Browsing by Author "Akello, Anne Ruth"
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Item An Analysis of Post-Traumatic Stress Disorder and Quality of Life Among Adults Living with HIV in Western Uganda(HIV/AIDS - Research and Palliative, 2024) Kabunga, Amir; Kigongo, Eustes; Udho, Samson; Auma, Anna Grace; Tumwesigye, Raymond; Musinguzi, Marvin; Acup, Walter; Akello, Anne Ruth; Okalo, Ponsiano; Nabaziwa, Jannat; Shikanga, Enos Mwirotsi; Halima, NamataBackground: HIV/AIDS remains a significant global public health issue, profoundly impacting infected individuals. Living with HIV involves complex mental health dynamics, with post-traumatic stress disorder (PTSD) being a prevalent challenge. This study aims to examine the correlation between PTSD and quality of life among HIV-positive individuals in western Uganda. Material and Methods: Conducted between May and July 2023, this facility-based cross-sectional study surveyed 439 participants from four HIV clinics in southwestern Uganda. Data were collected through interviewer-administered questionnaires, analyzed using descriptive statistics, simple linear regression, and multiple linear regression (p<0.05). Results: Respondents had a mean age of 40.6 years, with 68.3% female, 54.9% married, and 55.1% lacking formal education. The reported PTSD prevalence among HIV-positive individuals was 33.7%, significantly correlating with reduced overall quality of life (β = −4.52; p<0.001). The social quality of life had the highest mean score of 14.24 (±3.45) while the environmental quality of life had the lowest mean score 11.89 (±2.68). Conclusion: Our study reveals a concerning prevalence of PTSD, affecting 1 in 3 individuals, emphasizing the pressing need for comprehensive mental health support within HIV care settings. We observed a significant negative impact of PTSD on overall quality of life, particularly in physical and social aspects. Integrating mental health screening into routine HIV care is crucial, using validated tools like the PSTD Checklist Civilian Version, alongside training for healthcare providers to recognize PTSD symptoms in the context of HIV diagnosis and treatment.Item Burnout and coping mechanisms among healthcare professionals in central Uganda(Psychiatry, 2024) Kabunga, Amir; Kigongo, Eustes; Okalo, Ponsiano; Udho, Samson; Auma, Anna Grace; Tumwesigye, Raymond; Akello, Anne Ruth; Musinguzi, Marvin; Acup, Walter; Nabaziwa, Jannat; Shikanga, Enos Mwirotsi; Namata, HaliamaBackground: The escalating global prevalence of burnout among healthcare professionals poses a serious health concern. Recent studies focus on prevalence and predictors of burnout among healthcare providers, emphasizing the need for well-being interventions. This study investigates burnout and coping mechanisms among healthcare professionals in central Uganda, addressing the dearth of knowledge about coping strategies specific to the region. Methods: An analytical facility cross-sectional study was conducted in five healthcare facilities in central Uganda between June to July 2023. Participants included physicians, nurses, and technicians actively engaged in direct patient care. Data were collected using socio-demographic surveys, the Professional Quality of Life (ProQOL-5), and the Brief-COPE tools. Results: The study revealed a high prevalence of burnout, with 39.8% of participants experiencing significant levels. Active coping, positive reframing, and denial were negatively correlated with low burnout levels. Dysfunctional coping, specifically self-distraction and denial, showed positive correlations with average and high burnout levels. Emotion-focused coping mechanisms were not employed across burnout levels. Conclusions: The results emphasize the demanding nature of healthcare roles in the region and highlight the need for comprehensive, context-specific interventions to address burnout globally. While some healthcare professionals utilized adaptive strategies such as seeking social support, engaging in self-care activities, and utilizing problem-solving skills, others resorted to maladaptive coping mechanisms such as substance use and avoidance behaviors. This dichotomy highlights the need for targeted interventions to promote adaptive coping strategies and mitigate the negative impact of maladaptive behaviors on individual well-being and patient careItem Burnout and quality of life among healthcare workers in central Uganda(PLoS ONE, 2024) Kabunga, Amir; Kigongo, Eustes; Okalo, Ponsiano; Udho, Samson; Auma, Anna Grace; Tumwesigye, Raymond; Akello, Anne Ruth; Musinguzi, Marvin; Acup, Walter; Nabaziwa, Jannat; Shikanga, Enos Mwirotsi; Namata, HaliamaBackground The widespread problem of burnout among healthcare workers is not only common but also a significant concern that impacts the entire healthcare system in Uganda. It is essential to understand the connection between burnout and quality of life among healthcare workers in the specific context of central Uganda, where healthcare professionals face high patient volumes, limited resources, exposure to infectious diseases, and socioeconomic challenges. This study examined the relationship between burnout and quality of life among healthcare workers in central Uganda. Methods This research utilized a cross-sectional study conducted across various healthcare settings in central Uganda. The data were analyzed at descriptive, bivariate, and multivariate levels. The relationship between dependent and independent variables was evaluated using an independent t-test for binary variables and a one-way analysis of variance (ANOVA) for categorical variables. Significance was determined with a reported p-value, with relationships deemed significant at p < 0.2. For multivariable analysis, multiple linear regression was employed using a forward selection method, with significance set at 5% (p < 0.05). Results Our findings indicate that nearly 40% of healthcare workers reported experiencing