequately satisfied. The financial resources are mainly from the small and medium scale business enterprises owned by
Somali refugees in Kisenyi while the social support is mainly in form of financial remittances from relatives and friends from industrialised or developed countries. In addition to financial resources and mutual social support, the non-discriminatory and accepting attitudes and behaviours of Ugandans resulted in the satisfaction of the human needs of housing, education, peace and security, and employment of this category of Somali refugees. The positive evaluation of the satisfaction of Somali refugees’ needs of housing, education, food and financial security by Ugandans is because most Ugandans living in Kisenyi are in a poorer financial position than Somali refugees. On the other hand, Somali refugees’ negative evaluation of the satisfaction of their needs is due to Somali refugees comparing their better conditions of living in Somalia before the outbreak of the civil war with their conditions of living in Kisenyi.
The findings of the study suggest that financial resources and a non-discriminatory and accepting host environment are instrumentally important in promoting Somali refugees’ wellbeing since they guarantee adequate satisfaction of the human needs of Somali refugees. I therefore conclude by noting that having means to financial resources and a non-discriminatory and accepting host environment are fundamental in promoting and guaranteeing refugees’ wellbeing in general and Somali refugees in particular
Yamo
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A single-nucleotide-polymorphism real-time PCR assay for genotyping of Mycobacterium tuberculosis complex in peri-urban Kampala
Get PDFThe study, we report the development of a LightCycler® real-time PCR single-nucleotide-polymorphism (LRPS) assay for the rapid determination of MTBC lineages/sublineages in minimally processed sputum samples from TB patients.Background: Accurate and high-throughput genotyping of Mycobacterium tuberculosis complex (MTBC) may be
important for understanding the epidemiology and pathogenesis of tuberculosis (TB). In this study, we report the development of a LightCycler® real-time PCR single-nucleotide-polymorphism (LRPS) assay for the rapid
determination of MTBC lineages/sublineages in minimally processed sputum samples from TB patients.
Method: Genotyping analysis of 70 MTBC strains was performed using the Long Sequence Polymorphism-PCR
(LSP-PCR) technique and the LRPS assay in parallel. For targeted sequencing, 9 MTBC isolates (three isolates per
MTBC lineage) were analyzed for lineage-specific single nucleotide polymorphisms (SNPs) in the following three
genes to verify LRPS results: Rv004c for MTB Uganda family, Rv2962 for MTB lineage 4, and Rv0129c for MTB lineage3. The MTBC lineages present in 300 smear-positive sputum samples were then determined by the validated LRPS method without prior culturing.
Results: The LSP-PCR and LRPS assays produced consistent genotyping data for all 70 MTBC strains; however, the LSP-PCR assay was 10-fold less sensitive than the LRPS method and required higher DNA concentrations to
successfully characterize the MTBC lineage of certain samples. Targeted sequencing of genes containing lineage specific SNPs was 100 % concordant with the genotyping results and provided further validation of the LRPS assay. Of the 300 sputum samples analyzed, 58 % contained MTBC from the MTBC-Uganda family, 27 % from the MTBC lineage 4 (excluding MTBC Uganda family), 13 % from the MTBC lineage 3, and the remaining 2 % were of indeterminate lineage.
Conclusion: The LRPS assay is a sensitive, high-throughput technique with potential application to routine
genotyping of MTBC in sputum samples from TB patient
Abaguuna Abasaatu No Ogusoota Mu Kibira
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Broadcasting governance and development in ‘Museveni's Uganda’
Get PDFThis is an Accepted Manuscript of an article published by Taylor & Francis in African Journalism Studies on 09 Jun 2015, available online: https://doi.org/10.1080/23743670.2015.1041301Despite recent developments in technology and globalisation, the broadcast and print media in many countries still run on separate tracks. This article, which is based on qualitative research carried out between 2012 and 2014, examines the governance and development of media in ‘Museveni’s Uganda’ (1986- ), with specific reference to broadcasting. The aim is to explore the extent to which legislation and the regulation of broadcasting have affected its development in Uganda. The key question is: How has broadcasting governance affected broadcast media development in Uganda during the Museveni years? The main approach was content analysis of relevant legislation and policies, and key informant interviews with major stakeholders. The key finding is that in the period under examination, Uganda adopted a piecemeal approach to legislation, and to a great extent relied on laws rather than policies to govern broadcasting. Broadcasting diversity and independence remained elusive, and little development of the sector beyond growth in numbers (multiplicity of outlets)
was experienced. There is a need to review existing frameworks
Omukulembeze owe Ebinhonhi
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Barriers to Condom Use among High Risk Men Who Have Sex with Men in Uganda: A Qualitative Study
Get PDFThis study was to assess unprotected sexual intercourse is a major risk factor for HIV transmission. Men who have sex with men (MSM) face challenges in accessing HIV prevention services, including condoms.Background Unprotected sexual intercourse is a major risk factor for HIV transmission. Men who have sex with men (MSM) face challenges in accessing HIV prevention services, including condoms.
However, there is limited in-depth assessment and documentation of the barriers to condom use among MSM in sub-Saharan Africa. In this paper, we examine the barriers to condom use among MSM in Uganda.
Methods
The data for this study were extracted from a larger qualitative study conducted among 85 self-identified adult (>18 years) MSM in 11 districts in Uganda between July and December
2013. Data on sexual behaviours and access and barriers to condom use were collected using semi-structured interviews. All interviews were audio-recorded and transcribed verbatim.
This paper presents an analysis of data for 33 MSM who did not use condoms at last sex, with a focus on barriers to condom use. Analysis was conducted using the content analysis approach.
Results
Six major barriers to condom use were identified: Difficulties with using condoms, access challenges, lack of knowledge and misinformation about condom use, partner and relationship related issues, financial incentives and socio-economic vulnerability, and alcohol consumption.
Conclusion
The findings suggest that several reasons account for lack of condom use among high-risk
MSM. The findings are valuable to inform interventions needed to increase condom use among MSM
Musana, Mwezi, Maadhi ni Mpewo
Get PDFThis is a children story book.This is a children's story explaining how God created the sun, moon, water and air and we benefit from them as His creatures