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Prevalence and Factors Associated with Switching to Second Line Treatment among HIV-Positive Adolescents Receiving Antiretroviral Therapy in Gulu City.
(Lira University, 2023) Katushabe, Resty; Ocen, Francis; Opollo, Marc Sam
Background: Human Immunodeficiency Virus (HIV) is a major public health problem, with approximately 37.7 million people across the globe infected with HIV by 2020, (adult 36 million, children aged 0-14 years 1.7 million). The world health organization calls upon all HIV-positive individuals with virologic failure to switch from the current-line to the next-line antiretroviral therapy (Keiser et al.,2010, Ramadhani et al., 2016). To determine the prevalence and factors associated with switching to second-line ART among HIV-positive adolescents receiving ART in Gulu city. Methods: This was a cross-sectional study using secondary data and participants included adolescents initiated on ART in Gulu city between 2017-2021. A total of 280 files of adolescents were included in the study from three Health facilities in Gulu city. Data was analyzed using Stata version 15. A chi-sequence test and multivariate analysis were used to determine the factors associated with switching. Results: The prevalence of switching was 10.3%, most participants were female 165 (58.9%) and those between 10-14 years dominated the study 178 (63.5%). Viral Load >1000 copies while on the first-line ART, was significantly associated with switching to second line ART (p=0.046). Conclusion: There was a prevalence of switching from first-line ART to second-line ART among adolescents in Gulu city and the associated factor was high first viral load. Keywords: Prevalence, Factors Associated, Switching to Second Line Treatment, HIV-Positive Adolescents, and Antiretroviral Therapy.
Prevalence and Risk Factors for Multi-Drug Resistant Tuberculosis at LRRH in Lango Sub-Region Northern Uganda: A Cross-Sectional study.
(Lira University, 2023) Ssewanyana, Jimmy; Omech, Bernard; Okello, Nelson
Background: The emergence of drug-resistant TB over recent years is a growing global public health threat in developing countries. Uganda is among the countries with the highest MDR TB burden globally, with an estimated prevalence of multi-drug-resistant tuberculosis at 1.4% among all new cases and 12.1% among previously treated TB cases. Methods: A cross-sectional design was employed to collect data from 565 individuals using a data extraction tool and an interview guide for key informants to determine the prevalence of and factors associated with MDR-TB clients in LRRH. Quantitative data was analyzed with State Version 14 at univariate, bivariate, and multivariate levels. Applied thematic content analysis method was used for qualitative data analysis. Results: The prevalence of MDR-TB at LRRH in Lango sub-region was found to be 14.8% (84/565). The logistic regression revealed that treatment literacy (AOR =1.11, p<0.001) and a history of TB treatment (AOR = 6.22, P = 0.001) associates with development of MDR-TB. Conclusion: The study found out that 14.8% prevalence of MDR-TB at LRRH in Lango sub-region, surpass rates from previous research, including the 12.1% national prevalence among retreatment cases. Treatment literacy and history of treatment were the associated factors. Recommendations: Enhancing treatment literacy, strengthening monitoring, improving diagnostic access, supporting previously treated patients, training healthcare professionals, engaging communities, and conducting continuous research for combating MDR-TB in Lango sub-region. Keywords: prevalence, Multi-drug resistance, Tuberculosis.
Factors Influencing Contraceptive Use Among Teenage Girls 13-19 Years Old in Kole District.
(Lira University, 2023) Akello, Loy; Akullo, Betty Nancy; Nabasirye, Caroline
Introduction: Adolescent girls’ access to contraceptives is crucial for reducing unplanned pregnancies, abortions, and maternal deaths. Uganda faces challenges in meeting the sexual and reproductive health needs of adolescents, with Kole district particularly at risk of high teenage pregnancy complications. This study aimed to assess the prevalence and factors influencing contraceptive utilization among teenage girls in Kole district. Methods: The research design was a cross-sectional study, using a quantitative data collection method. The sample size of 289 was determined using the Kish (1965) formula. A multi-stage sampling technique was employed, randomly selecting two villages from each of the three sub-counties. Households within the villages were the unit of analysis, and participants was selected using simple random sampling. Data collection was done using a pretested questionnaire and analysed at univariate, bivariate and multivariate levels. Results: Results showed that 54.45% of the participants used contraceptives. Socio-cultural factors significantly influenced contraceptive use, with girls in supportive communities more likely to use contraceptives (AOR=0.28, 95% CI: 0.11-0.73, p=0.009). Health facility factors did not show significant associations. Fear of side effects was a significant barrier to contraceptive use (AOR=3.52, 95% CI: 1.51-8.19, p=0.004). Older teenage girls (17-19 years) were more likely to utilize contraceptives (AOR=5.49, 95% CI: 2.48-12.2, p<0.001). Conclusions: Improving contraceptive utilization among teenage girls in Kole requires multifaceted approaches that address socio-cultural factors that dispel fears related to side effects, and consider the unique needs of different age groups Recommendations: Addressing fear and age-related factors can promote contraceptive use among teenage girls. Keywords: Factors, Contraceptive use, Teenage girls.
