Browsing by Author "Batte, Charles"
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Item Acceptability of the Wulira App in Assessing Occupational Hearing Loss among Workers in a Steel and Iron Manufacturing Industry(Plos one, 2022) Atukunda, Immaculate; Semulimi, Andrew Weil; Bwambale, Festo; Mumbere, Joab; Twinamasiko, Nelson; Nakabuye, Mariam; Mukisa, John; Mukunya, David; Batte, CharlesIndustrial workers are at a high risk of acquiring noise induced hearing loss, yet there is minimal hearing loss screening of such groups of people. Pure Tone Audiometry (PTA), the gold standard for hearing loss screening, is expensive, and not readily available at health sites. Mobile audiometry can bridge this gap. However, there is limited knowledge on its acceptability in low-income countries like Uganda. We aimed to assess the acceptability of using the Wulira App, a validated mobile phone app, in assessing hearing loss among industrial workers in Kampala. We carried out a qualitative study in a steel and iron manufacturing industry in Kampala, in April 2021. Four Focus group discussions (FGDs) with 8 participants per FGD, and 12 In-depth Interviews (IDI), were conducted on the industrial workers. The industrial workers were first tested for hearing loss, then enrolled for the FGDs and IDI. A semi-structured interview guide was used. Audio recordings were transcribed verbatim. Themes were derived using thematic content analysis, borrowing from Sekhon’s model of Acceptability of Health Interventions. Industrial workers found the Wulira App user friendly, cheap, time saving, and an effective hearing loss assessment tool. However, barriers such as lack of smart phones, difficulty in navigating the app, and fear of getting bad news hindered the App’s acceptability, as a hearing assessment tool. Hearing loss assessment using Wulira App was acceptable to the industry workers. There is need of informing industrial workers on the essence of carrying out regular hearing loss screening, such that barriers like fear of getting screened are overcome.Item Assessment of the Impact of COVID-19 Pandemic on The Education and Psychosocial Wellbeing of School-Going Children in Bududa District, Uganda(Research Square, 2021) Batte, Charles; Semulimi, Andrew Weil; Kasoma Mutebi, Ronald; Mukisa, John; Olum, Ronald; Bongomin, FelixThe coronavirus disease – 2019 (COVID-19) pandemic has caused devastating effects across all sectors. The closure of schools negatively affected school going children globally. The present study sought to assess the effect of the ongoing COVID-19 pandemic and measures put in place to curb its spread on the psychosocial wellbeing of school going children in Bududa District, in Uganda. Methods: This was a cross-sectional study in which randomly enrolled school-going children from three conveniently selected sub-counties, Bukalasi, Bushiyi, and Bushika, in Bududa District, Uganda. Pretested standardised semi-structured questionnaires were used to collect data on the impact of COVID-19 pandemic on education and psychosocial status of the participants. Results: A total of 210 participants were studied. Of this, 122 (53.3%) were male, 203 (96.7%) lived in rural settings, and 155 (73.8%) were staying with both parents. The median age of the participants was 12 (interquartile range: 9 -15) years. One hundred ninety one (90.9%) participants were in primary school. Overall, 154 (73.3%) were worried about not going back to school during the lock down, however, 109 (51.9%) were able to return to school after the easing of the lockdown. Eighty-five (40.5%) participants received reading material at home during lockdown with 64 (30.5%) of the participants accessing teachings through radio. Of the 210 participants, 174 (82.9%) felt worried about the future, 172 (81.9%) felt like they were going to die during lockdown, 141 (67.1%) felt lonely at times, and 129 (61.4%) felt sad or low sometimes during the COVID-19 pandemic. A quarter (54) of 210 participants faced abuse of which 42 (77.8%) faced physical abuse from parents. Of 31 participants who sought help, 19 (61.3%) went to their parents with none getting help from non-governmental organisations. Fifty (23.8%) participants were engaged in work; 33 (66%) were paid, 4 (8%) were forced to work, and 22 (44%) faced physical challenges at their jobs. Conclusion: There was a substantial impact of the COVID-19 pandemic on