The National Research Repository of Uganda - NRU

Welcome to the National Research Repository of Uganda, abbreviated as "NRU". NRU was established in 2021. NRU is a collection of scholarly output by researchers from the UNCST Community, including scholarly articles and books, electronic theses and dissertations, conference proceedings, journals, technical reports and digitised library collections. It is the official Institutional Archive (IA) of UNCST.

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For information about the publishers' copyright policy on archiving your articles online or in an institutional archive, visit the Sherpa Site at http://www.sherpa.ac.uk/romeo.php The site gives a summary of the permissions normally given as part of each publisher's copyright transfer agreement. If you wish to publish your research findings in the NRU, please contact NRU administrator at admin@uncst.go.ug for details. NRU operates both open access and closed access models. Access to fulltext has been restricted in adherence to the UNCST Intellectual Property Rights (IPR) and Copyrights policies.

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Africa Portal is an online repository of open access library collection with over 3,000 books, journals, and digital documents on African policy issues. This is an initiative by the Centre for International Governance Innovation (CIGI), Makerere University (MAK), and the South African Institute of International Affairs (SAIIA). Please visit the Africa Portal at http://www.africaportal.org/library.

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‘Mummy told me that I have HIV, that is the only thing she told me’: Experiences of HIV status disclosure to children in Masaka Region, Uganda
(Public Library of Science, 2023-05-24) Kairania, Robert;; Onyango-Ouma, Washington;; Ondicho, Tom G. ;; Kagaayi, Joseph;; Kigozi, Godfrey
In sub-Saharan Africa (SSA), disclosure of HIV status to children remains low. Few studies have examined how children navigate and come to terms with their HIV status. The aim of this study was to explore experiences of children about disclosure of their HIV status.BACKGROUNDIn sub-Saharan Africa (SSA), disclosure of HIV status to children remains low. Few studies have examined how children navigate and come to terms with their HIV status. The aim of this study was to explore experiences of children about disclosure of their HIV status.Between October 2020 and July 2021, 18 purposively selected children aged between 12-17 whose HIV status had been disclosed to them by their caregivers or healthcare providers (HCPs) were recruited for this study. We conducted 18 in-depth interviews (IDIs) to collect data for this study. Data were analyzed using the semantic thematic analysis approach.METHODSBetween October 2020 and July 2021, 18 purposively selected children aged between 12-17 whose HIV status had been disclosed to them by their caregivers or healthcare providers (HCPs) were recruited for this study. We conducted 18 in-depth interviews (IDIs) to collect data for this study. Data were analyzed using the semantic thematic analysis approach.Primary data obtained through IDIs revealed that disclosure of HIV status to children occurred as a one-time event without pre-disclosure preparatory planning or focused post disclosure follow-up counseling irrespective of the discloser. Post disclosure psycho-social experiences elicited mixed responses. Some children experienced insults and belittlement and stigma and discrimination in the family and community for out-of-school children and at school for school-going children. Positive disclosure experiences involved receiving support to improve ART adherence through constantly being reminded to take their medications timely at the workplace, by supervisors, for working children and by teachers, at school for school-going children.RESULTSPrimary data obtained through IDIs revealed that disclosure of HIV status to children occurred as a one-time event without pre-disclosure preparatory planning or focused post disclosure follow-up counseling irrespective of the discloser. Post disclosure psycho-social experiences elicited mixed responses. Some children experienced insults and belittlement and stigma and discrimination in the family and community for out-of-school children and at school for school-going children. Positive disclosure experiences involved receiving support to improve ART adherence through constantly being reminded to take their medications timely at the workplace, by supervisors, for working children and by teachers, at school for school-going children.This research contributes to knowledge about children' s experiences of being HIV infected and can specifically be used to improve disclosure strategies.CONCLUSIONSThis research contributes to knowledge about children' s experiences of being HIV infected and can specifically be used to improve disclosure strategies. MEDLINE - Academic
