Southwestern Uganda Research Articles

Spatial and temporal variations of trophic state conditions of Lake Bunyonyi, south-western Uganda

The study was conducted to assess the spatial and temporal variations of the trophic state condition of Lake Bunyonyi between October 2019 and September 2020. Secchi depth (SD), total phosphorus (TP) and chlorophyll-a (Chl-a) concentration were measured to aid the quantification of trophic state condition of the lake using Carlson trophic state index (CTSI). The trophic state index (TSI) values based on SD, TP and Chl-a values were 60.82 ± 5.35, 68.99 ± 11.04 and 61.74 ± 7.51, respectively. March 2020 recorded the highest mean CSTI value (70.14 ± 4.04), while in September 2020, the lowest mean value (58.03 ± 6.22) was obtained. Based on CTSI values, the lake was eutrophic in both dry and wet seasons albeit with differences in the values. The eutrophic state of the lake is possibly attributed to nutrients inflow into the lake via runoff and drainage from farmlands. The negative value of TSI-Chl-a–TSI-TP deviation pointed out that the lake is not phosphorus limited, while the positive TSI-Chl-a–TSI-SD mean deviation value revealed the effect of Chl-a and TP on the lake’s transparency. The study recommends the necessity to develop guidelines for the trophic status monitoring of Lake Bunyonyi since results suggest the deteriorating lake condition.

Thinness among children aged 5–17 years living in Nakivale refugee settlement, South Western Uganda: a cross-sectional study

BackgroundHunger and malnutrition are rampant among refugees and displaced populations, many of whom are infants and children. We sought to determine the prevalence and factors associated with thinness among children aged 5–17 years living in Nakivale refugee settlement, Isingiro district, southwestern Uganda.MethodsThis was a cross sectional study that enrolled 420 children aged 5 to 17 years. The World Health Organization cluster sampling was used to select 30 villages from which 14 households were selected by consecutive sampling and participants were then chosen per household by simple random sampling. Data were collected on the participant socio-demographic, family, dietary, medical, hygiene and refugee status factors. Thinness was defined as having a z-score < -2 standard deviations of Body Mass Index-for-age from the median WHO growth standards. The prevalence of thinness was determined by ascertaining the total number of children with thinness over the total number of children studied. Multivariable logistic regression model was used to determine the factors independently associated with thinness with p < 0.05 level of significance.ResultsA total of 420 children aged 5–17 years were enrolled into the study. The median age (IQR) was 8.6 (6.8–11.8) and majority 248 (59.1%) were female. The prevalence of thinness was 5.5% (95% CI: 3.7-8.1%). The factors independently associated with thinness were; living with a chronic disease (aOR 6.47, 95%CI; 1.63–24.64, p = 0.008), use of water from natural sources (aOR 3.32, 95%CI; 1.27–8.71, p = 0.015), and duration of stay in the settlement of less or equal to 10 years (aOR 3.19, 95%CI; 1.15–8.83, p = 0.025).ConclusionFive in every 100 children aged 5–17 years in Nakivale refugee settlement have thinness. Thinness was more likely among children who are living with a chronic disease, used water from natural sources and those whose families had stayed shorter in the settlement. Our findings suggest that children with chronic disease should receive extra food supplementation and have routine growth monitoring as part of their chronic care. The study reiterates a need to have clean and safe water supply and close nutrition assessment and monitoring, especially for newly registered refugee children.

Determining household and farm level governance factors affecting the transition to household food security in Isingiro district, south-western Uganda