Level of Satisfaction and Factors Associated with the Eight Antenatal Care Visits Model Among Pregnant Women at Kitgum General Hospital.
(Lira University, 2023) Adiga, James; Nabasirye, Caroline; Amito, Freda Ocheng
Background: Globally, 810 million women die from pregnancy related deaths and child births. The World Health Organization recommended the eight contacts antenatal care model. In Uganda, only 0.4% of women received all four goal-oriented services under the FANC and as such satisfaction with 8+ ANC anticipated to be lower. This study assessed the prevalence of maternal satisfaction and the associated factors with the current WHO 8 ANC model among pregnant women at Kitgum general hospital, Northern Uganda. Methods: A cross-sectional study employing quantitative approach was used for data collection. A total of 419 postnatal mothers were selected consecutively for exit interviews. Interviewer-administered structured questionnaires were used to collect data. Multivariable logistic regression models constructed using backward elimination and logistic regression was used in data analysis. Results: Out of the 419 women, 60.4% were from within the Municipality, 86.2% married, 39.9% were catholic and 47.7% had secondary level of education. Only 254(61%) were satisfied with the WHO 8 ANC visits and the predictors of 8 ANC model were first ANC attendance (AOR: 0.012; 95% CI: 0.003, 0.051; P<0.001), ever had a miscarriage (AOR: 0.367; 95% CI: 0.181, 0.747; p<0.006), and pregnancy planning (AOR: 0.084; 95% CI: 0.043, 0.164; p<0.001). Conclusion: Only 6 in 10 of pregnant women in the post-conflict Kitgum District, Northern Uganda are satisfied with the WHO 8 antenatal care visits. This is likely to reduce levels of utilization of the antenatal care services and can lead to a rise in the maternal complications and perinatal deaths. Keywords: Satisfaction and Factors, Antenatal care visits.
Prevalence of malaria in children under five and associated knowledge, attitude, and practices of prevention among caregivers in Amolatar district.
(Lira University., 2024) Otim, Allan; Anyolitho, Maxson Kenneth
Background: Despite improvement in prevention and control programs over time, malaria remains a significant public heath burden in Uganda, contributing considerably to hospitalization and fatalities. This study determined the prevalence of malaria among children under five and the associated knowledge, attitudes, and practices of prevention among caregivers in Amolatar. Methods: A community -based cross-sectional study with mixed methods of data collection was conducted from 16th to 30th August 2023. Questionnaires were administered to 418 households to determine their KAP on malaria and estimate the prevalence of malaria among children under five. 14 participants were interviewed to determine their KAP about malaria. Results: The prevalence of malaria among children under five was found to be 38.76% (n=162) High income level, female gender, and having secondary and tertiary education were associated with lower risk of malaria. Meanwhile those who neglected to check windows to prevent mosquito and not willing to and not willing to have their house sprayed for mosquito control showed higher odds of malaria prevalence (Aor =2.73, 95% CI: 1.29-5.76, p=0.008 and (Aor =2.62, 95% CI: 1.37-5.00, P =0.004) respectively. Conclusions and Recommendations: Malaria prevalence was considerably impacted by aged, gender, income, and education levels. Malaria prevalence was lower in women and people aged 41 to 50. Amolatar district health department and partners should embark on massive “test and treat “initiatives for malaria in the community. Allocate resources for mass drug administrations during integrated community case management (ICCM) Keywords: Prevalence, malaria, children, knowledge, attitude, practices, prevention, and caregivers.
Prevalence and factors associated with use of traditional medicine to induce abortion amongst female aged 18-49 years in lira district
(Lira University., 2023) Ebong, Doryn; Apili, Felister
Background: In Uganda about 58.8% of women use traditional medicine to induce abortion. The use of traditional medicine in treatment of other infections has been reported among the general population. This study investigated the prevalence and factors associated with the use of traditional medicine to induce abortion among female of child bearing age (18-49 years in Lira district. Methods: A mixed method research design with both quantitative and qualitative data collection approaches were enjoyed. Data was collected from 95 women under post abortion care using semi-structured questionnaires and interview guide for Key-informants. Quantitative data was analyzed using SPSS version 20 at univariate, bivariate and multivariate levels, while qualitative data was analyzed with thematic analysis. Results: The prevalence of use of traditional medicine to induce abortion was 15.8% and in the treatment of other diseases was at 33%. Associated factors includes level of education (AOR:3.800; P<0.05), knowledge about TM (AOR:2.400, p=004), family support (AOR: 3.243, p=0.004), community support on the use of AT (AOR; 4.816, p=0.008), tradition beliefs (AOR; 0.169, P=0.006), religion (AOR;6.00, P=0.006), cultural norms (AOR; 23.020, P<0.05), and inadequacy of drugs in the health facility (AOR; 056, P<0.05). Conclusion: The prevalence of the researcher recommended that the government increases the high at 15,8%. Therefore, the researcher recommended that the government increases the financial support for maternal and child health services; increasing accessibility to health services and community -based approaches to the priority. Keywords: prevalence, traditional medicine, abortion.
