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  • 1
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    Online Resource
    Ebola disease outbreak caused by the Sudan virus in Uganda, 2022: a descriptive epidemiological study
    Elsevier BV ; 2024
    In:  The Lancet Global Health Vol. 12, No. 10 ( 2024-10), p. e1684-e1692
    Details
    In: The Lancet Global Health, Elsevier BV, Vol. 12, No. 10 ( 2024-10), p. e1684-e1692
    Type of Medium: Online Resource
    ISSN: 2214-109X
    URL: Article
    DOI: 10.1016/S2214-109X(24)00260-2
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2024
    detail.hit.zdb_id: 2723488-5
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  • 2
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    Investigation of a COVID-19 Outbreak at a Regional Prison, Northern Uganda, September 2020
    Pan African Medical Journal ; 2022
    In:  Pan African Medical Journal Vol. 43 ( 2022)
    Details
    In: Pan African Medical Journal, Pan African Medical Journal, Vol. 43 ( 2022)
    Type of Medium: Online Resource
    ISSN: 1937-8688
    URL: Article
    DOI: 10.11604/pamj.2022.43.10.33598
    Language: English
    Publisher: Pan African Medical Journal
    Publication Date: 2022
    detail.hit.zdb_id: 2514347-5
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  • 3
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    Risk perception and psychological state of healthcare workers in referral hospitals during the early phase of the COVID-19 pandemic, Uganda
    Springer Science and Business Media LLC ; 2021
    In:  BMC Psychology Vol. 9, No. 1 ( 2021-12)
    Details
    In: BMC Psychology, Springer Science and Business Media LLC, Vol. 9, No. 1 ( 2021-12)
    Abstract: Safeguarding the psychological well-being of healthcare workers (HCWs) is crucial to ensuring sustainability and quality of healthcare services. During the COVID-19 pandemic, HCWs may be subject to excessive mental stress. We assessed the risk perception and immediate psychological state of HCWs early in the pandemic in referral hospitals involved in the management of COVID-19 patients in Uganda. Methods We conducted a cross-sectional survey in five referral hospitals from April 20–May 22, 2020. During this time, we distributed paper-based, self-administered questionnaires to all consenting HCWs on day shifts. The questionnaire included questions on socio-demographics, occupational behaviors, potential perceived risks, and psychological distress. We assessed risk perception towards COVID-19 using 27 concern statements with a four-point Likert scale. We defined psychological distress as a total score  〉  12 from the 12-item Goldberg’s General Health Questionnaire (GHQ-12). We used modified Poisson regression to identify factors associated with psychological distress. Results Among 335 HCWs who received questionnaires, 328 (98%) responded. Respondents’ mean age was 36 (range 18–59) years; 172 (52%) were male. The median duration of professional experience was eight (range 1–35) years; 208 (63%) worked more than 40 h per week; 116 (35%) were nurses, 52 (14%) doctors, 30 (9%) clinical officers, and 86 (26%) support staff. One hundred and forty-four (44%) had a GHQ-12 score  〉  12. The most common concerns reported included fear of infection at the workplace (81%), stigma from colleagues (79%), lack of workplace support (63%), and inadequate availability of personal protective equipment (PPE) (56%). In multivariable analysis, moderate (adjusted prevalence ratio, [aPR] = 2.2, 95% confidence interval [CI] 1.2–4.0) and high (aPR = 3.8, 95% CI 2.0–7.0) risk perception towards COVID-19 (compared with low-risk perception) were associated with psychological distress. Conclusions Forty-four percent of HCWs surveyed in hospitals treating COVID-19 patients during the early COVID-19 epidemic in Uganda reported psychological distress related to fear of infection, stigma, and inadequate PPE. Higher perceived personal risk towards COVID-19 was associated with increased psychological distress. To optimize patient care during the pandemic and future outbreaks, workplace management may consider identifying and addressing HCW concerns, ensuring sufficient PPE and training, and reducing infection-associated stigma.
