Browsing by Author "Mbona Tumwesigye, Nazarius"

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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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    Alcohol use, intimate partner violence, and HIV sexual risk behavior among young people in fishing communities of Lake Victoria, Uganda
    (BMC public health, 2021) Ojiambo Wandera, Stephen; Mbona Tumwesigye, Nazarius; Walakira, Eddy J.; Kisaakye, Peter; Wagman, Jennifer
    Few studies have investigated the association between alcohol use, intimate partner violence, and HIV sexual risk behavior among young people in fishing communities from eastern and central Uganda. Therefore, we aimed to determine the association between alcohol use, intimate partner violence, and HIV sexual risk behavior among young people in the fishing communities on the shores of Lake Victoria, in Uganda. Methods: We conducted multivariable logistic regression analyses of HIV risk behavior using cross-sectional data from 501 young people from Mukono (Katosi landing site) and Namayingo districts (Lugala landing site). Results: Almost all (97%) respondents reported at least one HIV risk behavior; more than half (54%) reported engagement in three or more HIV risk behaviors. Results from the adjusted model indicate that alcohol use, working for cash or kind, being married, and having multiple sexual partners increased the odds of HIV risk behavior. IPV was not associated with HIV risk behavior. Conclusion: Interventions to promote consistent condom use and fewer sexual partnerships are critical for young people in the fishing communities in Uganda.
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    Building capacity for injury research: A case study from Uganda
    (Abstracts, 2016) Hyder, Adnan A.; Kobusingye, Olive; Bachani, Abdulgafoor M.; Paichadze, Nino; Bishai, David; Wegener, Stephen; Mbona Tumwesigye, Nazarius; Guwatudde, David; Atuyambe, Lynn; Stevens, Kent A.
    Despite the high burden of injuries, they have largely been overlooked in global health research. One of the reasons for this is that in many developing countries there is limited supply of trained human resources for addressing injury research. Uganda is one such country where two critical gaps in addressing the lifelong consequences of trauma, injuries and disability are the lack of trained human resources and the lack of data. Objectives Through innovative model of sustainable development, the Johns Hopkins University-Makerere University Chronic Consequences of Trauma, Injuries and Disability in Uganda (JHU-MU Chronic TRIAD) program aims to strengthen research capacity on the long-term health and economic consequences of trauma, injuries and disability across the lifespan in Uganda.
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    Effect of four or more antenatal care visits on facility delivery and early postnatal care services utilization in Uganda: a propensity score matched analysis
    (BMC pregnancy and childbirth, 2022) Mwebesa, Edson; Kagaayi, Joseph; Ssebagereka, Anthony; Nakafeero, Mary; Ssenkusu, John M.; Guwatudde, David; Mbona Tumwesigye, Nazarius
    Maternal mortality remains a global public health issue, more predominantly in developing countries, and is associated with poor maternal health services utilization. Antenatal care (ANC) visits are positively associated with facility delivery and postnatal care (PNC) utilization. However, ANC in itself may not lead to such association but due to differences that exist among users (women). The purpose of this study, therefore, is to examine the effect of four or more ANC visits on facility delivery and early PNC and also the effect of facility-based delivery on early PNC using Propensity Score Matched Analysis (PSMA). Methods: The present study utilized the 2016 Uganda Demographic and Health Survey (UDHS) dataset. Women aged 15 – 49 years who had given birth three years preceding the survey were considered for this study. Propensity score-matched analysis was used to analyze the effect of four or more ANC visits on facility delivery and early PNC and also the effect of facility-based delivery on early PNC. Results: The results revealed a significant and positive effect of four or more ANC visits on facility delivery [ATT (Average Treatment Effect of the Treated)=0.118, 95% CI: 0.063 – 0.173] and early PNC [ATT=0.099, 95% CI: 0.076 – 0.121]. It also found a positive and significant effect of facility-based delivery on early PNC [ATT=0.518, 95% CI: 0.489 – 0.547]. Conclusion: Policies geared towards the provision of four or more ANC visits are an effective intervention towards improved facility-based delivery and early PNC utilisation in Uganda.
