20 research outputs found
Knowledge and attitudes of female Makerere University students towards induced abortion for unwanted pregnancy
No full textA Dissertation submitted to the Department of Nursing in partial fulfillment of the requirements for the award of the degree of Bachelor of Science in Nursing of Makerere UniversityInduced abortion is a vital reproductive health problem world wide and also in Uganda. Fourty six million or twenty two percent(22%) of all pregnancies world-wide end in induced abortions each year(Hord, 2001). About 297,000 induced abortions are performed in uganda each year and nearly 85,000 women are treated for complications of abortion(Susheela et al 2005). The objectives were to ascertain the knowledge of female university students about induced abortion, to determine the students' attitude towards induced abortion, and to obtain students veiws on the legal status of induced abortion in uganda. The study was descriptive cross-sectional and quantitative in narture, it involved 230 respodents. Data was collected using pre-tested structured self-administered questionaire. Data collected was analysed using a computer SPSS 11.0 program and results presented using tables, pie-charts and texts. Results showed that, majority of the respondents(95.6%) were aware of different approaches to prevent unwanted pregnancy; some methods of prevention mentioned include abstinence, condoms, natural-method(48.7%) was induced abortion(27.0). However, natural method cannot be relied on alone to prevent pregnancy and induced abortion should be discouraged as it leads to health and psychological problems. Knowledge on induced abortion was high as 63% could correctly define induced abortion. Knowledge on complications/effect of induced abortion was high, 81.7% of respondents mentioned, excessive bleeding,infertility, infections, death and psychological torture. The majority of respondents had heard about the practice of induced abortion(77.0) and had obtained their information mainly from friends/peers. Home as a source of information was least stated, therefore parents shuold be encouraged to actively particiapte in warning girls about dangers of induced abortion and discourage practice. Abortion was reportedly done by doctors(74.8%), nurses(45.2%), self(38.7%), relative(29.1%), herbalist(29.6%) and witch doctors(13.5%). Private clinics and hospitals were the commonest mentioned, as places where abortion is carried out. Methods mentioned for inducing abortion included, drugs, surgical procedures, local herbs and using metals/sticks. there was an overall negative attitude towards induced abortion for unwanted pregnancy noted among the respondents(83%). However 27% of the respondents had a positive attitude towards induced abortion. This should be discouraged since induced abortion poses many risk including, health and psychological problems. Conclusions made were that respondents are aware of induced abortion and their knowledge was high though limited. The overall attitude towards induced abortion was negative although reasons given were mainly, personal, social, cultural, economical, legal and religious reasons other than health reasons. The study recommends, for health education of women and girls on option to prevent unwanted pregnancy, and dangers of induced abortion. Girls and women should be warned against the practice of induced abortion. strict laws against induced abortion should be reinforced and implimented
Assessing the Knowledge and Practices regarding eye care and complications of Diabetes among Diabetic Patients 18 years and older, attending a tertiary Diabetic Clinic in Kampala, Uganda
No full textPurpose
The aim of this study was to audit the knowledge and practices regarding eye care and eye complications of diabetes mellitus (DM) among diabetic patients 18 years and above in Kampala, Uganda.
Methods.
A cross-sectional study was done to collect data on the demographics, level of awareness and practices of the 409 diabetic patients regarding eye care and eye complications of DM. Data collected was captured in EPIDATA version 3.1, exported to STATA version 15.0 for further management and analysis. Participants characteristics were summarized using summary statistics and graphs. Using a standard questionnaire, scores for knowledge and practice for diabetes; knowledge and practice on diabetic retinopathy were generated and in all the four scores aforesaid, participants were classified as having good or poor knowledge and practice1. Proportions of participants demonstrating good awareness and good practice were reported. Fishers and Pearson chi- square tests were used to test for associations between patient’s characteristics and knowledge and practice on DM. Bivariable and logistic regression analysis was performed and variables with a p-value of < 0.2 of the unadjusted odds ratio were further analyzed at multivariate logistic regression analysis to find out factors that significantly predict patient’s knowledge and practice on diabetes mellitus.
