Browsing by Author "Leontsini, Elli"
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Item Contextual Barriers and Motivators to Adult Male Medical Circumcision in Rakai, Uganda(Qualitative health research, 2013) Ssekubugu, Robert; Leontsini, Elli; Wawer, Maria J.; Serwadda, David; Kigozi, Godfrey; Kennedy, Caitlin E.; Nalugoda, Fred; Sekamwa, Richard; Wagman, Jennifer; Gray, Ronald H.Medical male circumcision (MMC) is a central component of HIV prevention. In this study we examined barriers to and facilitators of MMC in Rakai, Uganda. Interviews and focus groups with MMC acceptors, decliners, and community members were collected and analyzed iteratively. Themes were developed based on immersion, repeated reading, sorting, and coding of data using grounded theory. Pain, medical complications, infertility, lack of empirical efficacy, waiting time before resumption of sex, and religion were identified as obstacles to MMC acceptance. Prevention and healing of sexually transmitted infections (STIs), access to HIV and other ancillary care, penile hygiene, and peer influence were key motivators. Voluntary counseling and testing for HIV, partner influence, and sexual potency were both barriers and motivators. Individual and societal factors, such as pain and religion, might slow MMC scale up. Health benefits, such as HIV/STI prevention and penile hygiene, are essential in motivating men to accept MMC.Item Hypertension awareness, treatment and control in Africa: a systematic review(BMC Cardiovascular Disorders, 2013) Kayima, James; Wanyenze, Rhoda K.; Katamba, Achilles; Leontsini, Elli; Nuwaha, FredInadequate diagnosis and suboptimal control of hypertension is a major driver of cardiovascular morbidity and mortality in Africa. Understanding the levels of awareness, treatment and control of hypertension and the associated factors has important implications for hypertension control efforts. Methods: The PubMed database was searched for original articles related to awareness, treatment and control of hypertension in Africa published between 1993 and 2013. The key search terms were: Africa, awareness, treatment, control, and hypertension. Exploration of bibliographies cited in the identified articles was done to provide further studies. Full texts of the articles were obtained from various internet sources and individual authors. A data extraction sheet was used to collect this information. Results: Thirty eight studies drawn from 23 African countries from all regions of the continent met the inclusion criteria. The levels of awareness, treatment and control varied widely from country to country. Rural populations had lower levels of awareness than urban areas. North African countries had the highest levels of treatment in the continent. There was generally poor control of hypertension across the region even among subjects that were aware of their status and those that were treated. On the whole, the women had a better control status than the men. Conclusion: There are low levels of awareness and treatment of hypertension and even lower levels of control. Tailored research is required to uncover specific reasons behind these low levels of awareness and treatment, and especially control, in order to inform policy formulation for the improvement of outcomes of hypertensive patients in Africa.Item Pneumonia among children under five in Uganda: symptom recognition and actions taken by caretakers(African health sciences, 2014) Tuhebwe, Doreen; Tumushabe, Elly; Leontsini, Elli; Wanyenze, Rhoda K.caretakers recognized the danger signs and sought appropriate treatment promptly. Methods: We interviewed 278 caretakers in Mukono district Uganda, whose under-five children had suffered from probable pneumonia two weeks prior to the evaluation. Through structured questionnaires we assessed caretaker’s knowledge about danger signs among under-five children with pneumonia and the actions taken to manage probable pneumonia using descriptive statistics. We also conducted in-depth interviews with caretakers and community health workers. Results: Lower chest wall in drawing (a pneumonia specific danger sign) was mentioned by only 9.4% of the caretakers. Among the Integrated Management of Childhood Illnesses (IMCI) standard general danger signs, inability to feed was the most commonly cited danger sign (37.8%) followed by incessant vomiting (10.1%). No caretaker mentioned all the four standard general danger signs. In terms of actions taken, most caretakers offered drinks (49.6%) and traditional herbs (45.3%) while, 31.7% gave antibiotics. Conclusions: Caretaker’s knowledge about danger signs was inadequate in relation to the IMCI guidelines. Caretakers used both modern and traditional forms of treatment to manage pneumonia. Comprehensive interventions geared at increasing symptom recognition and improving health-seeking behavior are needed to reverse this trend.