Governance, in particular, decision-making plays a significant role in influencing the transition to households’ food security. It helps in addressing causative factors responsible for undermining household sustainable food security. This study aimed at determining household and farm level governance factors affecting the transition to household food security. Respondents who participated in the study were 284. The study employed a cross-sectional survey design to obtain qualitative and quantitative data on household food security. Household interviews, focus group discussions, key informants’ interviews, and observations were used to collect data. Qualitative data were analyzed by categorizing them into themes to find out respondents’ experiences and opinions. Quantitative data were coded, entered, cleaned, and summarized using descriptive statistics, frequencies, and chi-square. The study used Multiple Regression Model to establish the extent to which selected variables were responsible for the transition to household food security. Results on maize production showed that the association of occupation of coefficient (0.006) and income (-0.54) had a significant and positive value P=0.000 (P˂0.05) and was related to food security, while the association between family size (0.006) and land size (0.055), marital status (0.092), and land acreage (-0.108) had no significant relationship. Regarding beans, results indicated that the relationship between occupation (coefficient -0.059 and income (0.059) had a significant value P= 0.000, while the association between family size (0.096) and land size (0.055, marital status (0.092) and land acreage (-0.108) had no significant association. In the case of bananas, the association of occupation (0.038) and income (0.142) had a significant value of P=0.000, while the relationship between family size (0.010) and land size (-0.026), marital status (0.014), and land acreage (0.184) had no significant relationship. The study recommends increased government support in establishing effective decisions on household food security and strengthening them through a participatory and bottom-up approach. The study also recommends that the government and related stakeholders invest in household capacity building for inclusive gender participation in decision-making pertaining to food security; establish resilient household food production and increase support for strengthening it further. There is also a need for supporting climate change mitigation, environmental conservation, and farm-level landscape restoration. Key words: household, governance, transition, food security, participatory, sustainable, policy, livelihood

Self-reported and pill count measures of adherence to oral HIV PrEP among female sex workers living in South-Western Uganda.

Female sex workers (FSWs) in Uganda are at high risk of HIV infection. Scaling up oral pre-exposure prophylaxis (PrEP) will reduce HIV incidence if high levels of adherence are maintained. This study evaluates PrEP adherence using clinic-based pill counts and self-reported measures, and factors associated with protective levels of adherence. Participants were sex workers who had been taking PrEP for at least 5 months and were attending routine follow-up visits for PrEP care in fishing communities and along the Trans-African Highway. Participants who had a pill count showing at least 85% use since their last clinic visit and those who reported taking their PrEP every day in the last 5 months were categorised as having 'protective adherence'. Spearman's correlation and weighted kappa assessed the relationship between pill count and self-reported measures. Bivariate and multivariate logistic regression was used to determine factors associated with protective adherence as measured by pill count. We recruited 524 FSWs, with a median age of 29 years (IQR 23-35). Participants were recruited from fishing communities and Trans-African Highway towns (n = 297, 56.7%, and n = 227, 43.0%). Nearly three quarters (n = 372, 71.0%) of women were estimated to have protective adherence based on pill count (i.e., a pill count of &gt;85%) and 50.4% by self-report in last 3 months. There was a strong positive association between self-reported measures and pill count measures (rest = 0.6453, 95% CI = 0.5924-0.6927) and a moderate agreement between self-reported measures and pill count measures, κ = 0.544 (95%CI = 0.4869-0.6011, p &lt; 0.001). Factors associated with protective adherence included being aged 35 years or older (aOR = 2.40, 95% CI = 1.17-4.86), living in a fishing community (aOR = 1.45, 95% CI = 0.62-3.38), and having an STI in last 3 months (aOR = 1.64, 95% CI = 1.07-2.49). Our findings indicate that PrEP-experienced FSWs attending clinical follow-up visits reported high protective levels of oral pre-exposure prophylaxis, as measured by both pill count and self-reported measures, and a moderate agreement between pill count and self-reported measures.

Behavioral and psycho-social impairments among people living with dementia and their management by caregivers in South-Western Uganda: a qualitative study

Objectives This study aimed to explore the behavioral and social impairments among people living with dementia (PLWD) in rural southwestern Uganda. It also explored the burden of caregivers for people living with dementia. Methods This was a qualitative study among people living with dementia and their caregivers. We consecutively enrolled 30 people living with dementia with their caregivers from their homes. We conducted in-depth interviews using a semi-structured interview guide. We did a thematic content analysis. Results The themes under-reported behavioral impairment were; difficulty in personal care, physical inactivity, and impaired judgment. Under the social and cognitive impairment theme, there was the failure to be in social gatherings like church, community groups, and markets. Under the caregivers’ role, their burden included managing behavioral, social, and cognitive impairments of PLWD. Although caregivers were committed to caring for PLWDs, this required sacrificing time at the expense of income-generating activities. Conclusions Dementia hinders the behavioral and social aspects of the affected people. Caregivers are highly burdened to care for PLWD. Strategies to minimize caregivers’ burden while caring for people living with dementia are recommended.

