Browsing by Author "Biribawa, Claire"

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    Alcohol consumption, hypertension and obesity: Relationship patterns along different age groups in Uganda
    (Preventive Medicine Reports, 2020) Mbona Tumwesigye, Nazarius; Mutungi, Gerald; Bahendeka, Silver; Wesonga, Ronald; Katureebe, Agaba; Biribawa, Claire; Guwatudde, David
    The prevalence of non-communicable diseases including hypertension and obesity is rising and alcohol consumption is a predisposing factor. This study explored the effect of alcohol consumption patterns on the hypertension-age group and obesity-age group relationships. The data were extracted from the 2014 National NCD Survey of adults aged 18–69 years. Hypertension was defined as a condition of having systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg while obesity was defined as having a body mass index ≥30 kg/m2 . Frequent alcohol consumption was measured as alcohol use ≥3 times a week. Multivariable log binomial regression analysis was used to assess independent relationship between the outcomes and alcohol consumption. The prevalences of hypertension, frequent alcohol consumption and obesity increased across age groups but were divergent towards last age group. Hypertension prevalence ratios were higher with higher age groups among moderate and nondrinkers but not among frequent drinkers. Alcohol drinking pattern modified the age hypertension relationship in a model with ungrouped age. The drinking pattern did not modify obesity-age relationship. Alcohol consumption pattern appeared to modify the hypertension-age group relationship. However, more research is needed to explain why prevalence ratios are higher with higher age groups among moderate drinkers and abstainers while they stagnate among the frequent drinkers. There was no evidence to show the effect of alcohol consumption on obesity-age group relationship
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    Estimating the burden of road traffic crashes in Uganda using police and health sector data sources
    (Injury prevention, 2021) Muni, Kennedy Maring; Ningwa, Albert; Osuret, Jimmy; Bayiga Zziwa, Esther; Namatovu, Stellah; Biribawa, Claire; Nakafeero, Mary; Mutto, Milton; Guwatudde, David; Kyamanywa, Patrick; Kobusingye, Olive
    d In many low-income countries, estimates of road injury burden are derived from police reports, and may not represent the complete picture of the burden in these countries. As a result, WHO and the Global Burden of Diseases, Injuries and Risk Factors Project often use complex models to generate country-specific estimates. Although such estimates inform prevention targets, they may be limited by the incompleteness of the data and the assumptions used in the models. In this crosssectional study, we provide an alternative approach to estimating road traffic injury burden for Uganda for the year 2016 using data from multiple data sources (the police, health facilities and mortuaries). Methods A digitised data collection tool was used to extract crash and injury information from files in 32 police stations, 31 health facilities and 4 mortuaries in Uganda. We estimated crash and injury burden using weights generated as inverse of the product of the probabilities of selection of police regions and stations. Results We estimated that 25 729 crashes occurred on Ugandan roads in 2016, involving 59 077 individuals with 7558 fatalities. This is more than twice the number of fatalities reported by the police for 2016 (3502) but lower than the estimate from the 2018 Global Status Report (12 036). Pedestrians accounted for the greatest proportion of the fatalities 2455 (32.5%), followed by motorcyclists 1357 (18%). Conclusions Using both police and health sector data gives more robust estimates for the road traffic burden in Uganda than using either source alone.
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    Gaps in Measles Vaccination Coverage in Kasese district, Western Uganda:Results of a Qualitative Evaluation
    (BMC Infectious Diseases, 2022) Walekhwa, Abel Wilson; Musoke, David; Nalugya, Aisha; Biribawa, Claire; Nsereko, Godfrey; Wafula, Solomon Tsebeni; Nakazibwe, Brenda; Nantongo, Mary; Odera, Doreen Awino; Chiara, Achangwa; Boyce, Ross Mathew; Mulogo, Edgar Mugema
    Despite the availability of a highly effective vaccine, measles remains a substantial public health problem in many countries including Uganda. In this study, conducted between June–August 2020 following a local outbreak, we sought to explore the factors that could affect measles vaccination coverage in rural western Uganda.
