Faculty of Public Health

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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
Factors associated with Occupational injuries amongst solid waste handlers in Mbale City.
(Lira University., 2023) Mwanga, Issa; Akello, Anne Ruth
Background: 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 handlers
Factors influencing consistent use of bed nets for the control of malaria among children under 5 years in Soroti District, North Eastern Uganda
(Malaria Journal, 2022) Akello, Anne Ruth; Byagamy, John Paul; Etajak, Samuel; Okadhi, Charles Stephen; Yeka, Adoke
Background: The use of insecticide-treated bed nets has been proven to be effective in reducing malaria transmission in highly endemic areas. Use of long-lasting insecticidal nets (LLINs) has been embraced by many malaria endemic countries. LLINs are up to 95% effective in inhibiting blood feeding, when used consistently even after 7 years. The challenge, however, is enhancing their consistent use, especially by the most vulnerable groups (children under 5 years and pregnant women). The study established factors associated with consistent use of bed nets for malaria control among children under 5 years in Soroti district. Methods: The study employed a cross-sectional design, with multi-stage sampling of households. A total of 400 households (HH) were sampled and the HH head in each household interviewed. Key informant interviews (KIIs) were conducted with 7 key informants who were knowledgeable on the subject matter. Data analysis was done using SPSS 17.0 at Univariate, Bivariate and Multivariable levels; after entry and cleaning. Key informants’ data were summarized manually; verbatim quotes and text used to reinforce quantitative data in line with objectives. Results: Only 56.8% of the 690 children under 5 years used bed nets consistently. The factors affecting consistent bed net use were age of the child, their use of bed nets the previous night, occupation of caretaker, respondents’ perceived susceptibility, perceived risk of getting malaria, size and shape of the bed nets. Rectangular nets were difficult to hang daily in huts according to most key informants. Conclusion: Consistent bed net use among under fives is still below the RBM target of 85% by 2015 and can be enhanced by providing conical bed nets and setting aside a health education programme to emphasize the effectiveness of even one mosquito in spreading malaria at night to the entire household and ability of bed nets to stop transmission better than other methods.
Household’s Willingness to Pay for Improved Solid Waste Collection Services in Lira City, Northern Uganda
(Lira University, 2022) Apio, Everline; Akello, Anne Ruth; Acanga, Alfred
Background: Waste management still remains a big challenge in most urban cities in Uganda including Lira City. This poses a great threat to human kind and the environment. Accordingly, household willingness to pay for solid waste services is paramount for better improvement of SWM at the community. Therefore, this study assessed factors influencing household’s willingness to pay for solid waste collection for disposal in Lira City. Methods: To achieve the study objectives, a survey was conducted utilizing a structured questionnaire to collect quantitative data from 585 randomly selected household heads. Key informant interview was conducted with City Environmental Officers, City Clerk, City Division Health Inspectors, Managers of Private Garbage Collecting Companies, Division Drivers and Staff Engaged in Solid Waste Collection and Market Vendors to supplement quantitative data. Descriptive analysis was used to ascertain the solid waste management practices used by the households and to determine the level of willingness to pay for improved waste collection in Lira City by the residents. The factors influencing household’s willingness to pay were analyzed using a binary logistic model. Results: The findings revealed that, 48.12% of the 585 household heads were willing to pay for improved solid waste collection services and the average amount household heads were to pay for improved solid waste collection services was UGX 3012≠ (0.84$) per month, according to the study, education level, occupation, distance to waste collection sites, and awareness of solid waste environmental concerns were all factors that influenced the amount that households were prepared to pay. Recommendations: As a result of the study findings, it was recommended that residents in Lira City be educated about the importance of effective solid waste management. Secondly, a thriving solid waste collection system should be built in the city, lest the environment’s and human population’s health will be jeopardized. Keywords: Household, Willingness to Pay, and Improved Solid Waste Collection Services
Knowledge, Attitude and Practices on used Polythene Bags Disposal among Residents of Lira City
(Lira University, 2022) Adyero, Cecilia; Akello, Anne Ruth