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Suubi + Adherence4Youth: a study protocol to optimize the Suubi Intervention for Adherence to HIV treatment for youth living with HIV in Uganda
(BioMed Central Ltd, 2023-04-20) Ssewamala, Fred M.;; Sauceda, John A.;; Brathwaite, Rachel ;; Neilands, Torsten B.;; Nabunya, Proscovia;; Brown, Derek;; Sensoy Bahar, Ozge;; Namuwonge, Flavia;; Nakasujja, Noeline;; Mugarura, Allan;; Mwebembezi, Abel;; Nartey, Portia;; Mukasa, Barbara;; Gwadz, Marya
Background Suubi is an evidenced based multi-component intervention that targets psychosocial and economic hardships to improve ART adherence, viral suppression, mental health, family financial stability, and family cohesion for adolescents living with HIV (ALHIV) in Uganda. Suubi was originally tested as a combined package of four components: 1) Financial Literacy Training; 2) incentivized matched Youth Savings Accounts with income-generating activities; 3) a manualized and visual-based intervention for ART adherence and stigma reduction; and 4) engagement with HIV treatment-experienced role models. However, it is unknown if each component in Suubi had a positive effect, how the components interacted, or if fewer components could have produced equivalent effects. Hence, the overall goal of this new study is to identify the most impactful and sustainable economic and psychosocial components across 48 health clinics in Uganda. Methods A total of 576 ALHIV (aged 11-17 years at enrollment) will be recruited from 48 clinics and each clinic will be randomized to one of 16 study conditions. Each condition represents every possible combination of the 4 components noted above. Assessments will be conducted at baseline, 12, 24, 36 and 48- months post-intervention initiation. Using the multi-phase optimization strategy (MOST), we will identify the optimal combination of components and associated costs for viral suppression, as well as test key mediators and moderators of the component-viral suppression relationship. Discussion The study is a shift in the paradigm of research to use new thinking to build/un-pack highly efficacious interventions that lead to new scientific knowledge in terms of understanding what drives an intervention's success and how to iterate on them in ways that are more efficient, affordable and scalable. The study advances intervention science for HIV care outcomes globally. Trial Registration This project was registered at clinicaltrials.gov (NCT05600621) on October, 31, 2022. Keywords: Optimization, Suubi + adherence, Youth, Economic empowerment, Viral suppression, Adherence, Intervention components, Multiphase Optimization Strategy, Adolescents living with HIV
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Appendico-ileal Knot: A Rare form of small Bowel Obstruction: A case report
(International Journal of Surgery Case Reports, 2024-10-15) Kabuye, Umaru; Damulira, John; Okuku, Maxwel Dancan
Small bowel obstruction (SBO) is a common surgical emergency with various causes. However, SBO resulting from appendicitis is uncommon and often overlooked. Appendico-ileal knotting, a rare and dangerous form of SBO, occurs when the appendix becomes twisted around the small intestine, leading to strangulation. Despite being reported since 1901, there have been very few documented cases of this condition. Diagnosing appendico-ileal knotting preoperatively is challenging, and even imaging techniques like computed tomography scans may not provide definitive diagnostic findings. Our current case report is a valuable addition to the limited literature and enhances understanding of this infrequent cause of SBO from a resource limited setting. We present the case of a 28-year-old female who presented with symptoms of dynamic SBO, including abdominal pain, vomiting, and constipation. Preoperative evaluation couldn't determine the exact cause. Diagnosis of a strangulated ileum was discovered, with the appendix identified as the source intraoperatively, leading to an open retrograde appendectomy. Postoperatively, the patient received IV ceftriaxone (1 g daily), metronidazole (500 mg tds), paracetamol (1 g tds), and IV crystalloids. Oral intake resumed gradually, and discharge occurred on day 4. Follow-up on 10th day was uneventful. Appendico ileal knotting is a rare cause of mechanical SBO. Knowledge of its pathophysiology, diagnosis, and management is very crucial to reduce its associated morbidity and mortality.