Patient Satisfaction and Perceptions Regarding Anti-Retroviral Therapy (ART) Services in Rural Southwestern Uganda

Patient Satisfaction and Perceptions Regarding Anti-Retroviral Therapy (ART) Services in Rural Southwestern Uganda

Study Habits Among Students in Primary Teachers’ Colleges in South-Western Uganda

The purpose of the study was to assess the study habits of students in primary teachers’ colleges in South Western Uganda. The research anchored on the Postpositivist philosophy adopted a cohort longitudinal survey research design incorporating correlational techniques. The research employed quantitative methods of data collection in nine government-aided PTCs in South Western Uganda. The sample size was 214 students obtained using simple random sampling from a population of 1192 students in the nine primary teachers’ colleges in South Western Uganda. Data was collected using Palsane and Sharma’s 3-point Likert scale study habits inventory and it was analyzed using SPSS version 20. Research findings revealed that generally, the students in primary teachers’ colleges in South Western Uganda exhibited good study habits in their ability to read and taking of examinations; fair study habits in time management, harnessing physical conditions, note taking, motivation, and memorization; and poor study habits in health and wellness. The conclusion drawn from the findings and other researchers was that students of primary teachers’ colleges in South Western Uganda generally had fair study habits. It was recommended that college administrators and parents should endeavour to organize programs that could assist students in primary teachers’ colleges to acquire good study habits

Determinants of Academic Performance of Primary Teachers’ College Students in South-Western Uganda

The purpose of the research was to establish the perceived determinants of academic performance of primary teachers’ College (PTC) students in South Western Uganda. The researchers anchored on social constructivist philosophy adopted a cohort longitudinal survey research design incorporating description techniques. The researchers employed qualitative methods of data collection and analysis. Data was collected from the nine government-aided PTCs in South Western Uganda. The sample size was 298 comprised of 214 students randomly selected from the nine PTCs and 72 tutors, nine PTC principals, two officials from Kyambogo University, and one official from the Ministry of Education and Sports purposively selected. Data was collected using unstructured questionnaires, interview guides, focus group discussion guides, and documentary analysis guides. Research findings revealed that respondents perceived the academic performance of PTC students in South Western Uganda as determined by an interplay of various factors under nine themes namely; administration, learning environment, tutors, study materials, time, students’ background, welfare, assessment, and study practices. This implies that if the college administration is effective, the learning environment is conducive, tutors demonstrate professionalism, study materials are available, adequate time is given to the program, students with the good background are admitted, there is improved students’ welfare, proper assessment is conducted and students are always engaged in study practices which support learning, there would be improved academic performance of students in PTCs in South Western Uganda. The conclusion drawn from the findings and other researchers was that there are several factors that determine academic performance in PTCs but much depends on the personality and leadership competencies of the college principal. It was recommended that principals of PTCs should be helped to apply leadership styles that enable all other factors that determine academic performance to thrive

Experiences and Perceptions on Community Client-Led ART Delivery (CCLADS) Model of Antiretroviral (ART) Delivery: Patients' and Providers' Perspectives in South Western Uganda.

Community Client-Led ART Delivery groups (CCLADS) were introduced as part of the differentiated service delivery models in 2017 to better serve growing number of HIV patients and reduce unnecessary burden on the HIV care delivery system. However, there is limited evidence on the exact patients' and care providers' experiences and perceptions regarding the CCLADS model of ART delivery. We therefore aimed to explore the experiences and perceptions on CCLADS model from the patient and provider perspectives. A descriptive qualitative study was conducted at two ART clinics in Southwestern Uganda. We conducted in-depth interviews (IDI) to get a deeper understanding of the patient and providers' perspective regarding the model. Responses from participants were recorded using audio recorders and were translated and transcribed. We used thematic approach to analyze the data. A total of 20 in depth interviews were conducted, with providers, CCLAD leaders and Adults Living with HIV (ALHIV) to assess the experiences and perceptions to participation among People Living with HIV (PLHIV) enrolled in CCLADS and the care providers. Key themes included benefits, limitations, experiences and perceptions of CCLADS. Benefits to ALHIV included: Longer refills, reduced transport costs, receive drugs in time, peer advice; to providers: time saving, less tiresome and reduced congestion at facility. Barriers included: stigma, limited outreaches, failure to comply. Patients perceived the model positively (cost effective, improved quality care, no missed appointment where as others were negative (blood samples not taken like before). Experiences also included enough time, learnt some activities and good adherence. Participation in the CCLADS groups provides several benefits to the patient including reduced transport, longer refills and good adherence. Stigma remains a challenge to CCLADS participation, which requires innovative and collaborative strategies from Ministry of Health (MOH) and implementation partners to address in order to sustain CCLADS participation.