Prevalence and Factors Associated with Seroconversion among HIV Exposed Infants under 18 months in Care in Pader District.
(Lira University., 2023) Denis, Odongkara; Anne, Akello Ruth
Introduction: The global community embarked on a historic quest to lay the foundation for the eventual end of the AIDS epidermic by 2030, however East and South Africa contributed 59% (more than half) of all pediatrics HIV infections globally. The MOH Uganda targets 5.3% or less infant’s infection rate. In Uganda, HIV prevalence among HIV exposed infants was estimated at 18% in 2018. The understanding of the remaining bottlenecks to elimination of mother- to- child transmission (eMTCT) is crucial to accelerating efforts towards eMTCT. Objective: This study was aimed at ascertaining the prevalence and identify the factors associated with HIV seroconversion amongst Exposed infants less than 18 months in care in Pader district. Methods: A cross sectional design was employed utilizing mixed methods of data collection to gather information on the variables that influence HIV infection seroconversion among exposed infants under the age of 18months in care in Pader district. Quantitative data were collected using semi-structured questionnaire and done by research assistants while qualitative information was obtained through key informant interviews with facility in-charge, ART clinic in-charges, mid-wives, store assistant and clients. Overall data collection was conducted by between December 2022 and January 2023. Quantitative data was analyzed using STATA version 17, at univariable, bio-variable and multivariable levels, and thematic analysis was used to analyse qualitative data. Ethical approval was obtained from Lacor Hospital Institutional Research Ethic Committee. Results: 384 respondents participated in the study, and 7.7% of the 384 infants Sero converted. None health facility delivery was associated with seroconversion (AOR=13.1, CI: 1.63-105.1) compared to facility births. Infants from mothers unaccompanied by their husbands were 0.12 less likely to seroconvert (AOR = 0.12, CI: 0.03-0.51), and infants of caretaker between ages 31-40 (AOR=0.07, CI: 0.01-0.94) and infants from mother between ages 41-50 (AOR= 0.04, CI: 0.01-0.98) were less likely to seroconvert compared to their counterparts. Additionally (qualitative): the key informants mentioned staff’s attitudes, under staffing, inadequate human resource, failure of some mothers to return for subsequent PCR reported during the interviews. Key words: Prevalence, seroconversion, HIV, and Infants.
Attempted Suicide: Lived Experiences of Refugees in Rhino Camp, West Nile Uganda
(Lira University, 2023) Robinson, Ojwok; Judith, Abal Akello
Introduction: Suicide is among the leading source of death universally and every year, more people die as a result of suicide than HIV, malaria breast cancer, war and homicide. Sucide rates are high among vulnerable groups who experience discrimination, such as refugees and migrants. Purpose: This study explored the lived experiences of refugees who attempted suicide in Rhino Camp, West Nile, Uganda, using Thomas Joiner’s Interpersonal Theory of Suicide Attempts as a theoretical framework. Methods: This study employed an interpretative phenomenological Research design and purposive sampling techniques to choose participants, the study population consisted of 15 participants (7 Key Informants and 8 Suicide Survivors) to ensure in-depth analysis of qualitative data. Face to face interviews using in depth interview guide and observations were used to gather data. The study data were collected between June - July 2023. Result: Data saturation was reached after 13th interviews. Thirteen themes emerged from the data: 1) Domestic Violence and relationship, 2) mental illness, 3) Financial difficulties, and 4) Inadequate food deliveries 5) Traumatic past, 6) Psychological distress, 7) Social isolation, and 8) Cultural stigma, 9) Community and family support, 10) Role of Religious, Cultural, and Opinion or other leaders, 11) Health facilities support, 12) Coping mechanisms, and 13) Psychosocial Support Providers. Conclusions: The lived experiences of refugee suicide survivors and themes identified enhanced scholarly understanding regarding the experience of refugee suicide survivors. This important information can help us develop strategies to prevent suicide among the refugee population and to provide support for suicide attempt survivors. Mental health professional and counsellors can use the results of this study to effectively support refugee suicide survivors. A rich comprehension of survivor experience can assist and empower mental health professionals to provide, effective psychoeducation and interventions and informed support to suicide survivors. Clinicians and policy makers need to remain open-minded about how attempt survivors might view their experience. Key words: Suicide, Refugees, Lived experiences, Mental Health, Rhino Camp
Mortality and Associated Factors Among Hospitalized COVID 19 Patient in Lira Regional Referral Hospital
(Lira University, 2023) Augastine, Ongoli; Bernard, Omech; Francis, Kiweewa
