Browsing by Author "Mathias, Tumwebaze"

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Factors Associated with Treatment Adherence of Patients on Anti-Tuberculosis Drugs Following Covid-19 Pandemic at Health Facilities of Masaka City, Uganda
(American Journal of Health, Medicine and Nursing Practice, 2022) Mathias, Tumwebaze; Bright Laban, Waswa; Patrick, Ogwok
Purpose: To examine factors associated with adherence of patients on Anti-tuberculosis treatment in Health facilities at Masaka City. Specifically the study was guided by four objectives; to establish the current level of adherence, to explore the patient knowledge, to find out socio-economic factors, and to identify Health facility factors contributing to adherence of patient on tuberculosis treatment. Methodology: A cross-sectional research design with both quantitative and qualitative approaches of data collection and analysis was used. At least 110 patients on tuberculosis drug were selected and 15 health workers working in tuberculosis clinics to give expert views on the problem under investigation. Interview guide and questionnaires were used and data were analyzed using Stata version 13. Descriptive statistics, percentages were presented in the findings on frequency distribution tables. Qualitative data obtained using interviews was analyzed using thematic content analysis and narrative reasoning. Results: Prevalence of adherence to TB treatment was at 86% from the patients the study was conducted. In the study most patients had adequate knowledge on Tuberculosis treatment and it had attributed a majority 86% with good adherence on Tuberculosis Drug. On health facility factors there was limited medical supplies of drug to improve care, most patients were youth. Statistically, there was significant relationship between frequent counseling and patient adherence at multivariate levels. (OR=15.5073; [95% Cl: 3.73553 to 27.27917]; p=0.010). There was no relationship between patients’ adherence and employment status and good conduct of health workers was significally associated with patient adherence. (OR=7.0566; [95%Cl: 2.77620 to 11.3371]; P=0.001). In this study factors affecting adherence included stigma, discrimination and suspension of transport as COVID-19 prevention guideline by Ministry of health Uganda negatively contributed to poor adherence of patients. This was attributed to by isolation and neglect by family members, relatives, health workers and the community for fear of COVID-19 suspicion at each respective health facility. Involvement of TB survivor in TB treatment would increase adherence and retention in care. Recommendations: In the study there was suboptimal adherence of 86% as opposed to MOH Uganda of 95%, due to stigma and discrimination. The study recommended each TB patient be assigned a family member and a village health team as treatment supporters. Intensified health education and pre TB treatment counselling on adherence increases patients ability to take medication consistently leading to good TB treatment outcomes. Not involving and supporting private clinics to provide TB services is a very big missed opportunity by the health sector. Most patients first visit private clinics before coming to public health centers. Involvement of TB survivor in TB treatment would increase adherence and retention in care.
First Hour Initiation of Breast Feeding & Associated Factors, among Mothers at Post Natal Ward in Fort Portal Referral Hospital, Uganda
(Science Research Publishing, 2021) Mathias, Tumwebaze; Elizabeth, Manimake Mijumbi; Margaret, Rukindo
Background: Breast milk is recommended as the best feeding option to neo nates and infants for it confers immunological benefits that help to reduce neonatal and infant morbidities and mortalities. WHO recommends that all infants should start breast feeding within one hour of birth i.e. early initiation of breast feeding (EIBF). Unfortunately, studies show that less than 40% of infants in resource limited settings Uganda inclusive are initiated on breast feeding practice, with no documented study done in Kabarole district to as sess the problem. This study therefore, set out to establish the prevalence and associated factors with the practice of first hour initiation of breast feeding at Fort Portal Regional Hospital, Kabarole district, Uganda. Methods: With a cross-sectional design, we collected data from 330 post natal mothers and their live-born infants at Fort Portal Regional Referral hospital from 5th-20th August 2019. With a standard interviewer administered tool, mothers who initiated breast feeding within the first hour after delivery of their newly born babies responded with yes and those that did not with a no. Prevalence of one hour initiation was got considering infants that were initiated on breast within one hour over the total live birth times 100 to get the percent preva lence. With Stata version 13 software, statistically significant relationships of the predisposing factors were determined at a p-value (p ≤ 0.05) at bivariate and at multivariate regression coefficient. Results: A total of 330 postnatal mothers targeted for this study, 100% response rate was covered. Mothers’ age ranged from 18 - 45 years with mean age 31 SD ± 6. The prevalence of initiation of breast feeding in the first hour of birth was 68%, a third of (32%) mothers had not initiated breast feeding in the first hour. A half (50%) of the direct predisposing factors for non-initiation of timely breastfeeding were due to birth asphyxia, almost a quarter 23% due to mother’s ill health and 7% due mother not being guided by the health worker on what to do. In this study mothers’ knowledge and awareness of the practice were very low at 20% while that of health workers was fair at 53%. Social demographic factors that influ ence 1st hour breast feeding practice were; young maternal age being less than 34 years, mothers occupation being self-employed (83%) or unemployed (73%) with 3 times higher odds of initiating breastfeeding within 1st (OR = 3, p = 0.003) than working class mothers (civil servants). Marital status of mothers being married (73%) significantly influenced early breastfeeding practice (p = 0.001). Health workers’ knowledge of the practice was signifi cantly associated (OR = 2.7, X2 = 11.32, *p = 0.00078) with enforcement of mother initiation of breast feeding in first hour compared to the less knowl edgeable ones. Conclusion: The practice of timely initiation of breastfeeding at Fort Portal Regional Referral hospital at 68.2% was sub-optimal against WHO universal practice recommendations. Mothers’ low knowledge on timely initiation of breast feeding practice was the most deterrent factor for first hour initiation of breastfeeding practice. Providing breastfeeding counselling to all mothers during ANC and training on best breastfeeding practices and counselling skills for health staff at Fort Portal Referral hospital are urgent recommendation in this study to improve the practice.
