Browsing by Author "Chinyenze, Kundai"

Now showing 1 - 6 of 6
  • Thumbnail Image
    Item
    Barriers and Facilitators of Family Planning Use in Fishing Communities of Lake Victoria in Uganda
    (Journal of primary care & community health, 2020) Nanvubya, Annet; Wanyenze, Rhoda K.; Kamacooko, Onesmus; Nakaweesa, Teddy; Mpendo, Juliet; Kawoozo, Barbarah; Matovu, Francis; Nabukalu, Sarah; Omoding, Geoffrey; Kaweesi, Jed; Ndugga, John; Bagaya, Bernard; Chinyenze, Kundai; Price, Matt; Van Geertruyden, Jean P.
    Family planning (FP) is a key element in the conduct of research and is essential in managing family sizes. Although fishing communities (FCs) are targeted populations for HIV prevention research, their FP practices are poorly understood. We explored barriers and facilitators of FP use in FCs of Lake Victoria in Uganda. Methods: We employed a mixed-methods approach comprising a cross-sectional survey, in-depth interviews, and focus group discussions in 2 FCs. Multivariable logistic regression was used to analyze quantitative data and a thematic approach to generate themes from the qualitative data. Results: Up to 1410 individuals participated in the survey and 47 in the qualitative study. Just over a third (35.6%) used FP. The most commonly used methods were condoms, pills, and injectables. In Kigungu community, participants whose religion was Anglican and Muslim were more likely to use FP than Catholics (adjusted odds ratio [aOR] 1.45; 95% CI 1.05-1.99 and aOR 1.45; 95% CI 1.05-2.07, respectively). Participants were more likely to use FP if they had satisfactory FP knowledge compared to those with no satisfactory FP knowledge (aOR 1.79; 95% CI 1.23-2.61), or if they were married compared to their single counterparts (aOR 1.84; 95% CI 1.32-2.57). In both communities, participants were more likely to use FP if they had 2 or more sexual partners in the past 12 months than those with less than 2 sexual partners (aOR 1.41 95% CI 1.07-1.87 and aOR 2.60; 95% CI 1.36-4.97). Excessive bleeding and delayed fecundity; fertility desire; gender preferences of children; method stock outs and lack of FP trained personnel constituted barriers to FP use. There were also cultural influences in favor of large families.
  • Thumbnail Image
    Item
    Correlates of knowledge of family planning among people living in fishing communities of Lake Victoria, Uganda
    (BMC public health, 2020) Nanvubya, Annet; Wanyenze, Rhoda K.; Nakaweesa, Teddy; Mpendo, Juliet; Kawoozo, Barbarah; Matovu, Francis; Nabukalu, Sarah; Omoding, Geoffrey; Kaweesi, Jed; Ndugga, John; Kamacooko, Onesmus; Chinyenze, Kundai; Price, Matt; Van Geertruyden, Jean P.
    Knowledge of family planning (FP) is a key determinant of contraceptive use which ultimately plays a role in attainment of good health and in conduct of clinical research. People living in fishing communities (FCs) have limited access to health services including FP and are targeted for future clinical research but their knowledge of FP and its correlates are scantily known. We determined correlates of knowledge of FP among people living in FCs of L. victoria in Uganda to inform future FP education programs in FCs. Methods: We conducted a comparative cross-sectional survey among participants aged 15–49 years from Kigungu and Nsazi. Participants were asked if they were aware of any FP method. All those who responded in the affirmative were further asked to mention what FP methods they had heard of or knew. Those who reported knowledge of at least one FP method were asked a series of questions about FP methods and their side effects. Knowledge was categorized into good or poor knowledge based on their mean total score. Poor knowledge constituted a score below the mean while good knowledge constituted a score of more than or equal to the mean total score. To further explore attitudes and perceptions of FP, ten in-depth interviews and four focus group discussions were conducted. Results: Of the 1410 screened participants, 94.5% were aware of at least one FP method. Pills and injectable hormonal methods were the most commonly known methods. Slightly over a third (38%) had good knowledge of FP. Correlates of knowledge of FP were; being female (aOR: 1.92 95% CI: 1.39–2.67), residing in Kigungu (aOR: 4.01 95% CI: 2.77–5.81), being married (aOR: 1.59 95% CI: 1.11–2.28) and currently being in a sexual relationship (aOR: 1.75 95% CI: 1.18–2.60). Concerns about safety and effectiveness of some modern FP methods exist. Misconceptions on effects of FP like sterility, cancers and foetal abnormalities were common
  • Thumbnail Image
    Item
    Mobility for maternal health among women in hard-to-reach fishing communities on Lake Victoria, Uganda; a community-based cross-sectional survey
    (BMC health services research, 2021) Ssetaala, Ali; Ssempiira, Julius; Nanyonjo, Gertrude; Okech, Brenda; Chinyenze, Kundai; Bagaya, Bernard; Price, Matt A.; Kiwanuka, Noah; Degomme, Olivier
