Browsing by Author "Matovu, Nicholas"
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Item 8-Year Follow-up of a Maternal Education Trial in a Low-Resource Setting(Pediatrics, 2024-04) Kakwangire, Paul; Muhoozi, K. M. Grace; Ngari, Moses; Matovu, Nicholas; Westerberg, Cecilie Ane; Iversen, Ole Per; Atukunda, PrudenceOBJECTIVES: Nutrition and stimulation interventions promote early childhood development, but little is known about their long-term benefits in low- and middle-income countries. We conducted a follow-up study of a cluster-randomized maternal education trial performed in children aged 6 to 8 months to assess the sustainability of developmental benefits after 8 years. METHODS: The education intervention lasted 6 months and consisted of nutrition, hygiene, sanitation, and child stimulation aspects. We assessed child processing and cognitive abilities using the Kaufman Assessment Battery for Children Second Edition (KABC-II) and attention and inhibitory control using the Test of Variables of Attention after 8 years. The original trial included 511 mother-child pairs (intervention, n 5 263; control, n 5 248), whereas in the current study, 361 (71%; intervention, n 5 185; control, n 5 176) pairs were available for analyses. RESULTS: The intervention group scored higher than the controls (all P < .001) on all 5 KABC-II subscales and on the KABC-II global score (mean difference: 14; 95% confidence interval, 12–16; P < .001). For all 5 Test of Variables of Attention variables, the intervention group scored higher than the controls on both the visual and auditory tasks (all P < .05). Because the intervention was delivered as a package, a limitation is that we cannot pinpoint the individual contribution of each component (nutrition, hygiene, and stimulation) to the developmental benefits. CONCLUSIONS: The intervention group consistently scored markedly higher on both neuropsychological tests. Thus, even 8 years after the original maternal education intervention, the developmental benefits that we observed at child age of 1, 2, and 3 years, were sustained.Item Colorectal cancer research priorities in Uganda: perspectives from local key experts and stakeholders(Informa UK Limited, 2024-10-25) Matovu, Nicholas; Mugisha, Noleb Mugume; Jatho, Alfred; McShane, Charlene M.The incidence of colorectal cancer (CRC) is increasing in Uganda but there is limited local research to guide policy and programming for CRC prevention and control. A stakeholder engagement workshop took place in Kampala on 19 March 2024 to identify challenges and opportunities for CRC prevention and control in Uganda. A total of 30 stakeholders with expertise in CRC primary and secondary prevention, diagnosis, treatment, palliative care as well as cancer survivors participated in the workshop. Key challenges for primary prevention included low knowledge/awareness of CRC among the general population and health workers, and rising prevalence of CRC related risk factors. Limited CRC screening, diagnostic facilities and specialists were identified as barriers to diagnosis. Treatment related challenges included limited accessibility to surgical services and drugs, late-stage presentation leading to poor treatment response, treatment abandonment and drug related toxicity. Lack of universal health coverage policies, limited community-based cancer awareness programs, and lack of national cancer registries were cited as policy and economics challenges. Opportunities to address these challenges were discussed. Our findings highlight areas for further research and prioritization to address Uganda’s growing CRC burden and may be applicable to other low-resource settings.Item The association between dietary diversity and development among children under 24 months in rural Uganda:(Public Health Nutrition, 2021-03) Kakwangire, Paul; Moss, Cami; Matovu, Nicholas; Atukunda, Prudence; Westerberg, C. Ane; Iversen, O Per; Muhoozi, K. M. GraceObjective: To assess the association between dietary diversity and development among children under 24 months in rural Uganda and to establish other factors that could be associated with development among these children. Design: A secondary data analysis of a cluster-randomised controlled maternal education trial (n 511) was conducted on a sub-sample of 385 children. We used adjusted ORs (AORs) to assess the associations of dietary diversity scores (DDS) and other baseline factors assessed at 6–8 months with child development domains (communication, fine motor, gross motor, personal–social and problem solving) at 20–24 months of age. Setting: Rural areas in Kabale and Kisoro districts of south-western Uganda. Participants: Children under 24 months. Results: After multivariable analysis, DDS at 6–8 months were positively associated with normal fine motor skills development at 20–24 months (AOR = 1•18; 95 % CI 1•01, 1•37; P = 0•02). No significant association