Alloimmunization to Rh Antigen (D, C, E, C, E) Among Pregnant Women Attending Antenatal Care in South Western Uganda.

Maternal red cell alloimmunization to Rh antigen in pregnant women occurs when the immune system is sensitized by foreign red blood cell surface antigens, in this case fetal red blood cells, inducing an immune response. Various antigens of blood group systems may cause alloimmunization, especially the Rh, Kel, Fy, JK, and MNS systems. This study aimed to determine alloimmunization to the different frequencies of Rh antigen among pregnant women in South Western Uganda. A total of 1369 pregnant women consented and were recruited into a cross-sectional study during their regular antenatal visits during the period August 2020 to July 2021. Samples (4 mL) of anticoagulated and coagulated blood were obtained, and Rh blood grouping including Rh antigen and the indirect antiglobulin test (IAT) was carried out using the agglutination technology of the LISS ID-Card technique in the Ortho Biovue ID-Micro Typing System. Out of 1369 participants recruited to the study, 78 (5.7%) were D-, 1291 were D+, and 134 (9.8%) had alloantibodies. Among those with alloantibodies, 115 (85.8%) were D+ and 19 (14.2%) D-. The percentage alloimmunization according to the Rh antigens was highest in e (9.72%), c (2.48%), C (2.34%) and E (0.94%) antigens. With the ABO system, alloimmunization was highest in blood group B (10.7%), followed by A (10.6%), O (9.2%) and then AB (7.1%). Alloimmunization was more prevalent in D- (24%) than in D+ participants (8.9%). Rhesus antigen e was the most prevalent antigen (99.8%), followed by c. The alloimmunization rate of 9.8% among these participants is high, and appears in both D+ and D- women. The other Rhesus antigens are seen to cause alloimmunization, with antigen e causing the highest prevalence. In conclusion, there is a need to identify antibodies and study the outcome for clinical significance, especially in D+ women, to facilitate proper pregnancy management.

Diabetic Foot Ulcers: Surgical Characteristics, Treatment Modalities and Short-Term Treatment Outcomes at a Tertiary Hospital in South-Western Uganda

Diabetic Foot Ulcers: Surgical Characteristics, Treatment Modalities and Short-Term Treatment Outcomes at a Tertiary Hospital in South-Western Uganda

Prevalence of violence towards men living with HIV/AIDS in rural communities of SouthWestern Uganda.

Violence towards HIV positive men is one of the silent barriers to utilization of HIV care services. HIV positive men are potential victims of violence from other people including women, and violence may interfere with treatment outcomes. This study determined the prevalence of violence towards HIV positive men in rural communities of southwestern Uganda. A cross-sectional study was conducted among 307 HIV positive men at selected health centers using an interviewer administered questionnaire. Data were analyzed in SPSS version 23 using chi-square and multivariate regression at 95% level of significance and a precision of 0.05. Of the 307 participants, 45.3% had experienced violence. Of these, 23.8% (n=73) had experienced kicking or slapping while 12.7% (39) reported sexual violence. Factors associated with violence were; using alcohol and drugs (aOR 0.26, 95% CI 0.09-0.76, p=0.014), knowledge of support structures (OR 2.25, 95% CI 1.33-3.78, p=0.002) and owning land for farming (aOR 0.26, 95% CI 0.10-0.70, p=0.011). The prevalence of violence at 45.3% is quite high especially since violence against men is rarely talked about. This should not be ignored there should be strategies to support this vulnerable group.