Results.
A total of 409 participants were interviewed in the study, majority were females 293 (71.6%) and mean age (SD) was 50 (12) years. A high proportion of participants 314 (76.9%) was aware that DM could affect the eyes but only 24 (5.9%) stated diabetic retinopathy as an eye complication in diabetic patients. Good knowledge about diabetes mellitus was demonstrated by 178 (43.5%) of the study participants. However, only 33.3% had good knowledge on eye care and diabetic retinopathy. It was determined that female diabetic patients and those who stayed with DM for 10 years and beyond were less likely to have good practice on DM compared to male patients and those who had been with DM for less than five years (OR, 95% CI: 0.58, 0.36-0.95, P=0.029: OR, 95% CI: 0.53, 0.32-0.87, P=0.011). It was also found that diabetic patients with good knowledge of DM were at least three times more likely to have good practice compared to those with the poor knowledge (OR, 95% CI: 3.2, 2.1 -4.8, P <0.001).
Conclusion
Lack of knowledge regarding the importance and need for periodic eye check-up for diabetic retinopathy was a significant finding in his study. Good knowledge on diabetes, gender and duration of DM had significant association with the patients practice patterns
Progress on implementing the WHO-GLASS recommendations on priority pathogen-antibiotic sensitivity testing in Africa: A Scoping Review
No full textProgress on implementing the WHO-GLASS recommendations on priority pathogen-antibiotic sensitivity testing in Africa: A Scoping Revie
Leveraging disease outbreak news to strengthen the global response to antimicrobial resistance: a call for action
No full textDescribing Point of Entry into Care and Being Lost to Program in a Cohort of HIV Positive Pregnant Women in a Large Urban Centre in Uganda
No full textIntroduction. We aim to describe the time of entry into care and factors associated with being lost to program (LTP) in pregnant women on Option B Plus in an integrated HIV and antenatal care (ANC) clinic in Uganda. Methods. We included all pregnant women enrolled into the integrated HIV-ANC clinic from January 2012 to 31st July 2014, while the follow up period extended up to October 30th 2015. LTP was defined as being out of care for ≥3 months. Results. Overall 856 women were included. Only 36.4% (86/236) of the women were enrolled in the first trimester. Overall 69 (8.1%) were LTP. In the multivariate analysis older women (HR: 0.80 per five-year increase, CI: 0.64-1.0, and = 0.060) and women on ART at the time of pregnancy (0.58, CI: 0.34-0.98, and = 0.040) were more likely not to be LTP. Among women already on ART at the time of pregnancy no factor was associated with LTP. Conclusion. Our results suggest the need for interventions to enhance prompt linkage of HIV positive women to HIV services for ART initiation and for increased retention particularly in young and ART naive women
Impact of a mobile phone-based interactive voice response software on tuberculosis treatment outcomes in Uganda (CFL-TB): a protocol for a randomized controlled trial
No full textAbstract Background Throughout the last decade, tuberculosis (TB) treatment success has not surpassed 90%, the global target. The impact of mobile health interventions (MHIs) on TB treatment outcomes is unknown, especially in low- and middle-income countries (LMICs). MHIs, including interactive voice response technology (IVRT), may enhance adherence and retention in the care of patients with tuberculosis and improve TB treatment outcomes. This study seeks to determine the impact of IVRT-based MHI on TB treatment success (treatment completion and cure rates) in patients with TB receiving care at five public health facilities in Uganda. Methods We used a theory-based and human-centered design (HCD) to adapt an already piloted software to design “Call for life-TB” (CFL-TB), an MHI that utilizes IVRT to deliver adherence and appointment reminders and allows remote symptom reporting. This open-label, multicenter, randomized controlled trial (RCT), with nested qualitative and economic evaluation studies, will determine the impact of CFL-TB on TB treatment success in patients with drug-susceptible TB in Uganda. Participants (n = 274) at the five study sites will be randomized (1:1 ratio) to either control (standard of care) or intervention (adherence and appointment reminders, and health tips) arms. Multivariable regression models will be used to compare treatment success, adherence to treatment and clinic appointments, and treatment completion at 6 months