    Type of Medium: Online Resource
    ISSN: 2050-7283
    URL: Article
    DOI: 10.1186/s40359-021-00706-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2705921-2
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  • 4
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    Ownership and use of long-lasting insecticidal nets three months after a mass distribution campaign in Uganda, 2021
    Springer Science and Business Media LLC ; 2022
    In:  Malaria Journal Vol. 21, No. 1 ( 2022-12-03)
    Details
    In: Malaria Journal, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2022-12-03)
    Abstract: Uganda conducted its third mass long-lasting insecticidal net ( LLIN) distribution campaign in 2021. The target of the campaign was to ensure that 100% of households own at least one LLIN per two persons and to achieve 85% use of distributed LLINs. LLIN ownership, use and associated factors were assessed 3 months after the campaign. Methods A cross-sectional household survey was conducted in 14 districts from 13 to 30 April, 2021. Households were selected using multistage sampling. Each was asked about LLIN ownership, use, duration since received to the time of interview, and the presence of LLINs was visually verified. Outcomes were having at least one LLIN per two household members, and individual LLIN use. Modified Poisson regression was used to assess associations between exposures and outcomes. Results In total, 5529 households with 27,585 residents and 15,426 LLINs were included in the analysis. Overall, 95% of households owned ≥ 1 LLIN, 92% of the households owned ≥ 1 LLIN  〈  3 months old, 64% of households owned ≥ 1 LLIN per two persons in the household. Eighty-seven per cent could sleep under an LLIN if every LLIN in the household were used by two people, but only 69% slept under an LLIN the night before the survey. Factors associated with LLIN ownership included believing that LLINs are protective against malaria (aPR = 1.13; 95% CI  1.04–1.24). Reported use of mosquito repellents was negatively associated with ownership of LLINs (aPR = 0.96; 95% CI 0.95–0.98). The prevalence of LLIN use was 9% higher among persons who had LLINs 3–12 months old (aPR = 1.09; 95% CI  1.06–1.11) and 10% higher among those who had LLINs 13–24 months old (aPR = 1.10; 95% CI  1.06–1.14) than those who had LLINs  〈  3 months old. Of 3,859 LLINs identified in the households but not used for sleeping the previous night, 3250 (84%) were 〈  3 months old. Among these 3250, 41% were not used because owners were using old LLINs; 16% were not used because of lack of space for hanging them; 11% were not used because of fear of chemicals in the net; 5% were not used because of dislike of the smell of the nets; and, 27% were not used for other reasons. Conclusion The substantial difference between the population that had access to LLINs and the population that slept under LLINs indicates that the National Malaria Control Programme (NMCP) may need to focus on addressing the main drivers or barriers to LLIN use. NMCP and/or other stakeholders could consider designing and conducting targeted behaviour change communication during subsequent mass distribution of LLINs after the mass distribution campaign to counter misconceptions about new LLINs.
    Type of Medium: Online Resource
    ISSN: 1475-2875
    URL: Article
    DOI: 10.1186/s12936-022-04401-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2091229-8
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  • 5
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    Assessment of the accuracy of malaria microscopy in private health facilities in Entebbe Municipality, Uganda: a cross-sectional study
    Springer Science and Business Media LLC ; 2021
    In:  Malaria Journal Vol. 20, No. 1 ( 2021-12)
    Details
    In: Malaria Journal, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2021-12)