high levels of burnout. The average score for overall quality of life was 10.71 (±4.89), with variations observed across different domains. The study reveals a significant connection between socio-demographic factors, burnout, and overall quality of life, emphasizing the impact of job category, supervisory support, sleep quality, and burnout on the well-being of healthcare workers. Predictive analysis illustrates how these factors influence both overall quality of life scores and scores in specific domains. Particularly noteworthy is that nurses and technicians tend to have a lower quality of life compared to physicians. Conclusion The results underscore the relationship between socio-demographic factors, burnout, and particular aspects of quality of life. Notably, job category, supervisory support, sleep quality, and burnout stand out as significant factors shaping the well-being of healthcare workers. Nurses and technicians encounter distinct challenges, suggesting the need for interventions tailored to their needs. Addressing issues such as inadequate supervisory support, burnout, and sleep-related problems is recognized as a potential approach to improving the overall quality of life among healthcare workers.Item 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 SamBackground: 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 UgandaItem 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 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, AdokeBackground: 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.Item Factors influencing willingness to pay for improved solid waste collection services among households in urban cities in Uganda: empirical evidence from Lira City.(BMC Public Health, 2024) Apio, Everline; Opio, Bosco; Acanga, Alfred; Akello, Anne RuthWaste management in Lira City, Uganda faces significant challenges, particularly in the area of waste collection. Pollution and health risks from uncollected waste are rampant, posing serious threats to human health and the environment. This persistent problem demands urgent attention and effective solutions to improve waste collection and safeguard the well-being of the community and the natural surroundings. This study aimed to assess households’ willingness to pay for improved waste collection services, examine their waste management practices, and identify influencing factors. We employed a multistage sampling technique to randomly select 585 household heads and conducted key informant interviews with city officials and private waste collectors. Data analysis was conducted with STATA 17 and results showed that 48.12% of households were willing to pay an average of UGX 3012 ($0.84) per month for better services. Factors including education level, occupation, distance to waste collection sites, and environmental awareness significantly influenced this willingness. The study highlights a significant gap in public awareness and understanding of efficient solid waste management practices and concludes that enhancing public awareness is crucial for improving environmental health and safety in Lira CityItem 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, AlfredBackground: 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 ServicesItem Knowledge, Attitude and Practices on used Polythene Bags Disposal among Residents of Lira City(Lira University, 2022) Adyero, Cecilia; Akello, Anne RuthBackground: 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 CityItem 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 RuthMass 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.Item A systematic review and meta-analysis of compassion fatigue among healthcare professionals before and during COVID-19 in Sub-Saharan Africa(PLOS Glob Public Health, 2024) Kabunga, Amir; Kigongo, Eustes; Tumwesigye, Raymond; Udho, Samson; Musinguzi, Marvin; Acup, Walter; Auma, Anna Grace; Akello, Anne Ruth; Okalo, Ponsiano; Nabaziwa, Jannat; Shikanga, Enos MwirotsiCompassion fatigue is a significant concern globally, particularly in Sub-Saharan Africa, where the COVID-19 pandemic exacerbated existing challenges, placing unprecedented strain on healthcare professionals. This study systematically estimated the prevalence of compassion fatigue among healthcare professionals before and during COVID-19 in SubSaharan Africa. A systematic review was conducted using keywords in PubMed, ScienceDirect, Google Scholar, and grey literature, covering all literature published between 2012 and December 30, 2023. The search team independently conducted study selection, quality assessments, data extractions, and analysis of all included studies. The systematic review, reported following PRISMA guidelines, included 11 studies. The results show that the pooled overall prevalence of compassion fatigue in Sub-Saharan Africa was 70% (95% CI: 57–82, I 2 = 88.37%). The highest prevalence was found in Eastern Africa at 74% (95% CI: 55–93, I 2 = 94.40%), compared to 64% in Southern Africa (95% CI: 49–79, I 2 = 59.01%). Nurses reported the highest rates of compassion fatigue at 80% (95% CI: 57–100, I 2 = 34.77%), followed by general healthcare professionals at 59% (95% CI: 22–97, I 2 = 94.11%) and nursing students at 50% (95% CI: 35–64, I 2 = 0.00%). Before COVID-19, the overall prevalence of compassion fatigue was 66% (95% CI: 41–91, I 2 = 27%). During COVID-19, this increased to 74% (95% CI: 63–85, I 2 = 88.73%). Our results indicate that nearly 3 in 4 healthcare professionals in Sub-Saharan Africa experience compassion fatigue, and this prevalence increased due to the pandemic. The high prevalence underscores the importance of addressing and mitigating compassion fatigue to support the mental health and emotional well-being of healthcare professionals dedicated to helping others in challenging circumstances.Item 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 RuthBackground: 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.