Background: Corona Virus Disease 2019 (COVID- 19) caused public emergency with serious morbidity and mortality worldwide between 2020. The direct impact of the diseases and associated mortality may have been relatively limited in sub-Saharan Africa (SSA), compared to in impact in other religions. The factors that are considered high risk for acquisition of COVID-19 and associated high mortality rate among inpatients are varied in different settings, there are limited data from regional referral designated COVID 19 Treatment Units (CTU) in Uganda. Objectives: To describe COVID-19 characteristic, clinical outcomes and associated risk factors among patients admitted in COVID 19 treatment Unit at Lira Regional Referral Hospital-Northern Uganda. Methods and Materials: We conducted a retrospective chart review of patient admitted with confirmed diagnosis of COVID 19 between May 2020 at Lira regional and March 2022 at Lira Regional Referral Hospital (LRRH). Primary outcome was in-patient mortality. Data abstract included social-demographic, clinical characteristics, treatment modalities, in-hospital outcomes (death or discharged alive). Categorical data was presented as Frequencies and percentage. Continuous data was described using Mean and standard deviation (S.D). The independent association between the dependent variables and the independent variables were tested Chi Square and the Chi Square value reported. Predicators for mortality among COVID-19 patients hospitalized in CTU at LRRH were determined using logistic regression and the results reported as adjusted odds ratio (aOR). Test for significance was done at 95% confidence interval. Results: In final analysis, 490 participants were considered. Out of this, 251 (52%) were females. Majority were older than 60 years of age. Most of the patients presented with cough 369(89.56%), difficult in breathing (DIB) 293(78.76%), chest pain 237(69.3%), general body weakness (GBW)199(63.38%) and fever179(61.3%). Commoner-existing comorbidities were hypertension 139(29.96%), diabetes mellitus 89(19.47%) and HIV 44(10%). Of all the patients admitted, 187(40%) had severe disease and 34(7%) were critically ill. Overall, 142(29%) died. Predictors of all cause in hospital mortality were low oxygen saturation (SPO2) 92-100% had 89% decreased mortality compared to SPO2<92% (aOR-O.11, 95% CI0.03- 0.44, P-value-0.002). Body temperature 35.5-37.5 degrees Celsius had 78% decreased mortality compared to abnormal temperature above or below this range (aOR-0.22, 95% CI0.05-0.99, p- value-0.049). Not having Chronic Disease (CLD) had 99% decreased mortality compared to having CLD (aOR-0.01, 95% CI0.001-0.46, p-value-0.017). Age 31-45 yrs had 86% decreased mortality compared to 18-30yrs (aOR-0.14,95% CI0.03-0.74, P-value-0.021). Conclusion: More than 1 quota (29%) of the patients admitted in lira regional referral hospital with COVID 19 died. Majority of the patients were elderly with pre-existing illnesses and most of them presented with severe and critical condition. Key words: Mortality, Hospitalized, COVID 19, Patients Regional, Referral Hospital
Factors Influencing Utilization of Cervical Cancer Screening among Women attending Maternal Child Health Services in Yumbe Regional Referral Hospital
(Lira University, 2023) Boniface, Otyama Ongwech; Sam, Marc, Opollo; Edward, Kumakech
Introduction: Cervical cancer remains a significant global health challenge, particularly in low- resource settings, where access to cervical cancer screening services in often limited. This study aimed to identify factors influencing the utilization of cervical cancer screening among women attending MCH at YRRH. Method: A cross-sectional design utilizing a mixed method of data collection (quantitative and qualitative) approaches was conducted among 422 women attending MCH at YRRH. Results: The findings showed that 12.3% of women had screened for cervical cancer. At bivariate levels, factors influencing screening utilization included limited use of contraceptive (p=0.001), not screening for STIs (p=0.001), living far from the health facility, (p=0.011) attaining tertiary and secondary education, (p=0.001 and p=0.040 respectively), being employed, (p=0.028), and income above and at median level p=0.005 and, p=0.006 respectively). At multivariate levels, attaining tertiary education was the most significant factor for cervical cancer screening utilization, (p=0.041). Women with tertiary education were 6.9 times likely to screen. Knowing the absence of screening equipment reduced the likelihood of utilization by 77%, (p=0.001). Not using contraceptives was associated with 72% likelihood of screening, (p=0.03). Non-smokers were 0.12 times likely to screening compared to smokers, (p=0.046) Conclusion: Finding from the study indicated a low level of cervical cancer screening among women, highlighting factors influencing cervical cancer screening utilization among women in YRRH. Recommendation: The study recommended for innovative way to reach out to communities with poor access to health care with the information about cervical cancer to improve the level of awareness. Key words: Influencing. Utilization, Cervical, Cancer, Screening, Women, Maternal, Child, Health, Services, Regional, Referral, Hospital
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
Community and Health System Factors Associated with Parental Readiness for Human Papilloma Virus Vaccination Uptake Among Adolescents in Lira District
(Lira University, 2023) James, Ogwal C., K.; Dr. Sam, Opolo Marc