the education and psychosocial wellbeing of school-going children in Bududa District. A comprehensive child psychological support service should be scaled up to provide support to school going children in vulnerable communities.Item Factors Associated with Readiness to Start Antiretroviral Therapy (ART) among young people (15-24 years) at four HIV clinics in Mulago Hospital, Uganda(African Health Sciences, 2021) Nkalubo, Jonathan; Mugaba, Moureen; Asasira, Ignatius; Nakiganda, Racheal; Namutebi, Florence; Arnaud, Nick Ntore; Musisi, Nicholas Kagumba; Abasira, Trinity; Jemba, Pius; Ndyabawe, Racheal; Tumuhairwe, Rosette; Batte, Charles; Bakeera-Kitaka, SabrinaGlobally, the HIV burden continues to rise among young people despite the discovery of ART. This study assessed demographic and psycho-social factors among young people associated with readiness to be initiated on ART. A quantitative cross-sectional study was conducted among newly diagnosed HIV positive young people aged 15-24 years at 4 HIV clinics at Mulago Hospital. Readiness was measured as a self-report by the individual to the question, “How ready do you feel to start ART?Item Hyperglycemia in pregnancy diagnosed using glycated hemoglobin (HbA1c) in Uganda: a preliminary cross-sectional report [version 1; peer review: 1 approved](Emerald Open Research, 2020) Bongomin, Felix; Kyazze, Andrew P.; Ninsiima, Sandra; Olum, Ronald; Nattabi, Gloria; Nabakka, Winnie; Kukunda, Rebecca; Batte, Charles; Ssekamatte, Phillip; Baruch Baluku, Joseph; Kibirige, Davis; Cose, Stephen; Andia-Biraro, IreneHyperglycemia in pregnancy (HIP) is a common medical complication during pregnancy and is associated with several short and long-term maternal-fetal consequences. We aimed to determine the prevalence and factors associated with HIP among Ugandan women. Methods: We consecutively enrolled eligible pregnant women attending antenatal care at Kawempe National Referral Hospital, Kampala, Uganda in September 2020. Mothers known to be living with diabetes mellitus or haemoglobinopathies and those with anemia (hemoglobin <11g/dl) were excluded. Random blood sugar (RBS) and glycated hemoglobin A1c (HbA1c) were measured on peripheral venous blood samples. HIP was defined as an HbA1c ≥5.7% with its subsets of diabetes in pregnancy (DIP) and prediabetes defined as HbA1c of ≥6.5% and 5.7-6.4% respectively. ROC curve analysis was performed to determine the optimum cutoff of RBS to screen for HIP. Results: A total of 224 mothers with a mean (± SD) age 26±5 years were enrolled, most of whom were in the 2nd or 3rd trimester (94.6%, n=212) with a mean gestation age of 26.6±7.3 weeks. Prevalence of 6HIP was 11.2% (n=25) (95% CI: 7.7-16.0). Among the mothers with HIP, 2.2% (n=5) had DIP and 8.9% (n=20) prediabetes. Patients with HIP were older (28 years vs. 26 years, p=0.027), had previous tuberculosis (TB) contact (24% vs. 6.5%, p=0.003) and had a bigger hip circumference (107.8 (±10.4) vs. 103.3 (±9.7) cm, p = 0.032). However only previous TB contact was predictive of HIP (odds ratio: 4.4, 95% CI: 1.2-14.0; p=0.022). Using HbA1c as a reference variable, we derived an optimum RBS cutoff of 4.75 mmol/L as predictive of HIP with a sensitivity and specificity of 90.7% and 56.4% (area under the curve = 0.75 (95% CI: 0.70-0.80, p<0.001)), respectively. Conclusions: HIP is common among young Ugandan women, the majority of whom are without identifiable risk factors.Item Latent Tuberculosis Infection Status of Pregnant Women in Uganda Determined Using QuantiFERON TB Gold-Plus(Oxford University Press, 2021) Bongomin, Felix; Ssekamatte, Phillip; Nattabi, Gloria; Olum, Ronald; Ninsiima, Sandra; Kyazze, Andrew Peter; Nabakka, Winnie; Kukunda, Rebecca; Cose, Stephen; Kibirige, Davis; Batte, Charles; Kaddumukasa, Mark; Kirenga, Bruce J.; Nakimuli, Annettee; Baruch Baluku, Joseph; ndia-Biraro, Irene AThe risk of progression of latent tuberculosis infection (LTBI) to active disease increases with pregnancy. This study determined the prevalence and risk factors associated with LTBI among pregnant women in Uganda. Methods. We enrolled 261 pregnant women, irrespective of gestational age. Participants who had known or suspected active tuberculosis (TB) on the basis of clinical evaluation or who had recently received treatment for TB were excluded. LTBI was defined as an interferon-γ concentration ≥0.35 IU/mL (calculated as either TB1 [eliciting CD4+ T-cell responses] or TB2 [eliciting CD8+ T-cell responses] antigen minus nil) using QuantiFERON TB Gold-Plus (QFT-plus) assay. Results. LTBI prevalence was 37.9% (n = 99) (95% confidence interval [CI], 32.3–44.0). However, 24 (9.2%) subjects had indeterminate QFT-plus results. Among participants with LTBI, TB1 and TB2 alone were positive in 11 (11.1%) and 18 (18.2%) participants, respectively. In multivariable analysis, human immunodeficiency virus (HIV) infection (adjusted odds ratio [aOR], 4.4 [95% confidence interval {CI}, 1.1–18.0]; P = .04) and age 30–39 years (aOR, 4.0 [95% CI, 1.2–12.7]; P = .02) were independently associated with LTBI. Meanwhile, smoking status, alcohol use, nature of residence, crowding index, and TB contact were not associated with LTBI. Conclusions. Our findings are in keeping with the evidence that HIV infection and advancing age are important risk factors for LTBI in pregnancy. In our setting, we recommend routine screening for LTBI and TB preventive therapy among eligible pregnant women.Item Prevalence and factors associated with neonatal hypoglycemia in Northern Uganda: a community-based crosssectional study(Tropical Medicine and Health, 2020) Mukunya, David; Odongkara, Beatrice; Piloya, Thereza; Nankabirwa, Victoria; Achora, Vincentina; Batte, Charles; Ditai, James; Tylleskar, Thorkild; Ndeezi, Grace; Kiguli, Sarah; Tumwine, James K.Neonatal hypoglycemia is the most common endocrine abnormality in children, which is associated with increased morbidity and mortality. The burden and risk factors of neonatal hypoglycemia in rural communities in sub-Saharan Africa are unknown. Objective: To determine the prevalence and risk factors for neonatal hypoglycemia in Lira District, Northern Uganda. Methods: This was a community-based cross-sectional study, nested in a cluster randomized controlled trial designed to promote health facility births and newborn care practices in Lira District, Northern Uganda. This study recruited neonates born to mothers in the parent study. Random blood glucose was measured using an On Call® Plus glucometer (ACON Laboratories, Inc., 10125 Mesa Road, San Diego, CA, USA). We defined hypoglycemia as a blood glucose of < 47 mg/dl. To determine the factors associated with neonatal hypoglycemia, a multivariable linear regression mixed-effects model was used. Results: We examined 1416 participants of mean age 3.1 days (standard deviation (SD) 2.1) and mean weight of 3.2 kg (SD 0.5). The mean neonatal blood glucose level was 81.6 mg/dl (SD 16.8). The prevalence of a blood glucose concentration of < 47 mg/dl was 2.2% (31/1416): 95% CI 1.2%, 3.9%. The risk factors for neonatal hypoglycemia were delayed breastfeeding initiation [adjusted mean difference, − 2.6; 95% CI, − 4.4, − 0.79] and child age of 3 days or less [adjusted mean, − 12.2; 95% CI, − 14.0, − 10.4]. Conclusion: The incidence of neonatal hypoglycemia was low in this community and was predicted by delay in initiating breastfeeding and a child age of 3 days or less. We therefore suggest targeted screening and management of neonatal hypoglycemia among neonates before 3 days of age and those who are delayed in the onset of breastfeeding.Item Prevalence and factors associated with non-adherence to multi-drug resistant tuberculosis (MDR-TB) treatment at Mulago National Referral Hospital, Kampala, Uganda(African Health Sciences, 2021) Batte, Charles; Namusobya, Martha S.; Kirabo, Racheal; Mukisa, John; Adakun, Susan; Katamba, AchillesIn Uganda, 12% of previously treated TB cases and 1.6% of new cases have MDR-TB and require specialized treatment and care. Adherence is crucial for improving MDR-TB treatment outcomes. There is paucity of information on the extent to which these patients adhere to treatment and what the drivers of non-adherence are. Methods: We conducted a cohort study using retrospectively collected routine program data for patients treated for MDRTB between January 2012 – May 2016 at Mulago Hospital. We extracted anonymized data on non-adherence (missing 10% or more of DOT), socio-economic, demographic, and treatment characteristics of the patients. All participants were sensitive to MDR-TB drugs after second line Drug Susceptible Testing (DST) at entry into the study. Factors associated with non-adherence to MDR-TB treatment were determined using generalized linear models for the binomial family with log link and robust standard errors. We