Browsing by Author "Kihembo, Christine"

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    Effects and factors associated with indoor residual spraying with Actellic 300 CS on malaria morbidity in Lira District, Northern Uganda
    (Malaria Journal, 2019) Tugume, Abdulaziz; Muneza, Fiston; Oporia, Frederick; Kiconco, Arthur; Kihembo, Christine; Nakanwagi Kisakye, Angela; Nsubuga, Peter; Sekimpi, Deogratias; Yeka, Adoke
    Indoor residual spraying (IRS) with Actellic 300 CS was conducted in Lira District between July and August 2016. No formal assessment has been conducted to estimate the effect of spraying with Actellic 300 CS on malaria morbidity in the Ugandan settings. This study assessed malaria morbidity trends before and after IRS with Actellic 300 CS in Lira District in Northern Uganda. Methods: The study employed a mixed methods design. Malaria morbidity records from four health facilities were reviewed, focusing on 6 months before and after the IRS intervention. The outcome of interest was malaria morbidity defined as; proportion of outpatient attendance due to total malaria, proportion of outpatient attendance due to confirmed malaria and proportion of malaria case numbers confirmed by microscopy or rapid diagnostic test. Since malaria morbidity was based on count data, an ordinary Poisson regression model was used to obtain percentage point change (pp) in monthly malaria cases before and after IRS. A household survey was also conducted in 159 households to determine IRS coverage and factors associated with spraying. A modified Poisson regression model was fitted to determine factors associated with household spray status. Results: The proportion of outpatient attendance due to malaria dropped from 18.7% before spraying to 15.1% after IRS. The proportion of outpatient attendance due to confirmed malaria also dropped from 5.1% before spraying to 4.0% after the IRS intervention. There was a decreasing trend in malaria test positivity rate (TPR) for every unit increase in month after spraying. The decreasing trend in TPR was more prominent 5–6 months after the IRS intervention (Adj. pp = − 0.60, P-value = 0.015; Adj. pp = − 1.19, P-value < 0.001). The IRS coverage was estimated at 89.3%. Households of respondents who were formally employed or owned any form of business were more likely to be unsprayed; (APR = 5.81, CI 2.72–12.68); (APR = 3.84, CI 1.20–12.31), respectively
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    Evaluation of the ebola virus disease preparedness and readiness program in Uganda: 2018 to 2019
    (Pan African Medical Journal, 2021) Nsubuga, Peter; Masiira, Ben; Kihembo, Christine; Byakika-Tusiime, Jayne; Ryan, Caroline; Nanyunja, Miriam; Kamadjeu, Raoul; Talisuna, Ambrose
    Introduction: the Democratic Republic of Congo (DRC) declared its 10th outbreak of Ebola virus disease (EVD) in 42 years on August 1st 2018. The rapid rise and spread of the EVD outbreak threatened health security in neighboring countries and global health security. The United Nations developed an EVD preparedness and readiness (EVD-PR) plan to assist the nine neighboring countries to advance their critical preparedness measures. In Uganda, EVD-PR was implemented between 2018 and 2019. The World Health Organization commissioned an independent evaluation to assess the impact of the investment in EVD-PR in Uganda. Objectives: i) to document the program achievements; ii) to determine if the capacities developed represented good value for the funds and resources invested; iii) to assess if more cost-effective or sustainable alternative approaches were available; iv) to explore if the investments were aligned with country public health priorities; and v) to document the factors that contributed to the program success or failure. Methods: during the EVD preparedness phase, Uganda's government conducted a risk assessment and divided the districts into three categories, based on the potential risk of EVD. Category I included districts that shared a border with the DRC provinces where EVD was ongoing or any other district with a direct transport route to the DRC. Category II were districts that shared a border with the DRC but not bordering the DRC provinces affected by the EVD outbreak. Category III was the remaining districts in Uganda. EVD-PR was implemented at the national level and in 22 category I districts. We interviewed key informants involved in program design, planning and implementation or monitoring at the national level and in five purposively selected category I districts. Results: Ebola virus disease preparedness and readiness was a success and this was attributed mainly to donor support, the ministry of health's technical capacity, good coordination, government support and community involvement. The resources invested in EVD-PR represented good value for the funds and the activities were well aligned to the public health priorities for Uganda. Conclusion: Ebola virus disease preparedness and readiness program in Uganda developed capacities that played an essential role in preventing cross border spread of EVD from the affected provinces in the DRC and enabled rapid containment of the two importation events. These capacities are now being used to detect and respond to the COVID-19 pandemic.
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    Factors Associated with Utilisation of Couple HIV Counselling and Testing Among HIV‑Positive Adults in Kyoga Fishing Community Uganda, May 2017: Cross Sectional Study
    (AIDS and behavior, 2017) Nakiire, Lydia; Kabwama, Steven; Majwala, Robert; Bbale, Joy Kusiima; Makumbi, Issa; Kalyango, Joan; Kihembo, Christine; Masiira, Ben; Bulage, Lilian; Kadobera, Daniel; Ario, Alex Riolexus; Nsubuga, Peter
    Couple HIV counseling and testing (CHCT) is key in preventing heterosexual HIV transmission and achievement of 90-90-90 UNAIDS treatment targets by 2020. We conducted secondary data analysis to assess utilization of CHCT and associated factors using logistic regression. 58/134 participants (49%) had ever utilized CHCT. Disclosure of individual HIV results to a partner [aOR = 16; 95% CI: (3.6–67)], residence for > 1 < 5 years [aOR = 0.04; 95% CI (0.005–0.33)], and none mobility [aOR = 3.6; 95% CI (1.1–12)] were significantly associated with CHCT. Age modified relationship between CHCT and disclosure (Likelihood-ratio test LR chi2 = 4.2 (p value = 0.041). Disclosure of individual HIV results with a partner and residence for more than 1 year improved utilization of CHCT; mobility reduced the odds of CHCT. Interventions should target prior discussion of individual HIV results among couples and mobile populations to increase CHCT.