Background: High vaccination rates against Human Papilloma Virus (HPV) is a milestone in primary prevention of cervical cancer. With an increasing number of cases and deaths in the country among women hover, like many other countries around the globe, Uganda has had a high number of district (over 90%) who were underperforming in HPV vaccine uptake among adolescent girls. Despite the safe, effective, and opportunities for free vaccine delivery in health – care settings, Lira district still have very low HPV vaccine uptakes of 17.4% less than national target 80%. Objective: To assess community and health system factors associated with parental PHV vaccine uptake among female adolescent age (9 to 15) years in Lira district. Methods: This study was a crossed-sectional design employing explanatory sequential quantitative and qualitative methods of data collection. The phenomenology design was used for qualitative approach. Additionally, quantitative research generates factual information that can be readily communicated through statistics and figures and from which one can draw factual conclusions. Structured questionnaire was used to parent/guardians of girls age (9 to 15) years and some health workers from some selected health facilities. A total of 577 participants were interviewed and data processed. Results: The study shown that, majority (61.2%) of the 577 interviewed participants were not aware of HPV vaccine and 38.8% reported being ready to vaccinate their adolescent girls age (9 to 15) years. There was statistical significance association with parental readiness to vaccinate adolescent girls age (9 to 15) years: level of formal education (x2=55.4, df=3, p<0.001); and occupation (x2=6.76 df=2, p=0.034). Community factors significantly associated the willingness of parents to immunize their teenage daughters are: family history of cervical cancer (x2=18.5, df=1, p<0.001); get information about HPV vaccination (x2=470.6, df=1, p<0.001) and knowledge about HPV vaccination (x2=184.1, df=2, p<0.001). The study considers variables such as the level of formal education, material status, family history of cervical cancer, knowledge about HPV vaccination, and income level. The adjusted odds ratios (AOR) indicate that parents with tertiary education are 2.25 times likely to be ready (AOR=2.25, p=0.01) while unmarried individuals are 0.47 times likely to be ready (AOR=0.47, p=0.009), those without a family history of cervical cancer are 0.36 times likely (AOR=0.36, p<0.001 and parents with poor knowledge about HPV vaccination are 0.05 likely to be ready (AOR=0.05, p<0.001). Distance, health staffs’ attitude, parents’ level of education, misconception, parents, occupation and vaccine shortage were the common barriers of HPV vaccine uptakes reported. Conclusion: HPV vaccine uptakes readiness was low (38.8%) below the national threshold of (80%) due to association factors and barriers which were program based, beneficiaries and health care provider related. Addressing them such as creation of awareness, outreaches, trainings to health staff, steady vaccine supply and mobile survives revival, staffing and using leaders as an access strategy shall increase uptake of HPV vaccine Key words: Community, Health, System, Parental, Readiness, Human, Papilloma, Virus, Vaccination, Adolescents .
Association Factors with Nutrient Intake and Nutritional Status of HIV Positive Breastfeeding Mothers in Apac District
(Lira University, 2023) Victoria, Atim Sharon; Bonny, Aloka
Introduction: Malnutrition among HIV/AIDS patients is a major challenge to the attainment of the sustainable development goals. This is important since severe malnutrition creates increased strain on the already overstained healthcare system once these patients are admitted. HIV infection causes excess nutrient loss and malabsorption, further increasing the nutritional requirements of HIV-infected lactating women. As a result, A HIV-infected lactating woman is a greater nutritional risk than a non-HIV-infected counterpart. While other students establish maternal under nutrition and associated factors in different parts of the world, few studies in Uganda highlighted the issue on predictors of nutrient intake and nutritional status among HIV positive breastfeeding women. Therefore, this study aimed at determining the associated factors with nutrient intake and nutrition status of HIV positive breastfeeding mothers in Apac district. Method: A cross-sectional study involving 224 HIV positive breastfeeding mothers was conducted. A pre-tested 24-hour recall questionnaire, using dietary diversity score for women (DDS-W) was used to collect the data. The nutritional status was assessed using body mass index (BMI), while the nutrient intake was assessed by entering the actual intakes into an excel sheet to calculate the total nutrient intake per individual from which mean nutrient intake and mean adequacy ratio (MAR) was finally calculated. The data was analyzed using Stata version 14 at univariate, bivariate and multivariate levels. Results: A total of 10.3% of participants were undernourished, with dietary score of 4.3 food groups while 21% had dietary diversity score. The participants were able to meet 61% of their recommended micro nutrition intake, with intake of energy, lipids, zinc, calcium, vitamins A, C, B6, and B12 below recommendations. The factors associated with nutritional status were material age [AOR =1.94, 95% CI (1.05-3.59)], presence of market [AOR =0.42, 95% CI (0.223-0.784)], means of obtaining food (AOR= 0.55, 95% CI (0.234-0.94)) and presence of cultural food taboos [AOR= 0.44, 95% CI (0.136-0.998)]. Factors associated with nutrient intake were presence of market [p=0.018, 95% ci (0.010-0104)], income [p=0.010, 95% CI (0.007-0.048)], DDS [p< 0.001, 95% CI (0.022-0.058)] and household head [p=0.049, 95% CI (-0.095-0.001)]. Conclusion: There prevalence of under nutrition among HIV positive Breastfeeding mothers in Apac district, coupled with poor dietary diversity score and low micronutrient intake. Interventions increasing DDS, nutrition education and income should be promoted. Key Words: Nutrient, Intake, Nutritional status, HIV, Positive, Breastfeeding, mothers
Prevalence, Treatment Outcomes and Factors Associated with Upper-Gastrointestinal Bleeding Among Adult In-Patients Receiving Care in Amolatar District.
