Browsing by Author "Bakesiima, Ritah"

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    Adherence to modern contraceptives among female refugee adolescents in northern Uganda: A prospective single cohort study
    (A prospective single cohort study, 2022) Bakesiima, Ritah; Gemzell-Danielsson, Kristina; Beyeza-Kashesya, Jolly; Ayebare, Elizabeth; Cleeve, Amanda; Larsson, Elin C.; Nabirye, Rose C.
    Background: Contraceptive adherence is the current and consistent use of a contraceptive method as prescribed by a health worker or family planning provider so as to prevent pregnancy. Globally, adherence is lowest among adolescents. This has greatly contributed to the high burden of adolescent pregnancies. Adherence and reasons for discontinuation among refugee adolescents are poorly understood. The aim of this study was to determine the rates and predictors of adherence to modern contraceptives among female refugee adolescents in northern Uganda. Methods: A prospective single cohort study, nested into a randomised controlled trial (RCT) assessing the effect of peer counselling on acceptance of modern contraceptives. The RCT was conducted among female refugee adolescents in Palabek refugee settlement, northern Uganda. The study involved 272 new starters of modern contraceptives who were followed up for six months from May 2019 to January 2020. The outcome was measured at one, three and six months after receiving a contraceptive method. Data was analysed using STATA version 14.0. Results: Adherence rates were low and reduced over time. By the end of the six months, only 44% of the participants were using a contraceptive method. The commonest reasons for non-adherence were side effects and partner prohibition. Participants using long acting reversible contraceptives (LARC) were more likely to adhere compared to those who were using short acting reversible contraceptives (SARC) (OR: 3.37, 95% CI: 1.914-5.937, p=<0.001). There was no difference in adherence between participants who received peer counselling and those who received routine counselling. Conclusion: Adherence to modern contraceptives was low, leaving adolescents at risk of unintended pregnancies. Participants using LARC were more likely to adhere than those using SARC. Interventions addressing fear of side effects and partner prohibition should be studied and implemented to enable adherence to modern contraceptives
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    Comparison of GeneXpert cycle threshold values with smear microscopy and culture as a measure of mycobacterial burden in five regional referral hospitals of Uganda- A cross-sectional study
    (PLoS ONE, 2019) Najjingo, Irene; Muttamba, Winters; Kirenga, Bruce J.; Nalunjogi, Joanitah; Bakesiima, Ritah; Olweny, Francis; Lusiba, Pastan; Katamba, Achilles; Joloba, Moses; Ssengooba, Willy
    Determining mycobacterial burden is important in assessing severity of disease, evaluating infectiousness and predicting patient treatment outcomes. Mycobacterial burden assessed by smear microscopy grade and time to culture positivity is clearly interpretable by most physicians. GeneXpert (Xpert) has been recommended by WHO as a first line tuberculosis (TB) diagnostic test as an alternative to smear microscopy. Xpert gives cycle threshold (Ct) values as a potential measure for mycobacterial burden. For physicians to clearly interpret Ct values as measures of mycobacterial burden, this study compared the Xpert quantification capabilities with those of smear microscopy and culture. The study also determined a linear relationship between Xpert Ct values and MGIT culture time to positivity (MGIT-TTP) and associated factors. A cut off Ct value which best predicts smear positivity was also determined using the Receiver Operator Curve analysis method. Results Excluding missing results and rifampicin resistant TB cases, a moderately strong correlation of 0.55 between Xpert Ct value and smear grade was obtained. A weak correlation of 0.37 was obtained between Xpert Ct values and MGIT time to positivity while that between Xpert Ct values and LJ culture was 0.34. The Xpert Ct values were found to increase by 2.57 for every unit increase in days to positive and HIV status was significantly associated with this relationship. A cut off Ct value of 23.62 was found to best predict smear positivity regardless of HIV status. Conclusion Our study findings show that GeneXpert Ct values are comparable to smear microscopy as a measure of M. tuberculosis burden and can be used to replace smear microscopy. However, given the low correlation between Xpert Ct value and culture positivity, Xpert Ct values cannot replace culture as a measure of M. tuberculosis burden among TB patients.
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    Dyslipidaemias in women using hormonal contraceptives: a cross sectional study in Mulago Hospital Family Planning Clinic, Kampala, Uganda
    (BMJ Open, 2018) Bakesiima, Ritah; Byakika-Kibwika, Pauline; Tumwine, James K.; Kalyango, Joan N.; Nabaasa, Gloria; Najjingo, Irene; Nabaggala, Grace S.; Olweny, Francis; Karamagi, Charles
    To determine the prevalence and factors associated with dyslipidaemias in women using hormonal contraceptives. Design Cross-sectional study Setting Mulago Hospital, Kampala, Uganda Participants Three hundred and eighty-four consenting women, aged 18–49 years, who had used hormonal contraceptives for at least 3 months prior to the study. Study outcome Dyslipidaemias (defined as derangements in lipid profile levels which included total cholesterol ≥200 mg/dL, high density lipoprotein <40 mg/ dL, triglyceride >150 mg/dL or low-density lipoprotein ≥160 mg/dL) for which the prevalence and associated factors were obtained.
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    Modern contraceptive use among female refugee adolescents in northern Uganda: prevalence and associated factors
    (Reproductive Health, 2020) Bakesiima, Ritah; Cleeve, Amanda; Larsson, Elin; Tumwine, James K.; Ndeezi, Grace; Danielsson, Kristina G.; Nabirye, Rose C.; Kashesya, Jolly B.
    Background: Adolescent pregnancies are persistently high among refugees. The pregnancies have been attributed to low contraceptive use in this population. The aim of this study was to determine the prevalence and factors associated with modern contraceptive use among female refugee adolescents in northern Uganda. Methods: This was a cross sectional study using both descriptive and analytical techniques. The study was carried out in Palabek refugee settlement in Northern Uganda from May to July 2019. A total of 839 refugee adolescents who were sexually active or in-union were consecutively enrolled. Interviewer administered questionnaires were used for data collection. Results: Modern contraceptive prevalence was 8.7% (95% CI: 7.0 to 10.8). The injectable was the most commonly used modern contraceptive method [42.5% (95% CI: 31.5 to 54.3)], and most of the participants had used the contraceptives for 6 months or less (59.7%). Reasons for not using modern contraceptives included fear of side effects (39.3%), partner prohibition (16.4%), and the desire to become pregnant (7.0%). Participants who were married (OR = 0.11, 95% CI: 0.04 to 0.35, p < 0.001), cohabiting (OR = 0.43, 95% CI: 0.20 to 0.93, p = 0.032) or having an older partner (OR = 0.93, 95% CI: 0.86 to 0.99, p = 0.046) were less likely to use modern contraceptives. Conclusion: Modern contraceptive use among female refugee adolescents was very low, and few reported a desire to become pregnant, leaving them vulnerable to unplanned pregnancies. Least likely to use modern contraceptives were participants who were married/cohabiting and those having older partners implying a gender power imbalance in fertility decision making. There is an urgent need for innovations to address the gender and power imbalances within relationships, which could shape fertility decision-making and increase modern contraceptive use among refugee adolescents.