Faculty of Public Health

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Browsing Faculty of Public Health by Author "Acup, Walter"

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    Adherence to Tuberculosis Treatment and Its Associated Factors among Drug-susceptible Tuberculosis Patients in Lira District, Northern Uganda
    (International Journal of Academic Research in Business and Social Sciences, 2023) Nabaziwa, Jannat; Kigongo, Eustes; Kabunga, Amir; Acup, Walter; Puleh, Sean Steven
    Uganda has a high incidence of tuberculosis infection at 200 cases per 100,000 people. With effective therapy and adherence to medications is essential for reducing the spread of tuberculosis in the community. However, many of the initiated patients do not get to finish the entire course of treatment. The purpose of this study was to investigate the level of and factors associated with tuberculosis treatment adherence among drug-susceptible tuberculosis patients in the Lira district. A facility-based cross-sectional survey was conducted among 234 randomly selected tuberculosis patients between October and December 2022. The Morisky medication adherence scale was used to measure adherence. Using a structured questionnaire to collect data on socio-demographic characteristics, community factors, and health service delivery factors associated with adherence. Binary logistic regression analysis was used to determine the correlates of adherence to tuberculosis drugs at a p value of 0.05. Most of the respondents (135, 57.7%) were males, (93, 39.7%) aged above 45 years, and (135, 57.7%) in a marital relationship. The prevalence of adherence to tuberculosis drugs was 84.6% (198/234) and was associated with marital status (AOR: 0.307; 95% CI: 0.13-0.0724, p=0.007) and the experience of stigma (AOR: 4.39; 95% CI: 1.612-11.958, p=0.004). The study reported that 2 in 10 drug-susceptible tuberculosis patients are non-adherent, which is lower than the targeted 90%. Marital status and stigma experience are predictors of non-adherence. Interventions by the ministry of health should target how to improve tuberculosis treatment and reduce stigma.
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    Factors associated with first antenatal care (ANC) attendance within 12 weeks of pregnancy among women in Lira City, Northern Uganda: a facility-based cross- sectional study
    (BMJ, 2023) Acup, Walter; Opollo, Marc Sam; Akullo, Betty Nancy; Musinguzi, Marvin; Kigongo, Eustes; Opio, Bosco; Kabunga, Amir
    Objective This study aimed at assessing factors associated with first antenatal care (ANC) attendance within 12 weeks of pregnancy among women in Lira City. Design A cross-sectional study. Settings The study was conducted in health facilities offering ANC services in Lira City, Northern Uganda. Participants The study was among 368 pregnant mothers attending their first ANC in the three selected facilities (Lira Regional Referral Hospital, Ober Health Center IV and Pentecostal Assembly of God Mission Health Center IV) in Lira City. Primary and secondary outcome measures Level of first ANC attendance within 12 weeks of pregnancy and associated factors. Results Early ANC attendance was 36.1%. Women who were: unmarried (adjusted OR (aOR): 0.40, 95% CI: 0.16 to 0.99), took >2 hours to reach a health facility (aOR: 0.21, 95% CI: 0.07 to 0.62), or not visited by village health teams or healthcare workers at home (aOR: 0.33, 95% CI: 0.12 to 0.92) were less likely to attend their first ANC early. On the other hand, women who were: not knowing first that ANC guides parents on infant care (aOR: 2.22, 95% CI: 1.06 to 4.67); pregnant without consent of spouse (aOR: 4.29, 95% CI: 1.75 to 10.55); attending ANC from a private facility (aOR: 2.89, 95% CI: 1.27 to 6.15); and having two to three healthcare workers present at the ANC clinic (aOR: 1.79, 95% CI: 1.03 to 3.13) were more likely to attend ANC early. Conclusions Despite the fact that the WHO recommends that all women begin ANC within 12 weeks after conception, Lira City in Northern Uganda had a low overall incidence of timely ANC initiation. Being unmarried, distance to reach a health facility, and being visited by village health teams or healthcare workers at home were all linked to timely ANC commencement. As a result, intervention efforts should concentrate on the highlighted determinants in order to promote ANC initiation in Lira City, Northern Uganda. This can be accomplished by providing information and education to the community on the timing and necessity of ANC in Northern Uganda.