(Lira University, 2023) Opio, Walter; Okello, Tom Richard; Nyeko, Richard
Background: Upper gastrointestinal bleeding is a very prevalent condition and its prevalence in Uganda is about 20.3%. Many studies have not yet identified prevalence, treatment outcome and factors associated with upper gastrointestinal bleeding in Amolatar and these necessitated this study. Objective: This aimed at determining the prevalence, treatment outcome, and factors associated with upper gastrointestinal bleeding among adult patients in Amolatar District, Northern Uganda. Methods: A cross-sectional study design was performed between January 2021 and December 2022 in five selected health facilities. Data was collected using a data extraction form on socio- demographic characteristics, health related factors and treatment outcomes. Data was entered and analyzed using SPSS version 20 at the level of univariate, bi-variate and multivariate to identify variables that were significantly associated with UGIB. Results: According to the study, the prevalence of upper gastrointestinal bleeding in Amolatar was found to be 24.5%. with all patients who were treated for UGIB (73.8%) treated and improved, (24.6%) were referred and (1.6%) patient died. Alcohol consumption (AOR: 2.261; CI 95%, 1089-4.634; p=0.026) and previous history of UGIB (AOR: 13.01; CI 95%, 6.723- 25.512; p=0.001) are factors found to be associated with UGIB. Conclusion: The prevalence of Upper gastrointestinal bleeding was at 24.5%, with all patients treated for UGIB, (73.8%) treated and improved, 24.6% were referred and the mortality rate stood at 1.6%. previous history of UGIB and alcohol consumption were independently significantly associated with Upper gastrointestinal bleeding. Recommendations: Further study on outcomes and factors associated with Upper gastrointestinal bleedings. Provision of health educations and sensitizations to the community on the causes, risks factors and the health outcomes of Upper gastrointestinal bleedings need to be undertaken. Keywords: Prevalence, Treatment Outcomes, Upper-Gastrointestinal Bleeding, Adult In- Patients
Medical Waste Management Practices and Associated Factors Among Health Workers in Public Health Facilities Within Lira City, Northern Uganda
(Lira University, 2023) Okii, Richard; Akech, Stella Immaculate; Musinguzi, Marvin
Background: According to research done at Lira Regional Referral Hospital (LRRH), only 56 percent of medical professionals appropriately manage medical waste. If not appropriately disposed of, these wastes can cause major health risks to health workers and communities, including injuries, infections, trauma, wounds, and environmental contamination. The objective was: To examine the medical waste management practices and associated factors among health workers in public health facilities in Lira City, Northern Uganda. Methods: This was a cross-sectional study conducted in public health facilities in Lira City in July, 2023. The study population was health workers and the sample size of 200 was determined using the Yamane formula (1967). Simple random sampling and a structured questionnaire were used to collect the data. Data were entered in SPSS version 23 and further analyzed in STATA version 15 at three levels including univariate (descriptive statistics), bivariate (cross tabulations X2), and multivariate level (multivariate logistic regression). Ethical approval was obtained from Lira University Research and Ethics Committee (LUREC) and the ethical considerations were observed during data collection. Results: Just over one-quarter (28.5%) of the health workers in public health facilities had good practices towards medical waste management. The predictors of good medical waste management practices included having knowledge about medical waste disposal (AOR=1.53, p=0.021, 95% CI 0.44-5.4), and occupation (AOR=2.757, p=0.04, CI 0.94-4.12) Conclusion: There are poor medical waste management practices in facilities in Lira City. We recommend that the government of Uganda should provide enough supplies to the facilities, City Health Authorities should conduct continuous medical education for the workers, and there should be supervision of health workers to ensure proper management of medical waste. Keywords: Medical Waste, Health Workers, Public Health Facilities