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    Multidrug-resistant tuberculosis outbreak associated with poor treatment adherence and delayed treatment: Arua District, Uganda, 2013–2017
    ( BMC infectious diseases, 2019) Okethwangu, Denis; Birungi, Doreen; Biribawa, Claire; Kwesiga, Benon; Turyahabwe, Stavia; Ario, Alex R.; Zhu, Bao-Ping
    In August 2017, the Uganda Ministry of Health was notified of increased cases of multidrug-resistant tuberculosis (MDR-TB) in Arua District, Uganda during 2017. We investigated to identify the scope of the increase and risk factors for infection, evaluate health facilities’ capacity to manage MDR-TB, and recommend evidence-based control measures. We defined an MDR-TB case-patient as a TB patient attending Arua Regional Referral Hospital (ARRH) during 2013–2017 with a sputum sample yielding Mycobacterium tuberculosis resistant to at least rifampicin and isoniazid, confirmed by an approved drug susceptibility test. We reviewed clinical records from ARRH and compared the number of MDR-TB cases during January–August 2017 with the same months in 2013–2016. To identify risk factors specific for MDR-TB among cases with secondary infection, we conducted a case-control study using persons with drug-susceptible TB matched by sub-county of residence as controls. We observed infection prevention and control practices in health facilities and community, and assessed health facilities’ capacity to manage TB. We identified 33 patients with MDR-TB, of whom 30 were secondary TB infection cases. The number of cases during January–August 2017 was 10, compared with 3–4 cases in January–August from 2013 to 2016 (p = 0. 02). Men were more affected than women (6.5 vs 1.6/100,000, p < 0.01), as were cases ≥18 years old compared to those < 18 years (8.7 vs 0.21/100,000, p < 0.01). In the case-control study, poor adherence to first-line anti-TB treatment (aOR = 9.2, 95% CI: 2.3–37) and initiating treatment > 15 months from symptom onset (aOR = 11, 95% CI: 1.5–87) were associated with MDR-TB. All ten facilities assessed reported stockouts of TB commodities. All 15 ambulatory MDR-TB patients we observed were not wearing masks given to them to minimize community infection. The MDR-TB ward at ARRH capacity was 4 patients but there were 11 patients. The number of cases during January–August in 2017 was significantly higher than during the same months in 2013–2016. Poor adherence to TB drugs and delayed treatment initiation were associated with MDR-TB infection. We recommended strengthening directly-observed treatment strategy, increasing access to treatment services, and increasing the number of beds in the MDR-TB ward at ARRH
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    State of pedestrian road safety in Uganda: a qualitative study of existing interventions
    (African Health Sciences, 2021) Osuret, Jimmy; Namatovu, Stellah; Biribawa, Claire; Balugaba, Bonny Enock; Bayiga Zziwa, Esther; Muni, Kennedy; Ningwa, Albert; Oporia, Frederick; Mutto, Milton; Kyamanywa, Patrick; Guwatudde, David; Kobusingye, Olive
    Pedestrians in Uganda account for 40% of road traffic fatalities and 25% of serious injuries annually. We explored the current pedestrian road traffic injury interventions in Uganda to understand why pedestrian injuries and deaths continue despite the presence of interventions. Methods: We conducted a qualitative study that involved a desk review of road safety policy, regulatory documents, and reports. We supplemented the document review with 14 key informant interviews and 4 focus group discussions with participants involved in road safety. Qualitative thematic content analysis was done using ATLAS. ti 7 software. Results: Five thematic topics emerged. Specifically, Uganda had a Non-Motorized Transport Policy whose implementation revealed several gaps. The needs of pedestrians and contextual evidence were ignored in road systems. The key programmatic challenges in pedestrian road safety management included inadequate funding, lack of political support, and lack of stakeholder collaboration. There was no evidence of plans for monitoring and evaluation of the various pedestrian road safety interventions. Conclusion: The research revealed low prioritization of pedestrian needs in the design, implementation, and evaluation of pedestrian road safety interventions. Addressing Uganda’s pedestrian needs requires concerted efforts to coordinate all road safety activities, political commitment, and budgetary support at all levels.