Prevalence and Predisposing Factors of Human Immunodeficiency Virus Infection among the Boda-Boda Riders in Mbarara Municipality-Uganda
(Science Research Publishing, 2020-07-09) Mathias, Tumwebaze; Emmanuel, O. Otiam; Kakwezi, Margaret Rukindo; John, Mwesigwa
Background: Boda-Boda is a well-known and booming motorcycle taxi that employs youths to earn a living. They transport passengers at a faster rate where other means of transport are inaccessible or would be time consuming. Global statistics show that HIV has continued to be a major global Public Health issue especially among the “Most At-risk Populations” (MAPs) that include commercial transporters and Boda-Boda riders. Aim: This study aimed at assessing the prevalence and predisposing factors for HIV/AIDS among Boda-Boda riders living in Mbarara Municipality. Specifically, the study determined the prevalence of HIV among the Boda-Boda riders, identi fied social demographic predisposing factors for HIV and determined know ledge of Boda riders on prevention of HIV. Study setting: Boda-Boda opera tors in the transport sector are at high risk of HIV infection but the HIV sta tus of the Boda Riders in Mbarara was not known a reason why the study was instituted: Study design: This was an analytical and descriptive cross-sectional study that employed quantitative methods of data collection. The study pop ulation comprised the registered Boda-Boda operators from two divisions of Kakoba and Kakiika in Mbarara municipality. Sample size and sampling methods: Using Morgan’s table (1970), the population of the registered Boda Riders was 15,041; this corresponded to a sample size of 375 respondents by Morgan Table. Systematic sampling procedure was used to get every 3rd reg istered rider on the list. Data collection: A pre-tested structured tool aided data collection after group pretest counseling. Individual counseling was also done prior to testing and giving results. The laboratory technologists drew blood to determine the sero-status of the respondents. Results were recorded as tested reactive (TRR) or tested non-reactive (TR). Unigold was used as tie breaker to confirm their diagnosis in order to ascertain those who were HIV positive on determine. Data analysis: Analysis was done at univariate, biva riate and multivariate using STATA version 13, Statistical significance of the relationship was determined for the p-value (p ≤ 0.05). Significant variables were then considered at multivariate level of analysis. Results: More than half 195 (52%) of the Boda-Boda cyclist had attained primary level of education and 36.5% secondary education. HIV prevalence among Boda-Boda riders was 9.9%. Riders who had never heard of VCT/HCT screening for HIV were three times likely to acquire HIV compared to those who ever heard of VCT/HCT screening (OR = 3.35; 95% CI 1.14 9.83; p = 0.027). Those with multiple partners were six times more likely to acquire HIV/AIDS compared to those who buy sex from prostitutes (OR = 6.13; 95% CI 1.54 24.38; p = 0.01). The level of awareness of VCT was found high at (94.7%), and the gen eral knowledge about utilization and importance of VCT services was at 80%, however condom use as a preventive measure was found low at 44.3% among the respondent Boda-Boda riders. Conclusion: Boda-Boda riders had high HIV prevalence of 9.9% compared to that of Mbarara district at 6.1% and much higher than 5.7% national HIV prevalence level. The predisposing fac tors to acquire HIV/AIDS were having multiple sexual partners, not having heard of HIV counseling and testing as well as low and inconsistent condom use at 44.3%. The study recommends health service providers and HIV counselors to intensify awareness and behavior change campaigns on condom use among the Boda-Boda riders as preventive measure against HIV
Prevalence and Risk Factors for Hypertension, Diabetes and Obesity among Lecturers and Support Staff of Bishop Stuart University in Mbarara, Uganda
(Science Research Publishing, 2019-03-19) Jordan, Amanyire; Mathias, Tumwebaze; Mauda, Kamatenesi Mugisha; Labani, Waswa Bright
