Browsing by Author "Batte, Anthony"
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Item Disclosure of HIV test results by women to their partners following antenatal HIV testing:(BMC Public Health, 2015-01-31) Batte, Anthony; Katahoire, Anne Ruhweza; Chimoyi, Anne; Ajambo, Susan; Tibingana, Brenda; Tibingana, Brenda; Banura, CecilyAbstract Background: Disclosure of HIV status by women to their partners is the backbone for prevention of HIV transmission among couples as well as promotion of the prevention of mother to child transmission of HIV interventions. The aim of this study was to determine the prevalence and factors associated with disclosure of HIV test results by women to their sexual partners following antenatal HIV testing in Kamwokya slum community, Kampala, Uganda. Methods: This was a population based cross-sectional study carried out from October to November 2011. A total of 408 randomly selected women aged 18–45 years, who had delivered a child within 2 years prior to the study, and had tested for HIV during antenatal care were recruited from Kamwokya community. A standardised interviewer- administered questionnaire was used to collect data. Data was entered into Epidata 2.1b and analysed using SPSS software version 16.0 and StatsDirect version 2.8.0. Results: Overall 83.8% (95% CI: 79.9- 87.1) of the women reported that they had disclosed their HIV status to their sexual partners. Disclosure was significantly higher among women whose partners had also tested for HIV (OR=24.86, 95% CI: 5.30 - 116.56). Other factors that were associated with disclosure were secondary education or above (OR=2.66, 95% CI: 1.34 - 5.30), having attended 3 or more antenatal care visits (OR=3.62, 95% CI: 1.70 - 7.72), being married/cohabiting (OR=8.76, 95% CI: 4.06 - 18.81) and whether or not they would opt not to disclose a family member’s HIV status (OR=1.61, 95% CI: 1.003 - 2.58). Overall, stigma was not significantly associated with disclosure. Conclusions: Disclosure of HIV test results to sexual partners in this group of women was relatively high. The results suggest that having a sexual partner who had also tested probably made it easier to disclose the woman’s HIV status. Other predictors of disclosure were secondary education and above and having attended more antenatal care visits. These findings suggest the need for promotion of sexual partner HIV testing, improvement of literacy levels of women, and encouragement of women to attend antenatal care, as key factors in promoting disclosure of HIV resultsItem Mortality Among Children Under Five Years Admitted For Routine Care Of Severe Acute Malnutrition: A Prospective Cohort Study From Kampala, Uganda(BMC pediatrics, 2020) Nalwanga, Damalie; Musiime, Victor; Kizito, Samuel; Kiggundu, John Baptist; Batte, Anthony; Musoke, Philippa; Tumwine, James K.Mortality among children under 5 years of age admitted to malnutrition units in sub-Saharan Africa remains high. The burden of HIV infection, a major risk factor for mortality among patients with severe acute malnutrition (SAM), has reduced due to concerted prevention and treatment strategies. None the less, anecdotal reports from the malnutrition unit at Uganda’s National Referral Hospital (NRH) indicate that there is high mortality among patients with severe acute malnutrition (SAM) in routine care. Uganda has recently adopted the revised World Health Organization (WHO) treatment guidelines for SAM to improve outcomes. The mortality among children with SAM in routine care has not been recently elucidated. We report the magnitude and factors associated with mortality among children under 5 years of age admitted to the NRH for routine care of SAM.This was a cohort study of all severely malnourished children admitted to the NRH between June and October 2017. The primary outcome was two-week mortality. Mortality was calculated using simple proportions and Cox regression analysis was used to determine factors associated with time to mortality. Data was entered into Epidata and analysed using Stata v14.Two-hundred-sixty (98.5%) children: 59.6% male; mean age 14.4 (SD 9.4) months, completed two weeks of follow-up. Of these, 25.2% (95% CI 