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    Factors Associated with First Antenatal Care Attendance Within Twelve Weeks of Pregnancy Among Women in Lira City
    (Lira University, 2022) Acup, Walter; Marc, Sam Opollo; Akullo, Betty Nancy
    Introduction: The World Health Organization (WHO) recommends all pregnant women attend first Antenatal care (ANC) within 12 weeks of pregnancy. However, most pregnant women (71%) in Uganda started first ANC after 12 weeks of pregnancy. This predisposes them to pregnancy complications and outcomes which makes it hard to reduce the current high maternal mortality ratio (MMR) of 336 deaths per 100,000 live births. This study aimed to assess factors associated with first ANC attendance within 12 weeks of pregnancy among women in Lira City. Methods: A cross-sectional study design was conducted among 368 pregnant mothers attending first ANC at Lira Regional Referral Hospital (LRRH), Pentecostal Assembly of God-Mission HC-IV, and Ober HC-IV. Data was collected using interviewer-administered structured questionnaires. In-depth interviews were used to collect qualitative data. A binary logistic regression analysis was computed to determine the association using crude and adjusted odds ratios at 95% confidence intervals. Independent variables with a p-value of less than 0.05 in the multivariable logistic regression model were considered significant Results: Of the 368 respondents interviewed, 36.1% reported first ANC within 12 weeks of pregnancy. Risk factors associated with first ANC attendance within 12 weeks of pregnancy were not being in a marital relationship (aOR:0.40, 95% CI:0.16-0.99), taking >2hours to reach health facility (aOR:0.21, 95% CI:0.07-0.62), not being visited by VHT/HW at home (aOR:0.33, 95% CI:0.12-0.92). Protective factors associated with first ANC attendance within 12 weeks of pregnancy were not knowing that first ANC guides parents on infant and child care (aOR:2.22, 95% CI:1.06-4.67), pregnancy not consented to by spouse (aOR:4.29, 95% CI:1.75-10.55), attending ANC from private health facility (aOR:2.89, 95% CI:1.27-6.15), and having 2-3 HWs present at ANC clinic (aOR:1.79, 95% CI:1.03-3.13). Conclusion: Majority of pregnant women initiate their first ANC visits late. Comparing this to the UDHS 2016, we can conclude that late ANC initiation is a major problem in countrywide. Therefore, Ministry of Health should improve on the staffing of midwives and nurses at all facilities, raising awareness through continues community mobilization and sensitization of the women, their husbands and the community at large about the importance of first and timely ANC attendance should be a priority through HW/VHTs.
