Theses & Dissertations

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Browsing Theses & Dissertations by Subject "Adherence"

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    Adherence to Benzathine Prophylaxis Among Rheumatic Fever and Rheumatic Heart Disease Patients Attending Outpatient Clinic at Lira Regional Referral Hospital
    (Lira University, 2022) Atala, Jenifer; Omech, Bernard; Obura, Bonniface
    Background:Secondary prevention of Rheumatic fever and Rheumatic Heart Disease with 3-4 weekly Benzathine prophylaxis is the most effective strategy in preventing disease progression and complications. Efficacy of this regimen is dependent on its rational use. However, adherence to Benzathine prophylaxis worldwide is suboptimal. Magnitude and impact of poor adherence is higher in developing countries. Methods: A retrospective cohort study design using mixed methods was done. To acquire information on adherence to monthly BPG injections, the quantitative component involved a retrospective chart review of secondary data extracted from the Lira RHD Registry. The primary information was qualitative, obtained from key informant and in-depth interviews with RHD patients, care givers, and healthcare professionals respectively. Utilizing a logistic regression model, data was evaluated. Predictors that were at alpha=0.2 were considered significant at bivariate analysis and submitted to multivariate analysis. A significant threshold was set at 0.05 and 95% confidence interval. Thematic analysis using both inductive and deductive coding was used to analyze qualitative data. Results: Overall, 57.8% (89/154) of patients adhered to their benzathine prophylactic regimen. Majority of participants had at least primary education (84/153). Those with tertiary education were 2.6 times more likely to adhere to Benzathine penicillin prophylaxis. (AOR 2.69, 95% CI: 1.00-7.3, P value 0.049). Demand side factors associated with adherence included logistics involved, suboptimal communication, patient related factors and condition related factors whereas supply side factors included medicine stockout, human resource related challenges, costs involved and poor provider client relationship. Conclusion: Adherence was sub-optimal. To address some of the issues impacting adherence to BPG prophylaxis among these patients, it is necessary to address the demand side and supply side factors associated with adherence to BPG, such as training of healthcare professionals and strengthening the sensitization and health education of patients and their caregivers on the need for the monthly BPG injections in relation to their condition.
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    Factors associated with adherence to community-directed treatment with Ivermectin for Onchocerciasis control among adults in Pader District, Northern Uganda
    (Lira University, 2023) Oyet, William Sam; Akello, Anne Ruth; Opollo, Marc Sam
    Background: Onchocerciasis is caused by a filarial nematode, Onchocerca volvulus, and transmitted by a female black fly of the genus Simulium. Ivermectin Mass Drug administration (IVM MDA) is the primary strategy for controlling Onchocerciasis in the endemic countries including Uganda. Pader district commenced annual IVM MDA implementation in 2008 and semi-annual in 2012. From 2008 to 2022, no study has been conducted on the factors associated with adherence to Ivermectin treatment. The objective of this study was to determine the factors associated with adherence to Ivermectin treatment for Onchocerciasis control among adults in Pader district. Methodology: A cross-sectional study design that targeted 384 adults who received ivermectin mass drug administration in Pader, between July 2022 and October 2022 was conducted in Pader District. Data was analyzed in STATA version 17. Logistic regression was used to determine the factors associated with adherence to Ivermectin treatment. The factors that show significant association at bivariate analysis were further subjected to multivariate analysis (logistic regression) Results: The study found out that there was a high level of adherence (67.6%) to Ivermectin treatment in Pader district, with waiting time (AOR=44.1, CI:9.42-206.1), community involvement (AOR=7.19, CI: 1.37-37.8), received health education (AOR=0.09; CI: 0.02- 0.35), and CCDs trained (AOR=0.16, CI: 00.02-0.94) showed significant association with ivermectin treatment adherence among respondents. Conclusions: The community involvement, wasting time, health education received and training CCDs showed good adherence to Ivermectin treatment in Pader district. Keywords: Adherence, community-directed treatment, Ivermectin, Onchocerciasis control, adults, Pader District, Northern Uganda