considered a p- value less than 0.05 as statistically significant. Results: The records of 227 MDR- TB patients met the inclusion criteria, 39.4% of whom were female, 32.6% aged between 25 – 34 years, and 54.6% living with HIV/AIDS. About 11.9% of the patients were non-adherent. The main driver for non-adherence was history of previous DR-TB treatment; previously treated DR-TB patients were 3.46 (Adjusted prevalence ratio: 3.46, 95 % CI: 1.68 - 7.14) times more likely to be non-adherent. Conclusion: One in 10 MDR-TB patients treated at Mulago hospital is non-adherent to treatment. History of previous DRTB treatment was significantly associated with non-adherence in this study. MDR-TB program should strengthen adherence counselling, strengthen DST surveillance, and close monitoring for previously treated DR-TB patients.Item Prevalence and factors contributing to mental health challenges among school-going adolescents: a case of a climate-vulnerable Manafwa Watershed in Uganda(BioMed Central, 2024-10) Batte, Charles; Apio, Pamela Okwir; Semulimi, Andrew Weil; Nuwasiima, Shivan; Kasoma, Ronald Mutebi; Mwesigwa, Martin Menya; Twinamasiko, Nelson; Siddharthan, Trishul; Mukisa, John; Mukunya, David; Abaatyo, Joan; Nalugya, Joyce SserunjogiGlobally, mental health challenges are common among school-going adolescents, with a prevalence of 50.2% and 43.6% for depression and anxiety disorders, respectively. In Northeastern Uganda, a prevalence of 26.6% and 8.6% for anxiety and depressive disorders respectively were reported among children. School-going adolescents are at higher risk of developing these mental health challenges and this could be worsened by natural disasters like landslides. We aimed to determine the prevalence and factors contributing to mental health challenges (having at least one of following; depression, anxiety, anger, disruptive behaviour and social concept) among school adolescents in the Manafwa Watershed area.BACKGROUNDGlobally, mental health challenges are common among school-going adolescents, with a prevalence of 50.2% and 43.6% for depression and anxiety disorders, respectively. In Northeastern Uganda, a prevalence of 26.6% and 8.6% for anxiety and depressive disorders respectively were reported among children. School-going adolescents are at higher risk of developing these mental health challenges and this could be worsened by natural disasters like landslides. We aimed to determine the prevalence and factors contributing to mental health challenges (having at least one of following; depression, anxiety, anger, disruptive behaviour and social concept) among school adolescents in the Manafwa Watershed area.This was a cross-sectional study in 3 districts of the Manafwa watershed area (Bududa, Manafwa, and Butaleja). We selected school-going adolescents aged 13-18 years because of the nature of study tools. Mental health challenges (anxiety, depression, anger, disruptive behaviour and self-concept) were assessed using the Beck Youth Inventory-II. Descriptive statistics and inferential analysis were performed to determine factors associated with mental health challenges.METHODSThis was a cross-sectional study in 3 districts of the Manafwa watershed area (Bududa, Manafwa, and Butaleja). We selected school-going adolescents aged 13-18 years because of the nature of study tools. Mental health challenges (anxiety, depression, anger, disruptive behaviour and self-concept) were assessed using the Beck Youth Inventory-II. Descriptive statistics and inferential analysis were performed to determine factors associated with mental health challenges.A total of 762 adolescents participated, with a median age of 17 years (interquartile range =16-17 years). More than half of the students were females. The prevalence of mental health challenges was 65% with a (confidence interval) = 54.0% - 75.0%; the majority 44% of the participants had anxiety, and 31% had disruptive behaviour. Families with more than five children [adjusted odds ratio = 1.18, 95% confidence interval= 1.08-1.29, p value = <0.001] and substance abuse [adjusted odds ratio = 1.20, 95% confidence interval= 1.15-1.24, p value <0.001] were significantly associated with mental health challenges.RESULTSA total of 762 adolescents participated, with a median age of 17 years (interquartile range =16-17 years). More than half of the students were females. The prevalence of mental health