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    Parents’ Readiness to Vaccinate Their Children Aged 5 to 17 Years Against Covid-19 and Its Associated Factors in Lira District, Uganda
    (Pediatric Health, Medicine and Therapeutics, 2023) Puleh, Sean Steven; Kigongo, Eustes; Opio, Innocent Ojok; Akech, Stella Immaculate; Opollo, Marc Sam; Achan, Everlyne; Acen, Joy; Anyolitho, Maxson Kenneth; Acup, Walter; Amir, Kabunga
    Background: Data on parents’ readiness to vaccinate their children aged 5 to 17 years against COVID-19 is still scarce. This study assessed parents’ readiness to vaccinate their children aged 5 to 17 years against COVID-19 and factors associated in Lira district, Uganda. Methods and Materials: A cross-sectional survey employing quantitative methods was conducted between October and November 2022 among 578 parents of children aged 5–17 years in 3 sub-counties in Lira district. An interviewer-administered questionnaire was used to collect data. Data was analyzed using descriptive statistics including means, percentages, frequencies, and odds ratios. Logistic regression was used to determine associations between the factors and the readiness of parents at a 95% level of significance. Results: Out of 634 participants, 578 responded to the questionnaire, giving a response rate of 91.2%. The majority of the parents (327, 56.8%) were female, had children aged between 12 and 15 years (266, 46.4%), and had completed primary education (351, 60.9%). Most of the parents were Christian (565, 98.4%), married (499, 86.6%), and had been vaccinated against COVID-19 (535, 92.6%). Results also indicated that 75.6% (ranging from 71.9% to 78.9%) of the parents were unwilling to vaccinate their children for the COVID-19 virus. The predictors of readiness were the age of the child (AOR: 2.02; 95% CI: 0.97–4.20; p=0.05) and lack of trust in the vaccine (AOR: 3.33; 95% CI: 1.95–5.71; p0.001). Conclusion: Our study shows that parents’ readiness to vaccinate their children aged 5 to 17 years was only 24.6%, which is suboptimal. The predictors of hesitancy were the age of the child and a lack of trust in the vaccine. Based on our results, the Ugandan authorities should provide health education interventions targeting parents to combat mistrust with respect to COVID-19 and the COVID-19 vaccine and highlight the benefits of the vaccines. Keywords: children, minors, hesitancy, readiness, vaccination
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    Parents’ Readiness to Vaccinate Their Children Aged 5 to 17 Years Against Covid-19 and Its Associated Factors in Lira District, Uganda
    (Pediatric Health, Medicine and Therapeutics Dovepress, 2023) Puleh, Sean Steven; Kigongo, Eustes; Opio, Innocent Ojok; Akech, Stella Immaculate; Opollo, Marc Sam; Achan, Everlyne; Acen, Joy; Anyolitho, Maxson Kenneth; Acup, Walter; Kabunga, Amir
    Background: Data on parents’ readiness to vaccinate their children aged 5 to 17 years against COVID-19 is still scarce. This study assessed parents’ readiness to vaccinate their children aged 5 to 17 years against COVID-19 and factors associated in Lira district, Uganda. Methods and Materials: A cross-sectional survey employing quantitative methods was conducted between October and November 2022 among 578 parents of children aged 5–17 years in 3 sub-counties in Lira district. An interviewer-administered questionnaire was used to collect data. Data was analyzed using descriptive statistics including means, percentages, frequencies, and odds ratios. Logistic regression was used to determine associations between the factors and the readiness of parents at a 95% level of significance. Results: Out of 634 participants, 578 responded to the questionnaire, giving a response rate of 91.2%. The majority of the parents (327, 56.8%) were female, had children aged between 12 and 15 years (266, 46.4%), and had completed primary education (351, 60.9%). Most of the parents were Christian (565, 98.4%), married (499, 86.6%), and had been vaccinated against COVID-19 (535, 92.6%). Results also indicated that 75.6% (ranging from 71.9% to 78.9%) of the parents were unwilling to vaccinate their children for the COVID-19 virus. The predictors of readiness were the age of the child (AOR: 2.02; 95% CI: 0.97–4.20; p=0.05) and lack of trust in the vaccine (AOR: 3.33; 95% CI: 1.95–5.71; p0.001). Conclusion: Our study shows that parents’ readiness to vaccinate their children aged 5 to 17 years was only 24.6%, which is suboptimal. The predictors of hesitancy were the age of the child and a lack of trust in the vaccine. Based on our results, the Ugandan authorities should provide health education interventions targeting parents to combat mistrust with respect to COVID-19 and the COVID-19 vaccine and highlight the benefits of the vaccines.