    Abstract: Although microscopy remains the gold standard for malaria diagnosis, little is known about its accuracy in the private health facilities in Uganda. This study evaluated the accuracy of malaria microscopy, and factors associated with inaccurate smear results at private health facilities in Entebbe Municipality, Uganda. Methods Between April and May 2018, all patients referred for a malaria smear in 16 private health facilities in Entebbe municipality were screened, and 321 patients were enrolled. A questionnaire was administered to collect demographic and clinical information, facility-based smear results were recorded from the participant’s consultation notes, and a research slide was obtained for expert microscopy during exit interview. A health facility assessment was conducted, and information on experience in performing malaria microscopy was collected from all facility personnel reading smears and the data was linked to the participant’s clinic visit. Results The test positivity rate of malaria parasitaemia was 15.0% by expert microscopy. The sensitivity, specificity and negative predictive value of the facility-based microscopy were high (95.8%, 90.1 and 99.2%, respectively). However; the positive predictive value (PPV) was low with 27/73 (63%) patients diagnosed with malaria not having the disease. Majority of the inaccurate results were from 2 of the 23 laboratory personnel reading the smears. The factors associated with inaccurate smear readings included being read by a technician; (1) who had less than 5 years’ experience in reading malaria smears (adjusted Odds Ratio [aOR] = 9.74, 95% confidence interval [CI] (1.06–89.5), p-value = 0.04), and (2) who was examining less than 5 smears a day (aOR = 38.8, 95% CI 9.65–156, p-value  〈  0.001). Conclusions The accuracy of malaria microscopy in this setting was high, although one third of the patients diagnosed with malaria did not have the disease. Majority of the errors in smear readings were made by two laboratory personnel, with the main factor associated with inaccurate smear results being low experience in malaria microscopy. In-service training may be sufficient to eliminate inaccurate smear results in this setting, and these private facilities would be ideal model facilities to improve the quality of malaria microscopy in Uganda especially in the public sector where accuracy is still poor.
    Type of Medium: Online Resource
    ISSN: 1475-2875
    URL: Article
    DOI: 10.1186/s12936-021-03787-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2091229-8
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  • 6
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    High blood pressure and associated factors among HIV-infected young persons aged 13 to 25 years at selected health facilities in Rwenzori region, western Uganda, September–October 2021
    Springer Science and Business Media LLC ; 2023
    In:  Clinical Hypertension Vol. 29, No. 1 ( 2023-04-15)
    Details
    In: Clinical Hypertension, Springer Science and Business Media LLC, Vol. 29, No. 1 ( 2023-04-15)
    Abstract: High blood pressure (HBP), including hypertension (HTN), is a predictor of cardiovascular events, and is an emerging challenge in young persons. The risk of cardiovascular events may be further amplified among people living with HIV (PLHIV). We determined the prevalence of HBP and associated factors among PLHIV aged 13 to 25 years in Rwenzori region, western Uganda. Methods We conducted a cross-sectional study among PLHIV aged 13 to 25 years at nine health facilities in Kabarole and Kasese districts during September 16 to October 15, 2021. We reviewed medical records to obtain clinical and demographic data. At a single clinic visit, we measured and classified BP as normal ( 〈  120/  〈  80 mmHg), elevated (120/  〈  80 to 129/  〈  80), stage 1 HTN (130/80 to 139/89), and stage 2 HTN (≥ 140/90). We categorized participants as having HBP if they had elevated BP or HTN. We performed multivariable analysis using modified Poisson regression to identify factors associated with HBP. Results Of the 1,045 PLHIV, most (68%) were female and the mean age was 20 (3.8) years. The prevalence of HBP was 49% ( n  = 515; 95% confidence interval [CI], 46%–52%), the prevalence of elevated BP was 22% ( n  = 229; 95% CI, 26%–31%), and the prevalence of HTN was 27% ( n  = 286; 95% CI, 25%–30%), including 220 (21%) with stage 1 HTN and 66 (6%) with stage 2 HTN. Older age (adjusted prevalence ratio [aPR], 1.21; 95% CI, 1.01–1.44 for age group of 18–25 years vs. 13–17 years), history of tobacco smoking (aPR, 1.41; 95% CI, 1.08–1.83), and higher resting heart rate (aPR, 1.15; 95% CI, 1.01–1.32 for  〉  76 beats/min vs. ≤ 76 beats/min) were associated with HBP. Conclusions Nearly half of the PLHIV evaluated had HBP, and one-quarter had HTN. These findings highlight a previously unknown high burden of HBP in this setting’s young populations. HBP was associated with older age, elevated resting heart rate, and ever smoking; all of which are known traditional risk factors for HBP in HIV-negative persons. To prevent future cardiovascular disease epidemics among PLHIV, there is a need to integrate HBP/HIV management.