Cervical Cancer Screening Uptake and associated factors among women of reproductive age (21-49 years) attending Amach Health Centre-IV in Lira District
(Lira University, 2023) Kasongo, Joseph; Kumakech, Edward; Kigongo, Eustes
Background: Cervical cancer is a significant global health concern, ranking as the fourth most common cancer among women worldwide. Fortunately, early screening and effective management can prevent its progression. However, the uptake of cervical cancer screening varies across different regions, remaining suboptimal in developing countries such as Uganda. This study aimed to assess the level of cervical cancer screening uptake and identify associated factors among women aged 21 to 49 years attending Amach Health Centre in Lira district, Uganda. Methodology: A mixed methods approach was employed, combining quantitative and qualitative data collection techniques. The study included 312 randomly selected women who participated in face-to-face interviews using structured questionnaires and key informant interviews with health workers. The data was analyzed using STATA software, including descriptive statistics, chi-square tests, and logistic regression. Results: The findings revealed that only 44.8% of the 310 interviewed women had ever undergone cervical cancer screening. The predictors of cervical cancer screening include: not being in a marital relationship (Apr: 2.767, 95% CI: 1.463-5.231, p=0.002), poor knowledge about cervical cancer (Apr: 0.561, 95% CI: 0.374-0.843, p=0.005), not being familiar with screening modalities (Apr: 0.653, 95% CI: 0.441-0.966, p=0.33), and women whose decisions were made by their spouses (Apr: 0.510, 95% CI: 0.271-0.961, p=0.05). Conclusion: About 4 in 10 women had undergone cervical cancer screening by the time of the study. This study underscores the importance of addressing barriers to cervical cancer screening in Uganda, particularly among women of reproductive age in rural areas. Recommendations should target improving access to cervical cancer screening through sensitization of the community and making services available. Keywords: Cervical Cancer Screening Uptake, Women, Reproductive Age
Prevalence and factors associated with Modern Contraceptive use among adolescent girls aged 15 to 19 years in Pagirinya Refugee Settlement, Northern Uganda
(Lira University, 2023) Amony, Sandra Sally; Udho, Samson; Apili, Felister
Background: World Health Organization revealed that about 23 million adolescents have their modern contraceptive needs not yet met. In Uganda, 12% of the adolescents in this age group are using modern contraceptives, with the lowest odds in the northern region. We determined the prevalence and factors associated to utilization of modern contraceptives among adolescents’ girls aged 15 to 19 years in Pagirinya Refugee Settlement, Adjumani district. Methodology: This is a community-based cross-sectional study to investigate modern contraceptive use among adolescents’ girls aged 15 to 19 years. Using probability sampling methods, 400 participants were selected. Questionnaires were pretested and data collectors trained. Data was analyzed using STATA. Results: 60% of the participants fell within the age range of 15-17 years, and all were females. 51.75% utilized modern contraceptives, multivariate analysis showed that Muslim girls were 2.45 times more likely to use modern contraceptives than protestants (AOR=2.45, 95% CI=1.22-4.91, p=0.012). girls who had not been pregnant were 76% less likely to use modern contraceptives (AOR=0.24, 95% CI=0.15-0.41, p<0.0010. the odds of modern contraceptive use reduced by 58% for those unaware of modern contraceptives (AOR=0.42, 95% CI=0.24- 0.71, p=0.001), 62% for those uncomfortable discussing it with health care providers (AOR=0.38, 95% CI=0.22-0.64, p<0.001). Conclusions: Modern contraceptive use among the adolescent girls aged 15 to 19 years in Pagirinya Refugee settlement was significantly high compared to other studies. Keywords: Adolescents, modern contraceptive, refugee, determinants, prevalence.