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Effects of COVID-19 Pandemic on Voluntary Medical Male Circumcision Services for HIV Prevention, Sub-Saharan Africa, 2020
(Emerging Infectious Diseases, 2022-12-28) Peck, Megan E.; Ong, Katherine S.; Kiggundu, Valerian; Bamwesigye, Jackson; Semakula, Muhammed; Kabuye, Geoffrey; Kyobutungi, Sheila; Makumbi, Fredrick E.; Toledo, Carlos
Beginning in March 2020, to reduce COVID-19 transmission, the US President’s Emergency Plan for AIDS Relief supporting voluntary medical male circumcision (VMMC) services was delayed in 15 sub-Saharan African countries. We reviewed performance indicators to compare the number of VMMCs performed in 2020 with those performed in previous years. In all countries, the annual number of VMMCs performed decreased 32.5% (from 3,898,960 in 2019 to 2,631,951 in 2020). That reduction is largely attributed to national and local COVID-19 mitigation measures instituted by ministries of health. Overall, 66.7% of the VMMC global annual target was met in 2020, compared with 102.0% in 2019. Countries were not uniformly affected; South Africa achieved only 30.7% of its annual target in 2020, but Rwanda achieved 123.0%. Continued disruption to the VMMC program may lead to reduced circumcision coverage and potentially increased HIV-susceptible populations. Strategies for modifying VMMC services provide lessons for adapting healthcare systems during a global pandemic.
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Prevalence and Risk Factors Associated with Tuberculosis Occurrence among Patients Attending Muhima District Hospital, Nyarugenge District, Rwanda
(European Journal of Social Sciences Studies, 2023-09-15) Elysee, Hitayezu; Kabuye, Fred; Niyigaba, Honore; Ngirinshuti, Vedaste
Tuberculosis (TB) is one the serious public health problems globally and locally and killed at least eight million in 2018 (WHO, 2019). TB is a curable disease if well treated and followed. One of the most key considerations for tracking and evaluating TB prevention and control programs is the prevalence and related risk factors. The study adopted a quantitative approach and a cross-sectional retrospective design to collect data from the respondents. A systematic sampling technique was used and secondary data recorded in the laboratory were collected. Specific objectives were: to determine the prevalence of tuberculosis among patients attending Muhima District Hospital in Nyarugenge District, and to identify behavioral factors associated with TB occurrence among patients attending Muhima District Hospital in Nyarugenge District. Descriptive and analytical statistics were used to analyze the data. The total number of respondents was 2161 patients. The majority, were male 1524(70.5%) and female were 637(29.5%). For the age, those less than 9 years were 19(.9%), between 10-17 years 76(3.5%), between 18-35 years 1185(54.8%), between 36-59 years 843(39.0%), and above 60 years 38(1.8%). Those who were married were 1014(47%), singles were 977(45.2%), and widower were 57(2.6%). For employment, 883(40.9%) were unemployed, 845(39.1%) were employed, 206(9.5%) were students, and 227(10.4%) were prisoners. Based on location, 1181(54.7%) were from urban areas, and 980(45.3%) were from rural areas. The prevalence of TB was 7.2%, out of which the females were 53(34.0%) and males were 103(66.0%). The prevalence of TB among HIV patients was 32.6%. For behavior practices, drinking alcohol was found among 908(42.0%) and smokers were 186(8.6%). For all the predictors of TB occurrence, none of them was statistically associated with TB occurrence. These include demographic characteristics, behavioral factors including use of alcohol, smoking and use of tobacco products, and serology. The prevalence of TB among patients attending Muhima District was higher than the National TB prevalence estimates reported by the World Health Organization (WHO, 2019), respectively 7.2% versus 5.2%. All predictors of TB occurrence including demographic characteristics and behavioral factors none of them was associated with TB occurrence. It is worth recommending a further study to understand in-depth risk factors for TB occurrence in the era of epidemiological transition.