    Type of Medium: Online Resource
    ISSN: 2056-5909
    URL: Article
    DOI: 10.1186/s40885-022-00230-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2806585-2
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  • 7
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    Effectiveness of in-service training plus the collaborative improvement strategy on the quality of routine malaria surveillance data: results of a pilot study in Kayunga District, Uganda
    Springer Science and Business Media LLC ; 2021
    In:  Malaria Journal Vol. 20, No. 1 ( 2021-06-29)
    Details
    In: Malaria Journal, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2021-06-29)
    Abstract: Surveillance data are essential for malaria control, but quality is often poor. The aim of the study was to evaluate the effectiveness of the novel combination of training plus an innovative quality improvement method—collaborative improvement (CI)—on the quality of malaria surveillance data in Uganda. Methods The intervention (training plus CI, or TCI), including brief in-service training and CI, was delivered in 5 health facilities (HFs) in Kayunga District from November 2015 to August 2016. HF teams monitored data quality, conducted plan-do-study-act cycles to test changes, attended periodic learning sessions, and received CI coaching. An independent evaluation was conducted to assess data completeness, accuracy, and timeliness. Using an interrupted time series design without a separate control group, data were abstracted from 156,707 outpatient department (OPD) records, laboratory registers, and aggregated monthly reports (MR) for 4 time periods: baseline—12 months, TCI scale-up—5 months; CI implementation—9 months; post-intervention—4 months. Monthly OPD register completeness was measured as the proportion of patient records with a malaria diagnosis with: (1) all data fields completed, and (2) all clinically-relevant fields completed. Accuracy was the relative difference between: (1) number of monthly malaria patients reported in OPD register versus MR, and (2) proportion of positive malaria tests reported in the laboratory register versus MR. Data were analysed with segmented linear regression modelling. Results Data completeness increased substantially following TCI. Compared to baseline, all-field completeness increased by 60.1%-points (95% confidence interval [CI]: 46.9–73.2%) at mid-point, and clinically-relevant completeness increased by 61.6%-points (95% CI: 56.6–66.7%). A relative − 57.4%-point (95% confidence interval: − 105.5, − 9.3%) change, indicating an improvement in accuracy of malaria test positivity reporting, but no effect on data accuracy for monthly malaria patients, were observed. Cost per additional malaria patient, for whom complete clinically-relevant data were recorded in the OPD register, was $3.53 (95% confidence interval: $3.03, $4.15). Conclusions TCI improved malaria surveillance completeness considerably, with limited impact on accuracy. Although these results are promising, the intervention’s effectiveness should be evaluated in more HFs, with longer follow-up, ideally in a randomized trial, before recommending CI for wide-scale use.
    Type of Medium: Online Resource
    ISSN: 1475-2875
    URL: Article
    DOI: 10.1186/s12936-021-03822-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2091229-8
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  • 8
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    Understanding the role of incentives for achieving and sustaining viral suppression: A qualitative sub-study of a financial incentives trial in Uganda
    Public Library of Science (PLoS) ; 2022
    In:  PLOS ONE Vol. 17, No. 6 ( 2022-6-24), p. e0270180-
    Details
    In: PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 6 ( 2022-6-24), p. e0270180-
    Abstract: Viral suppression among people living with HIV (PLHIV) is essential for protecting health and preventing HIV transmission, yet globally, rates of viral suppression are sub-optimal. Interventions to improve HIV prevention and care cascade outcomes remain vital. Financial incentives hold promise for improving these outcomes, yet to date, clinical trial results have been mixed. Methods This qualitative sub-study, embedded in a trial (NCT02890459) in Uganda to test whether incentives are effective for achieving viral suppression in PLHIV, sought to enhance our understanding of the factors that influence this outcome. Forty-nine (n = 49) PLHIV, purposely sampled to balance across gender, study arm, and viral suppression status, were interviewed to explore barriers and motivations for care engagement, adherence, and viral suppression, and attributions for decision-making, including perceived influence of incentives on behaviors. Results While many participants with undetectable viral load (VL) who received incentives said the incentives motivated their ART adherence, others expressed intrinsic motivation for adherence. All felt that incentives reduced burdens of transport costs, lost income due to time spent away from work, and food insecurity. Incentives may have activated attention and memory for some, as excitement about anticipating incentives helped them adhere to medication schedules. In comparison, participants who were randomized to receive incentives but had detectable VL faced a wider range, complexity and severity of challenges to care engagement. Notably, their narratives included more accounts of poor treatment in clinics, food insecurity, and severe forms of stigma. With or without incentives, adherence was reinforced through experiencing restored health due to ART, social support (especially from partners), and good quality counseling and clinical care. Conclusions In considering why incentives sometimes fail to achieve behavior change, it may be helpful to attend to the full set of factors- psychological, interpersonal, social and structural- that militate against the behavior change required to achieve behavioral outcomes. To be effective, incentives may need to be combined with other interventions to address the spectrum of barriers to care engagement.