Correction: Enhancing Tuberculosis Care in Southwestern Uganda: Facilitators and Barriers to Utilizing Mobile Health Technologies

Correction: Enhancing Tuberculosis Care in Southwestern Uganda: Facilitators and Barriers to Utilizing Mobile Health Technologies

Entry Academic Scores as a Predictor of Terminal Academic Achievement among Students in Primary Teachers’ Colleges in South-Western Uganda

The purpose of the research was to establish the influence of entry scores on students’ performance in final examinations in primary teachers’ colleges in South Western Uganda. The research anchored on postpositivist philosophy adopted a cohort longitudinal survey research design incorporating correlational techniques. The research employed quantitative methods of data collection in nine government-aided PTCs in South Western Uganda. The sample size was 214 students obtained using simple random sampling from 1192 students in the nine primary teachers’ colleges. Data were collected using closed-ended questionnaires and document analysis guides, and it was analysed using SPSS version 20. Research findings revealed that there was no statistically significant relationship between entry scores and academic performance (r = - .012, p = .864) of students in primary teachers’ colleges in South Western Uganda. From the findings, it was concluded that failure in academics in PTCs can be minimised by strengthening the training (teaching and learning), not increasing entry cores. The study recommended that the policy on entry into PTCs should be revised to include other factors like the candidate’s interest, attitude, talents etc. and lessen the emphasis on the scores one obtained at the previous academic level

Health Care Workers’ Experiences, Challenges of Obstetric Referral Processes and Self-Reported Solutions in South Western Uganda: Mixed Methods Study

IntroductionIn resource limited settings, the highest burden of adverse maternal-fetal outcomes at referral hospitals is registered from emergency obstetric referrals from lower health facilities. Implementation of referral protocols has not been optimally successful possibly attributed to lack of understanding of profile of obstetric referrals and local challenges faced during implementation process.ObjectiveThis study described the profile of emergency obstetric referrals, challenges faced in implementation of obstetric referral processes and explored self-reported solutions by health workers.MethodsThis was a mixed methods study done at Mbarara Regional Referral Hospital (MRRH) and health centre IVs in South-Western Uganda. We consecutively recruited emergency obstetric referrals from Isingiro district for delivery at MRRH. Using a pre-tested questionnaire, we collected demographics, obstetric and referral characteristics. We described the profile of referrals using frequencies and proportions based on demographics, obstetric and referral characteristics. We conducted focus group discussions and in-depth interviews with health workers using discussion/interview guides. Using thematic analysis, we ascertained the challenges and health worker self-reported solutions.ResultsWe recruited 161 referrals: 104(65%) were below 26 years, 16(10%) had no formal education, 11(7%) reported no income, 151(94%) had no professional-escort, 137(85%) used taxis, 151(96%) were referred by midwives. Common diagnoses were previous cesarean scar (24% [n=39]) and prolonged labour (21% [n=33]). There was no communication prior to referral and no feedback from MRRH to lower health facilities. Other challenges included inconsistencies of ambulance and anesthesia services, electric power, medical supplies, support supervision, and harassment by colleagues. Self-reported solutions included the use of phone call technology for communication, audit meetings, support supervision and increasing staffing level.ConclusionMost referrals are of poor social-economic status, use taxis, and lack professional-escort. Health workers suffer harassment, lack of communication and shortage of supplies. We need to experiment whether mobile phone technology could solve the communication gap.

An Evaluation of Antibiotic Prescription Rationality at Lower Primary Healthcare Facilities in Three Districts of South-Western Uganda.

PurposeAntimicrobial resistance is now one of the leading five causes of death globally. This study evaluated the rationality of antibiotic prescriptions at lower primary care levels in three districts of Southwestern Uganda.MethodsThis prospective cross-sectional study reviewed 9899 antibiotic prescriptions at 39 health centers following a drug delivery cycle by National Medical Stores in three phases (19 days each on average). Phase 1 started 3 days after delivery, mid-way (Phase 2) and towards the end (Phase 3). The proportion of rationally prescribed antibiotics was determined using a modified criterion by Badar and in reference to Uganda Clinical Guidelines (UCG). Using multivariate logistic regression, the factors associated with rational prescription were determined with 95% confidence intervals.ResultsSeven of every 10 antibiotic prescriptions were irrational. Half the prescriptions were made by unauthorized personnel (nurses) and many of the pediatric prescriptions (916, 46.5%) did not bear body weight measurements to guide appropriate dosing. Also, the proportion of rational prescriptions in reference to UCG, 2016 was very low (3387, 34.2%). However, a high proportion of antibiotic prescriptions were legibly written (9462, 95.7%), prescribed by generic names (9083, 91.8%) and had a diagnosis (9677, 97.8%) indicated. Multivariate logistic analysis showed that; availability of medicines (phase 1) (phase 2 AOR=1.14, 95% CI:1.02–1.28, phase 3, AOR=1.23, 95% CI:1.1–1.38), legibly written prescription (AOR=0.61, 95% CI: 0.47–0.78), indication of a date on the prescription (AOR=0.56, 95% CI0.38–0.81) and being a medical officer were factors associated with rational antibiotic prescription.ConclusionWe observed a high rate of irrational prescription in the study sites and the majority of these were by unauthorized personnel. A review of antibiotic use policies and focused interventions is crucial in these settings.