Outcomes and Factors associated with Multi-Drug Resistant Tuberculosis (MDR-TB) among Tuberculosis Patients attending Lira Regional Referral Hospital
(Lira University, 2023) Abor, Daniel; Opio, Bosco; Omech, Bernard
Background: Multi-Drug Resistant Tuberculosis (MDR-TB) remains a Public Health challenge in low resources countries. Uganda is still among the countries estimated by WHO to have incidences of MDR TB of at least 1000 cases. The burden of MDR-TB in Lango Sub- Region is high and yet its risk factors and treatment outcomes remain unknown. This study assessed treatment outcomes, factors associated with MDR-TB and MDR-TB patients’ experiences with health system services among TB patients in Lira Regional Referral Hospital (LRRH) from January 2020 to December, 2022. Methods: A cross sectional study involving quantitative and qualitative study was conducted among TB patients with treatment outcomes at LRRH from January 2020 to December 2022. Eligible participants were screened for MDR-TB and the independent variables which included; socio-demographics, clinical presentation, co-infections and morbidities. Descriptive statistics was used to determine treatment outcomes. Bivariate and multivariate analysis were done to determine predictors of MDR-TB. Key informant interviews for MDR-TB were done and analyzed manually to evaluate MDR-TB patients’ experiences. Results: Out of the 762 TB patients, 10.63% had MDR-TB. Higher proportions were males, 67.32% (513/762) and majority of the participants aged 30-45 years (38.58). among MDR patients, 38.27% (31/81) completed treatment, 30.86% (25/81) got cured, 18.52% (15/81) were lost to follow-up, and 12.35% (10/81) died. Distance of > 10km for LRRH (aOR=2.64, 95% CI: 1.45-5.17) and patients without previous tb treatment (aOR =0.03, 95% CI: 0.02-0.07) significantly predicted MDR-TB. Drugs’ side effects, additional financial and nutritional support were also key findings in qualitative reports. Conclusion: Higher proportions had favorable outcome. Distance of > 10km, previous TB treatment was associated with MDR-TB. drugs’ side effects, financial and nutritional support could affect treatment adherence. Keywords: Treatment Outcomes, Multi Drug Resistant Tuberculosis, Predictors and Referral Hospital
Contribution of Community Support Group to Home-Based Care of Persons Living with HIV and AIDS in Lira District: A Case of Amach Town Council and Amach Sub County
(Lira University, 2022) Auma, Zamaradi; Obici, Gilbert
Background: This study examined the contribution of community support groups on home based care to persons living with HIV (PLHIV) in Lira District. Specifically, the study examined the contribution of community support group on adherence to Anti-Retroviral Therapy (ART) for PLHIV, analyzed the contribution of community support groups on nutrition support to PLHIV, and examined the contribution of community support groups on palliative care to PLHIV. Methods: The study adopted a cross-sectional study design, which employed a mixed methods approach of both quantitative and qualitative methods. The study population consisted of 577 participants. Both simple random sampling technique and purposive sampling, were used to select a sample size of 226 respondents. The researcher used self-administered questionnaires to collect quantitative data and an interview guide to collect qualitative data. Descriptive statistics (mean, and standard deviation), and inferential statistics (correlation and regression) were used to analyze numerical data. Content analysis was used to analyse qualitative data from interviews to supplement quantitative data. Results: The findings suggested that community support group (mean=4.959, SD=0.5393) helps in enhancing home based care for PLHIV in Lira District. The study further revealed that community support group had a significant effect on adherence to ART (β=0.641, p<0.05), nutrition support (β=0.581, p<0.05) and palliative care (β=0.638, p<0.05). Conclusion: The study concludes that community support group significantly affects home based care for PLHIV in Lira District, Northern Uganda. This study contributes an original and empirical evidence of the association between community support group and home based care to PLHIV in Lira District. Recommendation: Therefore, for improved home based care to PLHIV, Lira District Local Government is encouraged to mobilize the local community to form community support groups so that they can be in position to give support to PLHIV in Lira District. Keywords: Community Support Group, Home-Based Care, and Persons Living with HIV and AIDS
Water, Sanitation and Hygiene Risk Factors associated with Diarrhoeal Diseases among Children under Five years in Lira City
(Lira University, 2022) Auma, Brenda; Opio, Bosco
Introduction: In developing countries like Uganda; diarrhea in children under five is one of the leading causes of illness and mortality. The country has the highest prevalence of diarrheal diseases among children under five of 22% in East Africa. This study assessed the water, sanitation and hygiene factors associated with diarrheal disease among children under five years in Lira City. Methodology: This was a quantitative community-based cross-sectional survey conducted between August and September 2022. Information on socio-demographic characteristics, water, sanitation, hand washing practices and diarrhea history was obtained from 492 mothers/caregivers of children under the age of five years using a semi-structured interviewer administered questionnaire. Data was analyzed at three levels using STATA (Stata Corp LLC, TX and USA) version 17 software. Descriptive statistics, univariate logistic and multivariate logistic regression analyses were used. Results: Among 492 children under-five, the prevalence of diarrhea was 142 (29.3%). Being a child under four years of age (AOR=0.14, CI: 0.04-0.58), eating food not stored in refrigerators (AOR=0.15, CI:0.03-0.76), living in households practicing open dumping of wastage (OR=6.57, CI:1.63-26.4), and living in a household with a rubbish pit not filled fully (OR=2.84, CI:1.36-5.94) were significantly associated with diarrhea among children under five in Lira City. Conclusion: The prevalence of diarrhea among under-five is high in Lira City. The socio demographic, sanitation, hygiene and environmental factors were found to be associated with diarrhea. Community sensitization on water, sanitation and hygiene risk factors is needed. Keywords: Water, Hygiene, Sanitation, Lira City and Diarrhea

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