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    State of pedestrian road safety in Uganda: are interventions failing or absent?
    (Research Square, 2019) Osuret, Jimmy; Namatovu, Stellah; Biribawa, Claire; Balugaba, Bonny E.; Bayiga Zziwa, Esther; Muni, Kennedy; Ningwa, Albert; Oporia, Frederick; Mutto, Milton; Kyamanywa, Patrick; Guwatudde, David; Kobusingye, Olive
    Background In Uganda, pedestrians are the most frequently injured category of road users, accounting for 40% of road traffic fatalities and 25% of serious injuries every year. There is paucity of information on existing pedestrian interventions and challenges that affect their implementation in Uganda. In this paper, we ascertain the state of pedestrian road safety interventions in Uganda and explore the challenges in the process of design, implementation, monitoring and evaluation of existing interventions. Methods We conducted a qualitative study that started with a desk review of existing policy documents, police statistics, media reports, non-governmental organization reports, and published research. We supplemented the review with 14 key informant interviews and 4 focus group discussions. Participants were drawn from various agencies and stakeholders responsible for road safety. In total, we collected and synthesized data on the design, implementation, and evaluation of pedestrian safety interventions from 25 documents. Data were analyzed using qualitative thematic content analysis. Results The National Road Safety Council within the Ministry of Works and Transport is the lead agency tasked with coordinating all road safety efforts, while the Uganda Police is largely engaged in enforcing pedestrian safety. We identified several existing policies and regulations for pedestrian safety like the Non- Motorized Transport policy whose implementation has been inadequate. Implementation is constrained by weak institutional capacity and limited resources. Moreover, road safety stakeholders operated in silos and this hindered efforts to coordinate pedestrian safety activities. Interventions like road designs were implemented with limited reference to any supporting data and therefore did not cater for pedestrian needs. Conclusion There are interventions targeting pedestrian safety in Uganda, but effective implementation is lacking or failing due to constraints related to weak institutional capacity. This necessitates strategies to mobilize resources to strengthen the capacity of the lead agency to effectively coordinate road safety interventions.
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    Timing of onset of symptom for COVID-19 from publicly reported confirmed cases in Uganda
    (Pan African Medical Journal, 2021) Riolexus Ario, Alex; Basuta Mirembe, Bernadette; Biribawa, Claire; Bulage, Lilian; Kadobera, Daniel; Wamala, Robert
    incubation period for COVID-19, 2-14 (average 5-6) days. Timing of onset of COVID-19 signs and symptoms amongst cases in Uganda is however not known. Methods: we utilized data on real-time reverse transcription polymerase chain reaction (RT-PCR) confirmed cases to investigate symptom onset timing, from 21st March to 4th September 2020. Since timing of COVID-19 symptom onset is highly likely to be an interval rather than a point estimate, we generated 3-tertile categories: 1st, 2nd and 3rd tertile denoting symptom presentation within 3, 4 to 6 and at least 7 days. We considered all signs and symptoms in the database and analysed using Chi-square test and multinomial logistic regression, controlling for age and sex. Results: we analysed a total of 420 symptomatic case-patients; 72.0% were males, median age of 33 years. Common symptoms were cough (47.6%), running nose (46.2%), fever (27.4%), headache (26.4%) and sore throat (20.5%). We utilized 293 cases with clinical symptom onset date recorded. Most of the patients, 37.5%, presented symptom within 3 days, 31.4% had symptoms in the 2nd and 31.4% in 3rd tertile, denoting 4 to 6 days and at least 7 days after exposure. Running nose (RRR=0.45, 95%CI: 0.24-0.84) and chest pain (RRR=0.64, 95%CI: 0.09-0.72) were more likely to occur in 3rd tertile than 1st or 2nd tertile. Cases aged ≥20 years were less likely to have symptoms in the 1st and 2nd tertile compared to ≤20 years (p<0.05). Conclusion: our study provides empirical evidence for epidemiological characterization of cases by signs and symptoms which complements current proposals for the length of active monitoring of persons exposed to SARS-CoV-2.