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Item Cost effectiveness Analysis of adding Tuberculosis Household Contact Investigation on Passive Case Finding Strategy in Southwestern Uganda.(Lira University, 2022) Odongo, Dickens; Omech, Bernard; Acanga, AlfredBackground: The standard passive case-finding strategy implemented by most developing countries is inadequate to detect new cases of TB. A household contact investigation is an alternative approach. The study aimed to evaluate the cost-effectiveness of adding household contact investigation (HHCI) to passive case-findings (PCF)strategy in the Tuberculosis control program in south western Uganda. Methods: The study utilized decision-analytic modelling and bottom-up costing (ingredients) methods. The study obtained cost and ability and probability estimates on from national TB program data, activity costs, publicized literature, and expert opinions. It was performed from the societal and provider perspectives over 1.5 years across 12 facilities in Ntuganu, Sheema, and Rwampara Districts. The primary effectiveness measure was the number of actual TB cases detected (yield) and the number needed to screen (NNS). The TB yield was calculated from the number of patients diagnosed over the screen. The incremental cost-effectiveness ratio (ICER) was expressed as cost in 2021 US$ per additional TB case detected. Results: The TB screening yields were 0.52% (1496/289140) for HHCI and 5.8% (197/3414) for PCF. HHCI yield among children 0-14 Vs. 15+ years [6.2% Vs.5.4%] P=0.04. The yield among PLHIV Vs. HIV-negative [15.8% Vs. 5.3%] P=0.03 in HHCI. The PCF yield in men Vs. women [1.12% Vs. 0.28%] P<0.01. The NNS in PCF was 193 [95% CI: 186-294] and 17 [95% CI: 14-22] in HHCI. The unit costs of detecting a TB case were US$ 204.22 for PCF and US$ 315.07 for HHCI. Patient and caregiver cost are five times in PCF than HHCI [US$ 26.37 Vs.US$ 5.42]. Under the study baseline assumption, adding HHCI to PCF strategies was not cost effectives at US$ 3,596.94 per additional case detected. Conclusion: HHCI improves access to TB diagnosis in children 0.14 years and PLHIV; however, PCF improves access to TB diagnosis among men. The unit cost of detecting one TB case in HHCI was higher than in PCP. Adding HHCI to PCF was not cost effective for detecting TB compared to PCF alone. Therefore, PCF remains the ideal and cost-effective strategy for low- resource countries like Uganda. Keywords: Cost-effectiveness, Yield, NNS, Tuberculosis, Household contact investigation, Passive case Findings, South western Uganda.Item Factors associated with Occupational injuries amongst solid waste handlers in Mbale City.(Lira University., 2023) Mwanga, Issa; Akello, Anne RuthBackground: Universally, occupational injuries are responsible for 15%of the deaths associated to occupational accidents. The work done by solid waste handlers exposes them to frequent occupational hazards which results in several injuries among them. The increase of work-related injuries from 43.7% to 63.9% among solid waste handlers in sub-Saharan Africa calls for more studies to be carried out. The objectives of this study was to assess the level of occupational injuries and associated factors amongst solid waste Handlers in Mbale City. Study methods: This was a cross- sectional design which employed mixed methods. Row data was collected using semi-structured questionnaires. Quantitative data was captured, cleaned and analyzed using SPSS version 20.0 at Univariate, Bivariate & Multivariate levels. Results: Occupational injuries level amongst solid waste handlers was 70.83% (85/120). Factors that were associated to this injury level included; No education (AOR 1.42; 95% C1=1.04-1.93), primary education (AOR: 1.49; 95% cI:1.00-2.24) and sharing protective clothing (AOR 1.58% CI =1.17-2.14). Findings: The study finding showed that the level of occupational injuries amongst solid waste handlers in Mbale City was greater as likened to that found by comparable research conducted in Tanzania, Ghana , Ethiopia and Egypt. The factors associated to occupational injuries level in this study includes; education, and sharing protective clothing. City Medical Officer of Health and policy makers should ensure provision of PPES to solid waste handlers, pre-employment screening and ensure waste handlers completed post primary education Conclusion: Occupational; injuries level amongst solid waste handlers at Mbale city was high at 70.83% Keywords: Occupational Injuries, solid waste, solid waste handlersItem Prevalence and Determinants of Asymptomatic Malaria Among Pregnant Women Attending Primary Health Care Services in Lira District / Lira City(Lira University, 2022) Acio, Harriet Sarah; Omech, Bernard; Oceng, Freda AmitoBackground: Asymptomatic malaria infection is a positive Rapid Diagnostic Test or blood smear for P. falciparum with no clinical signs or symptoms conclusive of Malaria. Most malaria infections among pregnant women in high or moderate transmission are asymptomatic, infected women may not seek treatment yet with a devastating consequences on both the mother and fetus and can progress to severe MIP by acting as reservoir of malaria infection. Objectives To assess the prevalence and determinants of asymptomatic Malaria among pregnant women attending services in PHC facilties in lira district/Lira City. Methods: The study used a descriptive cross-sectional design. Data was collected using a semi-structured questionnaire administered to pregnant women tested for asymptomatic MIP at their exit points. Analysised at three levels univariate, bivariate and multivariate respectively. Variables with p-values ˂0.05 were considered statistically significant factors influencing Asymtomatpic MIP on logistic regression. While qualitative data collected through key informat interview guide, analysised through content analysis. Results: Of the 267 respondents, 25.5% had asymptomatic malaria, living within Lira district (aOR=0.50,p=0.02,95% Cl=0.276-0.895) had a 50% incresed likilhood of asymptomatic MIP compared to living in Lira City, being aged 25-29 years (aOR=2.70, ,p=0.04,95% Cl=1.067-6.82) had a 2.70 odds of asymptomatic MIP compared to other age groups. Women from places where VHTs did,t know their roles (aOR=0.596, ,p=0.01,95% Cl=0.322-1.10) had a 0.4% incresed likilhood of asymptomatic MIP compared to others. Conclusion: High prevalence of asymptomatic malaria in Lira district compared to Lira City. Middle age mother were more than twice more likely to have assymptomic malaria.