    Maternal mortality is still a challenge in Uganda, at 336 deaths per 100,000 live births, especially in rural hard to reach communities. Distance to a health facility influences maternal deaths. We explored women’s mobility for maternal health, distances travelled for antenatal care (ANC) and childbirth among hard-to-reach Lake Victoria islands fishing communities (FCs) of Kalangala district, Uganda. Methods: A cross sectional survey among 450 consenting women aged 15–49 years, with a prior childbirth was conducted in 6 islands FCs, during January-May 2018. Data was collected on socio-demographics, ANC, birth attendance, and distances travelled from residence to ANC or childbirth during the most recent childbirth. Regression modeling was used to determine factors associated with over 5 km travel distance and mobility for childbirth. Results: The majority of women were residing in communities with a government (public) health facility [84.2 %, (379/450)]. Most ANC was at facilities within 5 km distance [72 %, (157/218)], while most women had travelled outside their communities for childbirth [58.9 %, (265/450)]. The longest distance travelled was 257.5 km for ANC and 426 km for childbirth attendance. Travel of over 5 km for childbirth was associated with adolescent girls and young women (AGYW) [AOR = 1.9, 95 % CI (1.1–3.6)], up to five years residency duration [AOR = 1.8, 95 % CI (1.0-3.3)], and absence of a public health facility in the community [AOR = 6.1, 95 % CI (1.4–27.1)]. Women who had stayed in the communities for up to 5 years [AOR = 3.0, 95 % CI (1.3–6.7)], those whose partners had completed at least eight years of formal education [AOR = 2.2, 95 % CI (1.0-4.7)], and those with up to one lifetime birth [AOR = 6.0, 95 % CI (2.0-18.1)] were likely to have moved to away from their communities for childbirth. Conclusions: Despite most women who attended ANC doing so within their communities, we observed that majority chose to give birth outside their communities. Longer travel distances were more likely among AGYW, among shorter term community residents and where public health facilities were absent.
  • Thumbnail Image
    Item
    Oral pre-exposure prophylaxis preference, uptake, adherence and continuation among adolescent girls and young women in Kampala, Uganda: a prospective cohort study
    (Journal of the International AIDS Society, 2022) Mayanja, Yunia; Kamacooko, Onesmus; Lunkuse, Jane Frances; Muturi-Kioi, Vincent; Buzibye, Allan; Omali, Denis; Chinyenze, Kundai; Kuteesa, Monica; Kaleebu, Pontiano; Price, Matt A.
    Oral pre-exposure prophylaxis (PrEP) has been scaled up; however, data from real-world settings are limited. We studied oral PrEP preference, uptake, adherence and continuation among adolescent girls and young women (AGYW) vulnerable to HIV in sub-Saharan Africa. Methods: We conducted a prospective cohort study among 14- to 24-year-old AGYW without HIV who were followed for 12 months in Kampala, Uganda. Within at least 14 days of enrolment, they received two education sessions, including demonstrations on five biomedical interventions that are; available (oral PrEP), will be available soon (long-acting injectable PrEP and anti-retroviral vaginal ring) and in development (PrEP implant and HIV vaccine). Information included mode and frequency of delivery, potential side effects and method availability. Volunteers ranked interventions, 1 = most preferred to 5 = least preferred. Oral PrEP was “preferred” if ranked among the top two choices. All were offered oral PrEP, and determinants of uptake assessed using Poisson regression with robust error variance. Adherence was assessed using plasma tenofovir levels and self-reports. Results: Between January and October 2019, 532 volunteers were screened; 285 enrolled of whom 265 received two education sessions. Mean age was 20 years (SD±2.2), 92.8% reported paid sex, 20.4% reported ≥10 sexual partners in the past 3 months, 38.5% used hormonal contraceptives, 26.9% had chlamydia, gonorrhoea and/or active syphilis. Of 265 volunteers, 47.6% preferred oral PrEP. Willingness to take PrEP was 90.2%; however, uptake was 30.6% (n = 81). Following enrolment, 51.9% started PrEP on day 14 (same day PrEP offered), 20.9% within 30 days and 27.2% after 30 days. PrEP uptake was associated with more sexual partners in the past 3 months: 2–9 partners (aRR = 2.36, 95% CI: 1.20–4.63) and ≥10 partners (aRR 4.70, 95% CI 2.41–9.17); oral PrEP preference (aRR 1.53, 95% CI 1.08–2.19) and being separated (aRR 1.55, 95% CI 1.04–2.33). Of 100 samples from 49 volunteers during follow up, 19 had quantifiable tenofovir levels (>10 μg/L) of which only three were protective (>40 μg/L). Conclusions: Half of AGYW preferred oral PrEP, uptake and adherence were low, uptake was associated with sexual behavioural risk and oral PrEP preference. Development of alternative biomedical products should be expedited to meet enduser preferences and, community delivery promoted during restricted movement.