challenges was 65% with a (confidence interval) = 54.0% - 75.0%; the majority 44% of the participants had anxiety, and 31% had disruptive behaviour. Families with more than five children [adjusted odds ratio = 1.18, 95% confidence interval= 1.08-1.29, p value = <0.001] and substance abuse [adjusted odds ratio = 1.20, 95% confidence interval= 1.15-1.24, p value <0.001] were significantly associated with mental health challenges.The prevalence of mental health challenges among students was high with majority having anxiety and disruptive behaviour. Adolescents from families with more than five children and those with substance abuse were more likely to have mental health challenges. We therefore recommend that various stakeholders such as the Ministry of Health, and the Ministry of Education, design a curriculum that caters to the mental health needs of children. Family planning awareness, awareness on Government laws prohibiting alcohol and substance use, and parenting skills should be raised by the local leaders.CONCLUSIONThe prevalence of mental health challenges among students was high with majority having anxiety and disruptive behaviour. Adolescents from families with more than five children and those with substance abuse were more likely to have mental health challenges. We therefore recommend that various stakeholders such as the Ministry of Health, and the Ministry of Education, design a curriculum that caters to the mental health needs of children. Family planning awareness, awareness on Government laws prohibiting alcohol and substance use, and parenting skills should be raised by the local leaders.Item Prevalence of Electrocardiographic Abnormalities Among People Living With HIV/AIDS in Sub-saharan Africa: Protocol for a Systematic Review and Meta analysis(Researchsquare, 2021) Semulimi, Andrew Weil M.; Kyazze, Andrew Peter; Mukisa, John; Batte, Charles; Bongomin, FelixElectrocardiographic (ECG) abnormalities are highly prevalent among people living with HIV/AIDS (PLWHA) contributing to the rising burden of cardiovascular diseases among this population. SubSaharan Africa (SSA) contributes more than two thirds to the global burden of HIV/AIDS. However, an accurate account of the prevalence of ECG abnormalities in SSA is unknown. This study aims to determine the prevalence of ECG abnormalities among PLWHA in Sub-Saharan Africa. A systematic review and meta-analysis will be conducted. Databases including EMBASE, MEDLINE, African Journal Online and The Cochrane Library (Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Methodology Register) will be used to search for studies published between 1st January 2000 and 31st December 2020. Studies reporting any form of ECG abnormalities will be considered. Additionally, articles in both English and French will be reviewed. Articles will be screened and reviewed by two independent reviewers to determine their eligibility and any disagreement will be resolved through discussions with fourth and fifth reviewer. Eligibility of the studies will be assessed and judged based on the pre-set criteria. Retrieved studies will be assessed for validity using the Cochrane risk of bias tool and the modified Newcastle Ottawa Scale by two reviewers. Analysis of proportions will be done using STATA MP Version 16.0. A p<0.05 will be considered statistically significant. In the face of a growing burden of cardiovascular diseases among PLWHA, this study will provide an estimate of ECG abnormalities among PLWHA which will emphasize the importance of ECGs in screening for cardiovascular diseases in this population.Item Using mobile audiometry (Wulira App) to assess noise induced hearing loss among industrial workers in Kampala, Uganda: A cross-sectional study(Plos one, 2023) Batte, Charles; Atukunda, Immaculate; Semulimi, Andrew Weil; Nakabuye, Mariam; Bwambale, Festo; Mumbere, Joab; Twinamasiko, Nelson; Mukunya, David; Nyarubeli, Israel Paul; Mukisa, JohnOccupational noise is a common cause of hearing loss in low-income countries. Unfortunately, screening for hearing loss is rarely done due to technical and logistical challenges associated with pure tone audiometry. Wulira app is a valid and potentially cost-effective alternative to pure tone audiometry in screening for occupational hearing loss. We aimed to determine the prevalence of occupational hearing loss among workers in a metal industry company in Kampala district.