A Multilevel Integrated Intervention to Reduce the Impact of HIV Stigma on HIV Treatment Outcomes Among Adolescents Living With HIV in Uganda: Protocol for a Randomized Controlled Trial.

BackgroundHIV stigma remains a formidable barrier to HIV treatment adherence among school-attending adolescents living with HIV, owing to high levels of HIV stigma within schools, rigid school structures and routines, lack of adherence support, and food insecurity. Thus, this protocol paper presents an evidence-informed multilevel intervention that will simultaneously address family- and school-related barriers to HIV treatment adherence and care engagement among adolescents living with HIV attending boarding schools in Uganda.ObjectiveThe proposed intervention—Multilevel Suubi (MSuubi)—has the following objectives: examine the impact of M-Suubi on HIV viral suppression (primary outcome) and adherence to HIV treatment, including keeping appointments, pharmacy refills, pill counts, and retention in care; examine the effect of M-Suubi on HIV stigma (internalized, anticipated, and enacted), with secondary analyses to explore hypothesized mechanisms of change (eg, depression) and intervention mediation; assess the cost and cost-effectiveness of each intervention condition; and qualitatively examine participants’ experiences with HIV stigma, HIV treatment adherence, and intervention and educators’ attitudes toward adolescents living with HIV and experiences with group-based HIV stigma reduction for educators, and program or policy implementation after training.MethodsMSuubi is a 5-year multilevel mixed methods randomized controlled trial targeting adolescents living with HIV aged 10 to 17 years enrolled in a primary or secondary school with a boarding section. This longitudinal study will use a 3-arm cluster randomized design across 42 HIV clinics in southwestern Uganda. Participants will be randomized at the clinic level to 1 of the 3 study conditions (n=14 schools; n=280 students per study arm). These include the bolstered usual care (consisting of the literature on antiretroviral therapy adherence promotion and stigma reduction), multiple family groups for HIV stigma reduction plus family economic empowerment (MFG-HIVSR plus FEE), and Group-based HIV stigma reduction for educators (GED-HIVSR). Adolescents randomized to the GED-HIVSR treatment arm will also receive the MFG-HIVSR plus FEE treatment. MSuubi will be provided for 20 months, with assessments at baseline and 12, 24, and 36 months.ResultsThis study was funded in September 2021. Participant screening and recruitment began in April 2022, with 158 dyads enrolled as of May 2022. Dissemination of the main study findings is anticipated in 2025.ConclusionsMSuubi will assess the effects of a combined intervention (family-based economic empowerment, financial literacy education, and school-based HIV stigma) on HIV stigma among adolescents living with HIV in Uganda. The results will expand our understanding of effective intervention strategies for reducing stigma among HIV-infected and noninfected populations in Uganda and improving HIV treatment outcomes among adolescents living with HIV in sub-Saharan Africa.Trial RegistrationClinicalTrials.gov NCT05307250; https://clinicaltrials.gov/ct2/show/NCT05307250International Registered Report Identifier (IRRID)PRR1-10.2196/40101

Gender-based violence and its determinants during the COVID-19 lockdown in a low-income country: a cross-sectional survey