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    Factors Associated with Utilisation of Couple HIV Counselling and Testing Among HIV‑Positive Adults in Kyoga Fishing Community Uganda, May 2017: Cross Sectional Study
    (AIDS and behavior, 2020) Nakiire, Lydia; Kabwama, Steven; Majwala, Robert; Kusiima Bbale, Joy; Makumbi, Issa; Kalyango, Joan; Kihembo, Christine; Masiira, Ben; Bulage, Lilian; Kadobera, Daniel; Riolexus Ario, Alex; Nsubuga, Peter; Wanyenze, Rhoda
    Couple HIV counseling and testing (CHCT) is key in preventing heterosexual HIV transmission and achievement of 90-90- 90 UNAIDS treatment targets by 2020. We conducted secondary data analysis to assess utilization of CHCT and associated factors using logistic regression. 58/134 participants (49%) had ever utilized CHCT. Disclosure of individual HIV results to a partner [aOR = 16; 95% CI: (3.6–67)], residence for > 1 < 5 years [aOR = 0.04; 95% CI (0.005–0.33)], and none mobility [aOR = 3.6; 95% CI (1.1–12)] were significantly associated with CHCT. Age modified relationship between CHCT and disclosure (Likelihood-ratio test LR chi2 = 4.2 (p value = 0.041). Disclosure of individual HIV results with a partner and residence for more than 1 year improved utilization of CHCT; mobility reduced the odds of CHCT. Interventions should target prior discussion of individual HIV results among couples and mobile populations to increase CHCT.
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    Factors Associated with Virological Nonsuppression among HIV-Positive Patients on Antiretroviral Therapy in Uganda, August 2014–July 2015
    (BMC infectious diseases, 2017) Bulage, Lilian; Ssewanyana, Isaac; Nankabirwa, Victoria; Nsubuga, Fred; Kihembo, Christine; Pande, Gerald; Ario, Alex R.; Matovu, Joseph K. B.; Wanyenze, Rhoda K.; Kiyaga, Charles
    Despite the growing number of people on antiretroviral therapy (ART), there is limited information about virological non suppression and its determinants among HIV-positive (HIV+) individuals enrolled in HIV care in many resource-limited settings. We estimated the proportion of virologically non-suppressed patients, and identified the factors associated with virological non suppression. Methods: We conducted a descriptive cross-sectional study using routinely collected program data from viral load (VL) samples collected across the country for testing at the Central Public Health Laboratories (CPHL) in Uganda. Data were generated between August 2014 and July 2015. We extracted data on socio-demographic, clinical and VL testing results. We defined virological non-suppression as having ≥1000 copies of viral RNA/ml of blood for plasma or ≥5000 copies of viral RNA/ml of blood for dry blood spots. We used logistic regression to identify factors associated with virological non-suppression. Results: The study was composed of 100,678 patients; of these, 94,766(94%) were for routine monitoring, 3492(4%) were suspected treatment failures while 1436(1%) were repeat testers after suspected failure. The overall proportion of non suppression was 11%. Patients on routine monitoring registered the lowest (10%) proportion of nonsuppressed patients. Virological non-suppression was higher among suspected treatment failures (29%) and repeat testers after suspected failure (50%). Repeat testers after suspected failure were six times more likely to have virological non-suppression (ORadj = 6.3, 95%CI = 5.5–7.2) when compared with suspected treatment failures (ORadj = 3.3, 95%CI = 3.0–3.6). The odds of virological non-suppression decreased with increasing age, with children aged 0–4 years (ORadj = 5.3, 95%CI = 4.6–6.1) and young adolescents (ORadj = 4.1, 95%CI = 3.7–4.6) registering the highest odds. Poor adherence (ORadj = 3.4, 95%CI = 2.9–3.9) and having active TB (ORadj = 1.9, 95%CI = 1.6–2.4) increased the odds of virological non-suppression. However, being on second/third line regimens (ORadj = 0.86, 95%CI = 0.78–0.95) protected patients against virological non-suppression. Conclusion: Young age, poor adherence and having active TB increased the odds of virological non-suppression while second/third line ART regimens were protective against non-suppression. We recommend close follow up and intensified targeted adherence support for repeat testers after suspected failure, children and adolescents.
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    Multisectoral prioritization of zoonotic diseases in Uganda, 2017: A One Health perspective
    (PLoS ONE, 2017) Sekamatte, Musa; Krishnasamy, Vikram; Bulage, Lilian; Kihembo, Christine; Nantima, Noelina; Monje, Fred; Ndumu, Deo; Sentumbwe, Juliet; Mbolanyi, Betty; Aruho, Robert; Kaboyo, Winyi; Mutonga, David; Basler, Colin; Paige, Sarah; Behravesh, Casey Barton
    Zoonotic diseases continue to be a public health burden globally. Uganda is especially vulnerable due to its location, biodiversity, and population. Given these concerns, the Ugandan government in collaboration with the Global Health Security Agenda conducted a One Health Zoonotic Disease Prioritization Workshop to identify zoonotic diseases of greatest national concern to the Ugandan government.