    Type of Medium: Online Resource
    ISSN: 1932-6203
    URL: Article
    DOI: 10.1371/journal.pone.0270180
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2022
    detail.hit.zdb_id: 2267670-3
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  • 9
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    Planning prompts to promote uptake of HIV services among men: a randomised trial in rural Uganda
    BMJ ; 2020
    In:  BMJ Global Health Vol. 5, No. 11 ( 2020-11), p. e003390-
    Details
    In: BMJ Global Health, BMJ, Vol. 5, No. 11 ( 2020-11), p. e003390-
    Abstract: Interventions informed by behavioural economics, such as planning prompts, have the potential to increase HIV testing at minimal or no cost. Planning prompts have not been previously evaluated for HIV testing uptake. We conducted a randomised clinical trial to evaluate the effectiveness of low-cost planning prompts to promote HIV testing among men. Methods We randomised adult men in rural Ugandan parishes to receive a calendar planning prompt that gave them the opportunity to make a plan to get tested for HIV at health campaigns held in their communities. Participants received either a calendar showing the dates when the community health campaign would be held (control group) or a calendar showing the dates and prompting them to select a date and time when they planned to attend (planning prompt group). Participants were not required to select a date and time or to share their selection with study staff. The primary outcome was HIV testing uptake at the community health campaign. Results Among 2362 participants, 1796 (76%) participants tested for HIV. Men who received a planning prompt were 2.2 percentage points more likely to test than the control group, although the difference was not statistically significant (77.1% vs 74.9%; 95% CI –1.2 to 5.7 percentage points, p=0.20). The planning prompt was more effective among men enrolled ≤40 days before the campaigns (3.6 percentage-point increase in testing; 95% CI –2.9 to 10.1, p=0.27) than among men enrolled 〉 40 days before the campaigns (1.8 percentage-point increase; 95% CI –2.3 to 5.8, p=0.39), although the effects within the subgroups were not significant. Conclusion These findings suggest that planning prompts may be an effective behavioural intervention to promote HIV testing at minimal or no cost. Large-scale studies should further assess the impact and cost-effectiveness of such interventions.
    Type of Medium: Online Resource
    ISSN: 2059-7908
    URL: Article
    DOI: 10.1136/bmjgh-2020-003390
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2851843-3
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  • 10
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    Socio-Economic Vulnerability to COVID-19: The Spatial Case of Greater Kampala Metropolitan Area (GKMA)
    Scientific Research Publishing, Inc. ; 2020
    In:  Journal of Geographic Information System Vol. 12, No. 04 ( 2020), p. 302-318
    Details
    In: Journal of Geographic Information System, Scientific Research Publishing, Inc., Vol. 12, No. 04 ( 2020), p. 302-318
    Type of Medium: Online Resource
    ISSN: 2151-1950 , 2151-1969
    URL: Article
    DOI: 10.4236/jgis.2020.124019
    Language: Unknown
    Publisher: Scientific Research Publishing, Inc.
    Publication Date: 2020
    detail.hit.zdb_id: 2645005-7
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