was found between DDS and other development domains. Children who were not ill at 6–8 months had higher odds of developing normal communication (AOR = 1•73; 95 % CI 1•08, 2•77) and gross motor (AOR = 1•91; 95 % CI 1•09, 3•36) skills than sick children. Girls had lower odds of developing normal gross motor skills compared with boys (AOR = 0•58; 95 % CI 0•33, 0•98). Maternal/caregiver nutritional education intervention was positively associated with development of gross motor, fine motor and problem-solving skills (P-values < 0•05). Conclusions: We found an association between child DDS at 6–8 months and improvement in fine motor skills development at 20–24 months. Child illness status, maternal/caregiver nutritional education intervention and sex were other significant baseline predictors of child development at 20–24 months. Keywords: Children, Cluster randomised, Development, Dietary diversity, Maternal education, Rural, UgandaItem Using dietary serving scores to assess adequacy of dietary intake and associated factors among adult patients with type 2 diabetes in Kampala: a cross-sectional study(2020-08-17) Kisaakye, Susan; Matovu, Nicholas; Guwatudde, David; Kajjura, RichardBackground/objectives: Adequate dietary intake for type 2 diabetes mellitus (T2DM) patients is central in preventing or delaying onset of diabetes related complications. This study used dietary serving scores (DSS) to determine the adequacy of dietary intake and associated factors among patients with T2DM in Kampala. Subjects/methods: A facility based cross-sectional study among adult T2DM patients attending diabetes clinics attached to health care facilities in Kampala was conducted. Semi structured demographic and 7-day Food Frequency Questionnaires (FFQ) were used to collect data on sociodemographic characteristics, environmental factors and dietary intake respectively. Dietary intake was computed using Dietary Serving Scores (DSS) and was grouped into two: "adequate dietary intake (DSS of 78 and above)" and "inadequate dietary intake (DSS below 78)". Multiple linear regression was used to assess correlates of dietary intake. Results: Out of the 400 participants, only 49 (12.25%; 95% CI: 9.04, 15.46) were classified as having adequate dietary intake. After adjusting for potential confounders, unmarried individuals (β = -2.367; p = 0.024) and those who are salaried (β = -3.162; p = 0.012) or self-employed (β = -4.214; p = 0.001) had significantly lower mean DSS compared to their respective counterparts. T2DM patients who attended Nsambya hospital diabetes clinic had significantly higher mean DSS (β = 3.698; p = 0.022) compared to those who receive treatment in Lubaga hospital. Conclusions: The prevalence of adequate dietary intake among patients with T2DM attending health facilities in Kampala is very low. More efforts are needed to educate patients on better dietary choices aligned with disease management.Item Using dietary serving scores to assess adequacy of dietary intake and associated factors among adult patients with type 2 diabetes in Kampala: a cross-sectional study(European Journal of Clinical Nutrition, 2021) Kisaakye, Susan; Matovu, Nicholas; Guwatudde, David; Kajjura, RichardAdequate dietary intake for type 2 diabetes mellitus (T2DM) patients is central in preventing or delaying onset of diabetes related complications. This study used dietary serving scores (DSS) to determine the adequacy of dietary intake and associated factors among patients with T2DM in Kampala. Subjects/Methods A facility based cross-sectional study among adult T2DM patients attending diabetes clinics attached to health care facilities in Kampala was conducted. Semi structured demographic and 7-day Food Frequency Questionnaires (FFQ) were used to collect data on sociodemographic characteristics, environmental factors and dietary intake respectively. Dietary intake was computed using Dietary Serving Scores (DSS) and was grouped into two: “adequate dietary intake (DSS of 78 and above)” and “inadequate dietary intake (DSS below 78)”. Multiple linear regression was used to assess correlates of dietary intake. Results Out of the 400 participants, only 49 (12.25%; 95% CI: 9.04, 15.46) were classified as having adequate dietary intake. After adjusting for potential confounders, unmarried individuals (β = −2.367; p = 0.024) and those who are salaried (β = −3.162; p = 0.012) or self-employed (β = −4.214; p = 0.001) had significantly lower mean DSS compared to their respective counterparts. T2DM patients who attended Nsambya hospital diabetes clinic had significantly higher mean DSS (β = 3.698; p = 0.022) compared to those who receive treatment in Lubaga hospital. Conclusions The prevalence of adequate dietary intake among patients with T2DM attending health facilities in Kampala is very low. More efforts are needed to educate patients on better dietary choices aligned with disease management.