19.9–30.4%) died. In-hospital mortality was 20.7% (95% CI15.9–25.6%). The prevalence of HIV infection was 12.2%. Factors associated with mortality included: positive HIV status (AHR 2.2, (95% CI; 1.2–4.2), p = 0.014), bacteraemia (AHR 9 (95% CI 3.4–23.0), p < 0.001, and low glomerular filtration rate (eGFR), AHR 3.2; (95% CI 1.7–6.3), p = 0.001).A 25% mortality among children with severe malnutrition remains unacceptably high despite significant reduction in HIV prevalence. Children with SAM who are HIV infected, have eGFR below 60 mL/min/1.73m2 or have bacteraemia, are more likely to die. Further studies to explore the relationship between eGFR and mortality among children with SAM are needed. Studies to establish efficacious antibiotics are urgently required to inform treatment guidelines for children with SAM.Item Outcomes of male circumcision performed by medical doctors and non–doctor health workers in central Uganda(Research Square, 2020) Kibansha Matumaini, Hope; Batte, Anthony; Otwombe, Kennedy; Lebotsa, Emily; Luboga, SamTask shifting for male circumcision is still a challenge. The aim of this study was to evaluate the outcomes of circumcision conducted by doctors compared to non-doctors in Kampala, Uganda Results: In this prospective cohort study, we observed and followed 274 males at 3 health facilities in Kampala, Uganda. Each participant was observed during the circumcision procedure, monitored for 2 hours post-surgery and assessed at 24hours, 3 days and after one week for adverse events. The mean age of the circumcised men was 24.82 (6.36) years. Of the circumcisions, 19.3% (53/274) were carried out by doctors while 80.7% (221/274) by non-doctor health workers. About 5.47% (15/274) experienced adverse events and the proportions by cadre were similar; medical doctors (5.66% [3/53]) and non-doctor health workers (5.43% [12/221]), p=0.99. Seven patients had evidence of pus discharge (all had been operated by non-doctors), only 2 patients had bleeding at 2 hours (one by medical doctor and one by nondoctor), 4 patients had evidence of excessive skin removal (2 by medical doctor vs 2 by non-doctors). There was no reported urethral injury or glans amputation. These results indicate that non-doctor health workers can offer circumcision services safely with low adverse event rates.Item Outcomes of voluntary medical male circumcision performed by medical doctors and non‑doctor health workers in central Uganda(African Journal of Urology, 2021) Kibansha Matumaini, Hope; Batte, Anthony; Otwombe, Kennedy; Lebotsa, Emily; Luboga, SamVoluntary medical male circumcision (VMMC) reduces the risk of HIV transmission. Task shifting of VMMCs to non-doctor health workers is recommended to enhance scale-up of VMMC programs. This study evaluated outcomes of circumcision conducted by doctors compared to non-doctors in central Uganda. Methods: In this prospective observational study, we observed and followed 274 males at 3 health facilities in Kampala, Uganda. Each participant was observed during the circumcision procedure, monitored for 2 h post-surgery and assessed at 24 h, 3 days and after one week for adverse events. Results: The median age of the circumcised men was 24.00(IQR, 20.00–28.00) years. Of the VMMCs, 19.3% (53/274) were carried out by doctors while 80.7% (221/274) by non-doctors. Following VMMC, 5.47% (15/274) men experienced adverse events and proportions of adverse events by cadre were similar; doctors (5.66% [3/53]) and non-doctor health workers (5.43% [12/221]), p = 0.99. Seven participants had pus discharge (all had been operated by non-doctors), 2 participants had bleeding at 2 h (one by doctor and one by non-doctor), and 4 participants had excessive skin removal (2 by doctors vs 2 by non-doctors). There was no reported urethral injury or glans amputation. Conclusion: Our study found no statistically significant difference in the incidence of adverse events among VMMCs conducted by doctors compared to non-doctor health workers. Our study showed no incidence of serious adverse events such as death, urethral injury or glans amputation following VMMCs. Our results add to the existing literature to guide task shifting in the context of VMMCs.