post-enrolment. Additionally, we will determine the cost-effectiveness, acceptability, and perceptions of stakeholders. The study received national ethical approval and was conducted in accordance with the international ethical guidelines. Discussion This randomized controlled trial aims to evaluate interactive voice response technology in the context of resource-limited settings with a high burden of TB and high illiteracy rates. The software to be evaluated was developed using HCD and the intervention was based on the IMB model. The software is tailored to the local context and is interoperable with the MHI ecosystem. The HCD approach ensures higher usability of the MHI by integrating human factors in the prototype development. This research will contribute towards the understanding of the implementation and impact of the MHI on TB treatment outcomes and the health system, especially in LMICs. Trial registration ClinicalTrials.gov NCT04709159 . Registered on January 14, 2021
Describing Point of Entry into Care and Being Lost to Program in a Cohort of HIV Positive Pregnant Women in a Large Urban Centre in Uganda
No full textIntroduction. We aim to describe the time of entry into care and factors associated with being lost to program (LTP) in pregnant women on Option B Plus in an integrated HIV and antenatal care (ANC) clinic in Uganda. Methods. We included all pregnant women enrolled into the integrated HIV-ANC clinic from January 2012 to 31st July 2014, while the follow up period extended up to October 30th 2015. LTP was defined as being out of care for ≥3 months. Results. Overall 856 women were included. Only 36.4% (86/236) of the women were enrolled in the first trimester. Overall 69 (8.1%) were LTP. In the multivariate analysis older women (HR: 0.80 per five-year increase, CI: 0.64–1.0, and P=0.060) and women on ART at the time of pregnancy (0.58, CI: 0.34–0.98, and P=0.040) were more likely not to be LTP. Among women already on ART at the time of pregnancy no factor was associated with LTP. Conclusion. Our results suggest the need for interventions to enhance prompt linkage of HIV positive women to HIV services for ART initiation and for increased retention particularly in young and ART naive women
Progress of Implementation of World Health Organization Global Antimicrobial Resistance Surveillance System Recommendations on Priority Pathogen-Antibiotic Sensitivity Testing in Africa: Protocol for a Scoping Review
No full textBackgroundAntimicrobial resistance (AMR) is a major global public health concern, particularly in low- and middle-income countries where resources and infrastructure for an adequate response are limited. The World Health Organization (WHO) Global Antimicrobial Resistance Surveillance System (GLASS) was introduced in 2016 to address these challenges, outlining recommendations for priority pathogen-antibiotic combinations. Despite this initiative, implementation in Africa remains understudied. This scoping review aims to assess the current state of implementing WHO GLASS recommendations on antimicrobial sensitivity testing (AST) in Africa.
ObjectiveThe primary objective of this study is to determine the current state of implementing the WHO GLASS recommendations on AST for priority pathogen-antimicrobial combinations. The review will further document if the reporting of AST results is according to “susceptible,” “intermediate,” and “resistant” recommendations according to GLASS.
MethodsFollowing the methodological framework by Arksey and O’Malley, studies published between January 2016 and November 2023 will be included. Search strategies will target electronic databases, including MEDLINE, Scopus, CINAHL, and Embase. Eligible studies will document isolates tested for antimicrobial sensitivity, focusing on WHO-priority specimens and pathogens. Data extraction will focus on key study characteristics, study context, population, and adherence to WHO GLASS recommendations on AST. Descriptive statistics involving summarizing the quantitative data extracted through measures of central tendency and variation will be used. Covidence and Microsoft Excel software will be used. This study will systematically identify, collate, and analyze relevant studies and data sources based on clear inclusion criteria to provide a clear picture of the progress achieved in the implementation of the WHO GLASS recommendations. Areas for further improvement will be documented to inform future efforts to strengthen GLASS implementation for enhanced AMR surveillance in Africa.
ResultsThe study results are expected in August 2024.