Background:Coronavirus disease 2019 (COVID-19) is a recent global pandemic associated with multidimensional health-related effects. In the fight against the spread of this novel pandemic, the majority have been living under restrictive conditions during its related lockdown that has created a conducive environment for gender-based violence (GBV). Our study aimed to ascertain the burden and determinants of GBV during the COVID-19 pandemic-related lockdown and curfew (CPLC) in Uganda. Methods:We conducted a quantitative descriptive cross-sectional study in Bushenyi-Ishaka municipality, southwestern Uganda in May, 2020. This study involved 339 adult participants regardless of their gender or ethnicity. Only 12 potential respondents declined to participate in this survey. Results:The prevalence of GBV during the CPLC was 42 per cent. The majority (57%) of victims were women. More than half (54%) of the victims and survivors of GBV attributed the violence to the lockdown. The determinants of GBV included being married, using substances of abuse and having financial problems. Conclusion:The prevalence of GBV skyrocketed during the CPLC in Uganda when compared to the period prior to the pandemic. Women were significantly more affected in all aspects of GBV. Therefore, we recommend developing targeted behavioural change communication strategies based upon our findings.

Prevalence and Factors Associated with Hepatitis B Infection Among Outpatient Adults in South-Western Uganda.

BackgroundAbout 2 billion people in the world are exposed to hepatitis B virus. Africa contributes 25% of the global Hepatitis B burden and prevalence in Uganda is 4.3%. Routine testing to establish the burden, improve prevention and control through early diagnosis and management are rare in hospital settings. We aimed at establishing the prevalence and factors associated with hepatitis B infection among adults attending outpatient clinic at Mbarara Regional Referral Hospital (MRRH) in Uganda.MethodsA hospital-based cross-sectional study was conducted among outpatients attending MRRH. Consecutive sampling method was used to recruit participants. Interviewer-administered questionnaires were used to collect data. Blood samples were collected to test HBsAg. Summary statistics were used to describe the socio-demographic characteristics of study participants and the proportion of Serostatus for hepatitis B infection. Bivariate followed by multivariate logistic regression analysis was conducted to assess the factors associated with hepatitis B infections. All independent variables with p-values <0.2 were entered into a multivariate model to adjust for confounding. A p value <0.05 was considered statistically significant.ResultsA total of 400 participants were recruited. 64.5% were females (n=258) and aged 18–29 years (48.5%, n=193). Overall, 22(5.5%) participants were found to be seropositive for hepatitis B infection. Residing in Kiruhura district (AOR = 11.9, 95% CI: 2.40–59.25, p<0.003) was significantly associated with hepatitis B infection while being female (AOR = 0.3, 95% CI: 0.11–0.88, p<0.018) was protective.ConclusionPrevalence of hepatitis B infection among adult patients attending outpatient clinic at MRRH was 5.5% with male gender and residing in Kiruhura district as factors associated with high prevalence of hepatitis B infection. Ministry of Health should scale up hepatitis B routine testing and treatment at MRRH and its catchment area, with special control programs such as screening, vaccination, and sensitization involving men.

Efficacy of career guidance and counselling among secondary schools in Uganda

Background: In Uganda, students face difficulty during career transition between different levels of education and employment despite government policies about implementation of career guidance and counselling services. Little has been documented about students’ levels of awareness, utilisation and extent of implementation of career guidance and counselling services within secondary schools in Uganda.Objective: This study aims at documenting students’ level of awareness and utilisation career guidance and counselling services, and how these services were being implemented in secondary schools in Uganda.Method: Cross-sectional survey was conducted using mixed methods in secondary schools in South Western Uganda. A total of 161 students in final year of secondary education (senior six) and 35 teachers across four schools met inclusion criteria and consented to participate in the study. Standardised questionnaires as primary tools of data collection were used. Quantitative data were analysed using SPSS (Version 23) and content analysis for qualitative data.Results: Majority of students (98.8%) revealed high awareness about existence of career guidance and counselling services, while 87.0% reported utilising the services. Implementation of career guidance and counselling in schools was demonstrated by type of programmes, information sources, models, timing and information structure by class level. However, challenges to implementation were sited, namely student, teachers, administrators, parents and policy factors.Conclusion and recommendation: Career guidance and counselling services were available and used in secondary schools. However, implementation was affected by functional and structural challenges that affected the quality of career counselling information and required alignment to national development goals.Contribution: The efficacy of career guidance and counselling in secondary schools in Uganda was documented in this article.