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    Prevalence and predictors of COVID-19 vaccination hesitancy among healthcare workers in Sub-Saharan Africa: A systematic review and meta-analysis
    (PLOS ONE, 2023) Kigongo, Eustes; Kabunga, Amir; Tumwesigye, Raymond; Musinguzi, Marvin; Izaruku, Ronald; Acup, Walter
    Background The COVID-19 vaccination is regarded as an effective intervention for controlling the pan demic. However, COVID-19 vaccine hesitancy is hampering efforts geared towards reduc ing the burden of the pandemic. Therefore, examining COVID-19 hesitancy and its predictors among healthcare workers is essential to improving COVID-19 uptake. In sub Saharan Africa, the pooled proportion of COVID-19 vaccine hesitancy is yet to be known. Purpose The present study was to estimate the pooled proportion of COVID-19 vaccine hesitancy and its predictors among healthcare workers in Sub-Saharan Africa. Methods A systematic search of articles was conducted in PubMed, Science Direct, African Journal Online, and Google Scholar. Data was extracted with the help of Excel. Data analysis was conducted using STATA 17. Heterogeneity in the studies was assessed using Cochrane Q and 12 tests. A random effects model was used to examine the pooled estimates to deter mine if heterogeneity was exhibited. Results A total of 15 studies involving 7498 participants were included in the final analysis. The pooled prevalence of COVID-19 vaccination hesitancy among healthcare workers was 46%, 95% CI (0.38–0.54). The predictors of COVID-19 hesitancy were negative beliefs towards vaccine 14.0% (OR = 1.05, 95% CI: 1.04, 1.06), perceived low risk of COVID-19 infection 24.0% (OR = 1.25, 95% CI: 1.23, 1.28), and vaccine side effects 25.0% (OR = 1.23, 95% CI: 1.21, 1.24). Conclusion The data revealed generally high hesitancy of COVID-19 vaccine among health workers in Sub-Saharan Africa. Future COVID-19 adoption and uptake should be improved by national and individual level efforts. In Sub-Saharan Africa, it is crucial to address the myths and obstacles preventing healthcare professionals from accepting the COVID-19 vaccination as soon as feasible since their willingness to get the vaccine serves as an important example for the broader public.
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    A systematic review and meta-analysis of the prevalence of depression among breast cancer patients in Sub-Saharan Africa
    (Avicenna Journal of Neuro Psycho Physiology, 2023) Kabunga, Amir; Kigongo, Eustes; Musinguzi, Marvin; Tumwesigye, Raymond; Acup, Walter
    Background: Breast cancer is linked to neuropsychiatric conditions, particularly depression, which lowers life expectancy. Studies from Sub-Saharan Africa, however, have revealed conflicting prevalence rates of depression. Objective: To assess the combined prevalence of breast cancer-related depression among patients in Sub-Saharan Africa. Methods: The following search terms—depression, depressive disorders, breast cancer, mammary cancer, mammary adenocarcinoma and breast carcinoma, and Sub-Saharan African—were used to conduct a systematic search for English articles on depression published in PubMed, Scopus, Web of Science, African Journal Online, and Google Scholar. A meta-command was used to combine the results of different studies on depression linked to breast cancer through a random effects model at a 95% confidence interval in Stata software (version 17). Results: After the elimination of duplicates, 9,272 articles were still found after the electronic search yielded 12051 results. A number of 19 articles were still available after abstract and title screening, and they underwent full-text screening. A number of 10 articles were removed for a variety of reasons, including the lack of the full text (n=2), incorrect publication type (n=2), and not reporting the full outcome of interest (n=6). In Sub-Saharan Africa, the combined prevalence of breast cancer patients was 60%. (95CI, 0.51-0.69). The prevalence rates of depression among breast cancer patients in East Africa, South Africa, and West Africa were reported as 64% (95CI, 0.51-0.75), 60% (95CI, 0.53-0.67), and 55%. (95CI, 0.36-0.73), respectively. Conclusion: In Sub-Saharan Africa, about 6 in 10 cancer patients experience depression. Since depression negatively affects the quality of life, it is important to properly diagnose depression in order to treat it effectively with the fewest possible side effects. Keywords: Breast cancer, Depression, Depressive disorders, Neuropsychiatric disorder