ConclusionsTo our knowledge, this scoping review will be the first to comprehensively examine the implementation of WHO GLASS recommendations in Africa, shedding light on the challenges and successes of AMR surveillance in the region. Addressing these issues aims to contribute to global efforts to combat AMR.
International Registered Report Identifier (IRRID)PRR1-10.2196/5814
Strengthening Community Antimicrobial Stewardship in Africa: A Systematic Review of the Roles, Challenges, and Opportunities of Community Health and Animal Health Workers [version 1; peer review: 1 approved, 1 approved with reservations]
No full textAntimicrobial resistance (AMR) remains a critical global health challenge, and is mainly due to inappropriate antimicrobial use in human and animal health sectors. This systematic review examines the roles of Community Animal Health Workers (CAHWs) and Community Health Workers (CHWs) in antimicrobial stewardship (AMS) across Africa where AMR burden is highest and AMS programs are limited. Following PRISMA guidelines, this systematic review analyzed 16 studies (2017–2024) from nine African nations. We identified seven key roles of CAHWs and CHWs in AMS: 1) provision of clinical services (13 studies); 2) community mobilization (8 studies); 3) health promotion (7 studies); 4) provision of preventive services (5 studies); 5) epidemiological surveillance (4 studies); 6) advocacy (2 studies), and 7) medical waste management (2 studies). Despite their roles, challenges such as lack of supportive legislation (3 studies), inadequate remuneration (2 studies), and total reliance on foreign funding hinder AMS program sustainability. While most studies (14 studies) indicated that CAHWs and CHWs had received AMS training, their roles in the national AMR strategies remain unclear. CAHW and CHWs could be leveraged in advancing health promotion, raising AMR awareness, supporting AMR surveillance, enhancing integrated management of diseases, and improving waste management within One Health frameworks. To realize this potential, there is a need to formalize CAHW/CHW roles through targeted legislation, specialized training and sustainable funding. This evidence highlights the critical need for policy reforms to harness their potential in strengthening health systems and curbing AMR across Africa. PROSPERO registration number: CRD42025102721
Progress on implementing the WHO-GLASS recommendations on priority pathogen-antibiotic sensitivity testing in Africa: A scoping review [version 1; peer review: 2 approved]
No full textIntroduction The World Health Organization global antimicrobial resistance surveillance system (GLASS) was rolled out in 2015 to guide antimicrobial resistance (AMR) surveillance. However, its implementation in Africa has not been fully evaluated. We conducted a scoping review to establish the progress of implementing the WHO 2015 GLASS manual in Africa. Methods We used MeSH terms to comprehensively search electronic databases (MEDLINE and Embase) for articles from Africa published in English between January 2016 and December 2023. The Arksey and O'Malley's methodological framework for scoping reviews was employed. Data were collected on compliance with WHO GLASS recommendations for AMR surveillance-priority samples, pathogens, and pathogen-antibiotic combinations and analysed using Microsoft Excel. Results Overall, 13,185 articles were identified. 7,409 were duplicates, and 5,141 articles were excluded based on titles and abstracts. 609 full-text articles were reviewed, and 147 were selected for data extraction. Of the 147 selected articles, 78.9% had been published between 2020 and 2023; 57.8% were from Eastern Africa. 93.9% of articles were on cross-sectional studies. 96.6% included only one priority sample type; blood (n=56), urine (n=64), and stool (n=22). Of the 60 articles that focused on blood as a priority sample type, 71.7%, 68.3%, 68.3%, 36.7%, 30%, and 10% reported recovery of Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Salmonella species and Streptococcus pneumoniae, respectively. Salmonella and Shigella species were reported to have been recovered from 91.3% and 73.9% of the 23 articles that focused on stool. E. coli and K. pneumoniae recoveries were also reported from 94.2% and 68.1% of the 69 articles that focused on urine. No article in this review reported having tested all the recommended WHO GLASS pathogen-antibiotic combinations for specific pathogens. Conclusion Progress has been made in implementing the GLASS recommendations in Africa, but adoption varies across countries limiting standardisation and comparability of data