  • Thumbnail Image
    Item
    Prevalence and correlates of HIV infection among adolescents and young people living in fishing populations along Lake Victoria Fishing Communities in Uganda
    (Pan African Medical Journal, 2020) Nanyonjo, Gertrude; Asiki, Gershim; Ssetaala, Ali; Nakaweesa, Teddy; Wambuzi, Mathias; Nanvubya, Annet; Mpendo, Juliet; Okech, Brenda; Kato Kitandwe, Paul; Nielsen, Leslie; Nalutaaya, Annet; Welsh, Sabrina; Ssentalo Bagaya, Bernard; Chinyenze, Kundai; Fast, Pat; Price, Matt; Kiwanuka, Noah
    fishing communities in Uganda are key populations for HIV, with persistently higher prevalence and incidence than the general population. Methods: between March and August 2014, a cross sectional survey was conducted in 10 fishing communities of Lake Victoria in Uganda. Data was collected on socio-behavioural characteristics using interviewer administered questionnaires and venous blood collected for HIV testing. Prevalent HIV infections among adolescents and young people aged 13 to 24 years was estimated and the factors associated with those infections determined using multi variable logistic regression modelling. Results: HIV prevalence was 10.8% among the 630 (96.5%) who provided a blood sample. Females were 3.5 times as likely to have HIV infection as males (aOR=3.52, 95% CI: 1.34-9.22). Young people aged 20-24 years were twice as likely to be HIV infected as those aged 13-19 years (aOR=1.77, 95% CI: 0.05-2.10), participants without formal education or those who had studied up to primary level were more likely to be HIV infected than those who had post primary education ((aOR=2.45, 95% CI: 1.19-5.07) or (5.29 (1.35-20.71) respectively). Reporting more than one sexual partner in the past 6 months was associated with HIV prevalent infection than those reporting no sexual partners (aOR=6.44, 95% CI: 1.27-32.83). Conclusion: adolescents and young people aged 13-24 years in fishing communities around Lake Victoria, Uganda, have a high HIV prevalence, with females having a three-fold higher level than males. These findings highlight the need to improve HIV prevention among young females living in these fishing communities.
  • Thumbnail Image
    Item
    Skilled Birth Attendance Among Women in Hard to Reach Island Fishing Communities on Lake Victoria; A Cross- Sectional Survey
    (Research Square, 2020) Ssetaala, Ali; Nanyonjo, Gertrude; Okech, Brenda; Chinyenze, Kundai; Price, Matt A.; Kiwanuka, Noah; Degomme, Olivier
    Maternal deaths continue to be a major challenge for maternal health in Uganda. Maternal deaths are at 336 maternal deaths per 100,000 live births, especially in rural hard to reach communities. Skilled birth attendance is key to preventing most maternal deaths. Rural fishing communities on Lake Victoria, Uganda could among communities with poor maternal health outcomes. We evaluated the extent of, and factors associated with skilled births attendance by women in fishing communities along Lake Victoria, Uganda at the most recent childbirth. Methods: A cross sectional survey among 486 consenting women aged 15-49 years, who were pregnant or had a birth or abortion in the past 6 months was conducted in 6 island fishing communities of Kalangala district, Uganda, during January-May 2018. Interviewer administered questionnaires were used to collect data on sociodemographics, antenatal care and skilled birth attendance during the most recent childbirth. Regression modeling was used to determine factors associated with women’s skilled birth attendance among 450 women with a previous childbirth. Results: Majority of women had a skilled delivery during the most recent birth [86.9%,(391/450)], with less than two in five skilled births being at the islands [34.0%, (133/391)]. Women who received any one of the seven assessed ANC components were twice as likely to have had a skilled childbirth as those who didn’t receive any ANC components (AOR=2.1; 95% CI:1.1-4.0). Joint participant and partner health decisions, reporting no prior pregnancy loss, fewer than two lifetime births and none fishing related partner occupation were also associated with a likelihood of having had a skilled birth during the most recent delivery. Conclusion: Skilled births attendance is still low in these island fishing communities. Tailored interventions to expand provision of components of ANC may improve women’s skilled birth attendance in these islands.