Aim: To establish the prevalence and risk factors for hypertension, diabetes and obesity among teaching and non-teaching staff of Bishop Stuart Univer sity, Mbarara-Uganda. Background: None communicable diseases (NCDs) are projected to exceed communicable diseases as the most common causes of death by 2030 in Africa. Most sub-Saharan African countries however lack detailed countrywide data on hypertension and other NCDs risk factors. Cognizant of Uganda’s recent inclusion of Hypertension and diabetes in the health policy agenda, this study was conducted among the university staff in a rural setting to provide benchmark information for design of appropriate in terventions. Study Design: This was a descriptive cross-sectional, institution al based survey design. Place and duration of the study: This study was conducted among the teaching and none teaching staff of Bishop Stuart Uni versity Mbarara, Uganda from 18th April-6th June 2017. Methodology: A structured questionnaire was used to gather social demographic and risk fac tors data from the university workers at their work stations. Blood pressure of each participant was measured and Hypertension was defined as systolic BP > 140 and/or diastolic (BP) > 90 mmHg. Anthropometric measurements: Body Mass index (BMI) was done by weight in (Kg) and Height in (M2 ) to establish weight levels. Obesity was considered at BMI > 40. A random Blood Sugar (RBS) > 200 mg/dl was considered as diabetic. Epi-info version 7 was used to enter data, analyzed using SPSS version 19. Results: A total of 156 University staff aged 25 - 75 years of both sexes, mean age 42 ± 8 were inter viewed of whom 51% were males. About 15% were administrative staff, 55% teaching staff, 3% senior lecturers and professors and 25% non-teaching staff.The prevalences of Hypertension, Diabetes, and obesity were 7.7%, 16%, and 28% respectively. But also majority (60.2%) were found at risk of developing both hypertension and diabetes. Less than 20% of the participants were knowledgeable on causes, signs and symptoms and preventive measures for Hypertension but had moderate knowledgeable of the risk factors, the most frequently mentioned risk by 71% was lack of exercise. Despite the awareness of risk factors, majority (61.3%) had not done any form of exercise and 64.1% had not had regular Blood pressure check ups. The study also demonstrated a statistically significant relationship between those aged more than 40 years and having hypertension (X2 = 5.82, P = 0.015, OR = 4.2). Likewise the risk of Diabetes increased with increasing age. Lecturers aged 40 years and above were 5.6 times likely to have diabetes compared to those aged less than 40 years (OR = 5.6, X2 = 16 , P = 0.0005). A significant number of respondents 57/156 (36.5%) reported history of HPT among their family members. Preva lence of obesity and overweight was observed higher in senior administrative staff and lecturers than in lower cadre staff 49% and 34% (p < 0.01). Conclu sion: Hypertension, Diabetes and obesity are conditions prevalent among the teaching and none teaching staff of BSU, but knowledge on risk factors, clin ical presentation and preventive strategies is limited. Routine physical exer cises, periodic body checkups and controlled diet are public Health interven tions recommended for control among the university staff.
Strengthening District Health Teams Capacity in Surveillance Systems and Response to Public Health Threats in Western Uganda through Field Epidemiology Training Program (FETP)
(Science Research Publishing, 2020-05-07) Mathias, Tumwebaze; Asiimwe, Solomon; Anna, Tukahirwa; Saul, Kamukama
Aim: To strengthen the District Capacity in surveillance for effective detec tion, Reporting and Response to Public Health threats. Background: The overall aim of a good surveillance system is to strengthen the capacity of a Health system through training of health personnel who can conduct effec tive surveillance activities. A good surveillance system is achieved through improved use of complete and timely health information to detect changes in time to institute a rapid response to the suspected outbreak of Public Health events. This assessment followed a 3-month Field Epidemiology Training program undertaken by the investigator who applied the acquired knowledge and skills in completion of the assessment. Study Design: It was a descriptive cross-sectional, institutional based epidemiological investigation conducted at district level and Health Centre 1V in Kabarole from 15th De cember 2019-March 2020. eReports were retrieved from DHIS-2 for epidemi ological weeks 44 in 2019 to week 3 in 2020. Data analysis: Micro soft word excel program was used to determine the reporting rates, epidemic disease trends and construction of malaria channel. SWOT analysis was done to identify poor HMIS reporting as the lead surveillance quality challenge and route cause analysis done to determine underlying causes. Results: Weekly reports analyzed were from a total of 53 Health facilities and one Health Cen tre four for malaria channel construction. Of the 53 functional Health facili ties assessed in the district, the average reporting Timeliness was 32% and Completeness at 63% from week 44 in 2019 to week 3 in 2020. This finding shows that the district was not achieving the 80% Timeliness and 80% Com pleteness national target. The poor reporting situation implies that the district