Background: The improper disposal of used polythene bags waste remains a significant public health challenge worldwide. In Uganda, 53% of solid waste are generated in urban areas especially in households. Lira City passed a solid waste management ordinance in 2019 to support with solid waste management including the polythene bags, tried to use enforcement among others but the implementation of the strategies became a challenge since polythene bags are used as daily shopping bags, and also for packing food. This study was therefore to assess the knowledge, attitude and practices of lira city residents on the disposal of used polythene bags. Methodology: The study design used was cross sectional, employing both qualitative and quantitative methods of data collection and analysis among 421 randomly selected residents of Lira City. Data was collected using structured questionnaires, key interview guides via face-face interviews. Quantitative data analysis was done using STATA 17 summarized as frequencies, percentages, means and standard deviations. Pearson Chi square test was run for bivariate analysis, and odds ratios for regression and p-value of 0.05 reported significant. Qualitative data analysis was manually done using the Braun & Clarke (2016) 6 steps. Results: Overall response rate was 99.8%. disposal practices of residents were improper at 52.5%, a good number of the respondents, 179 (42.5%) were aged 18 to 28 years, were female 273 (64.9%), and the most common level of education attained was primary 147 (34.9%). Most of them were self-employed 173 (41.1%), married 285 (61.3%), and catholic 165 (35.2%) by religion. A majority, 78.9% had good knowledge of proper disposal of used polythene bags. Factors associated with used polythene bags disposal among residents in Lira City include age (aOR; 3.007, 1.074-8.417), sex (aOR; 1.2, 0.82-1.97), reduce injuries (aOR; 1.2, 0.38-4.15), drainage blockage (aOR; 3.04, 2.00-4.63), and human health problems (aOR; 1.7, 1.15-2.73). Conclusion: Good knowledge on disposal of used polythene bags was high, disposal practices were poor at 52.5%. KII reported a knowledge gap in managing used polythene bags which has become a major challenge in Lira City. “the waste management practices of the people in the peri urban areas of the city is very poor and it’s even worse with used polythene bags, and there is need for awareness creation on general waste management with emphasis on disposal of used polythene bags” KI-1 said. Key words: Knowledge, Attitude, Practices, Polythene Bags, Disposal, and Residents of Lira City
Prevalence Of Malaria And Associated Tractors Among Children Under 5 Years Following Mass Net Campaign And Indoor Residual Spraying In Amolatar District
(Lira University, 2022) Orech, Sam; Akello, Anne Ruth
Mass LLINs distribution campaign and Indoor Residual Spraying (IRS) have been identified by the WHO as effective approaches for malaria prevention and control. Despite the scale up of interventions towards control and elimination of malaria, it’s still endemic in 91 countries worldwide with 3.3 billion people at risk of developing. In 2015, 212 million malaria cases occurred globally resulting into 429,000 deaths, 92% were in Africa. In 2019, 409,000 people died of malaria, mostly vulnerable children in sub-Saharan Africa. Methods A community based, cross-sectional research design using quantitative data collection method was used. Semi-structured questionnaire were employed. Bivariate and multivariate logistic regression analysis were done to identify factors associated to the prevalence of malaria among <5yrs. Results The intended respondents (238) were interviewed and up to 44.1% (105/238) children tested positive for malaria. At multivariate analysis, Children living with married caretakers (AOR=2.54, 95% CI=1.23-5.25) had statistically significant association with malaria prevalence, Children of caretakers with poor perception towards LLIN use had 68% increased odds of getting malaria. Whereas, children who stay far away from water bodies (AOR=0.07, 95% CI=0.01-0.56) had reduced odds of getting malaria Conclusions and recommendations Malaria remains the major public health problems among children under 5 years in Amolatar district. Children living with married caretakers, Caretakers with poor perception towards LLIN use and living near water bodies were the risk factors to malaria. DHTs to strengthen malaria prevention and control strategies among children <5 years, health information dissemination about eliminating stagnating water bodies, and addressing poor perception of mothers of children <5years.
Uptake of Integrated Community Case Management and Associated Factors Among Caregivers of Children Under Five Years in Apac District
(Lira University, 2022) Eluk, Job; Omech, Bernard; Akello, Anne Ruth
Background: Globally, child mortality remains a public health concern with 38 deaths per 1000 live births and accounting for 5.2 million deaths in children under 5 years, with Sub-Saharan Africa region having the highest figure of 76 deaths per 1,000 live births that is equivalent to one child in 13 dying before reaching age five in 2019. In Uganda, the child mortality rate has reduced gradually from 191 deaths per 1000 live births to 45.8 deaths per 1000 live births in 2019. Objective: To determine the Uptake of integrated community case management of childhood illnesses and associated factors among caregivers of children under five years in Apac district. Methods: This was a cross-sectional study using quantitative methods, 403 family caregivers of children under five in Apac District. Data was collected using a semi-structured questionnaire on Uptake, associated factors, and perceptions of caregivers towards ICCM services. Data was analyzed using STATA version 15.1. Results: The majority of the caregivers were female 337 (83.6%), with a mean age of 27.7 years and standard deviation of 6.64 years, attained primary education, 253(62.8%), Christians, 393 (97.5%), and married 346 (85.9%) were married. The level of Uptake of ICCM services was 38.7% (156/403). Results of the study indicate that the child’s illness (p=0.01, AOR=3.5(2.1-7.2), knowledge of ICCM (P<0.01, AOR12.1 (1.7-87), timely services (p<0.001, AOR (12.7(3.4-47), and referral by VHT (P<0.01, AOR 4.0(1.4-11.0). were statistically significant. Conclusion: The Uptake level of ICCM services provided by the VHTs was low, though caregivers had a good perception of ICCM services and child referral to health facilities by VHT. To improve Uptake of ICCM services, there is a need to provide more information regarding ICCM within the community.

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