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    Effect of suppressive acyclovir administered to HSV-2 positive mothers from week 28 to 36 weeks of pregnancy on adverse obstetric outcomes: a double-blind randomized placebo-controlled trial
    (Reproductive health, 2017) Nakubulwa, Sarah; Kaye, Dan K.; Bwanga, Freddie; Mbona Tumwesigye, Nazarius; Nakku-Joloba, Edith; Mirembe, Florence
    Acyclovir (ACV) given to HSV-2 positive women after 36 weeks reduces adverse outcomes but its benefit at lower gestation was undocumented. We determined the effect of oral acyclovir administered from 28 to 36 weeks on premature rupture of membranes (PROM) primarily and preterm delivery risk. This was a randomized, double-blind placebo-controlled trial among 200 HSV-2 positive pregnant women at 28 weeks of gestation at Mulago Hospital, Uganda. Participants were assigned randomly (1:1) to take either acyclovir 400 mg orally twice daily (intervention) or placebo (control) from 28 to 36 weeks. Both arms received acyclovir after 36 weeks until delivery. Development of Pre-PROM by 36 weeks and preterm delivery were outcomes. One hundred women were randomized to acyclovir and 100 to placebo arms between January 2014 and February 2015. There was tendency towards reduction of incidence of PROM at 36 weeks but this was not statistically significant (4.0% versus 10.0%; RR 0.35; 95% 0.11–1.10) in the acyclovir and placebo arms respectively. However, there was a significant reduction in the incidence of preterm delivery (11.1% versus 23.5%; RR 0.41; 95% 0.20–0.85) in the acyclovir and placebo arms respectively. Oral acyclovir given to HSV-2 positive pregnant women from 28 to 36 weeks reduced incidence of preterm delivery but did not significantly reduce incidence of pre-PROM.
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    Genital infections and risk of premature rupture of membranes in Mulago Hospital, Uganda: a case control study
    (BMC research notes, 2015) Nakubulwa, Sarah; Kaye, Dan K.; Bwanga, Freddie; Mbona Tumwesigye, Nazarius; Mirembe, Florence M.
    Inflammatory mediators that weaken and cause membrane rupture are released during the course of genital infections among pregnant women. We set out to determine the association of common genital infections (Trichomonas vaginalis, syphilis, Neisseria gonorrhea, Chlamydia trachomatis, Group B Streptococcus, Bacterial vaginosis, Herpes Simplex Virus Type 2 and candidiasis) and premature rupture of membranes in Mulago hospital, Uganda. Methods: We conducted an unmatched case–control study among women who were in the third trimester of pregnancy at New Mulago hospital, Uganda. The cases had PROM and the controls had intact membranes during latent phase of labour in the labour ward. We used interviewer-administered questionnaires to collect data on sociodemographic characteristics, obstetric and medical history. Laboratory tests were conducted to identify T. vaginalis, syphilis, N. gonorrhea, C. trachomatis, Group B Streptococcus, Bacterial vaginosis, Herpes Simplex Virus Type 2 (HSV-2) and candidiasis. Logistic regression models were used to estimate the odds ratios (OR) and 95 % CI of the association between genital infections and PROM.
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    Incidence and risk factors for herpes simplex virus type 2 seroconversion among pregnant women in Uganda: A prospective study
    (The Journal of Infection in Developing Countries, 2016) Nakubulwa, Sarah; Kaye, Dan K.; Bwanga, Freddie; Mbona Tumwesigye, Nazarius; Nakku-Joloba, Edith; Mirembe, Florence M.
    Herpes simplex virus type 2 (HSV-2) acquired during pregnancy is associated with adverse outcomes such as perinatal HSV-2 transmission. HSV-2 seroconversion occurs within four weeks of HSV-2 acquisition. There was neither documented incidence nor risk factors for HSV-2 seroconversion during pregnancy in Uganda. The objective of this study was to determine the incidence and risk factors for HSV-2 seroconversion among pregnant women in Mulago Hospital, Uganda. Methodology: A prospective study of 200 consenting HSV-2-negative women between 26 and 28 weeks of gestation was done between November 2013 and October 2014. HSV-2 serostatus was determined using HerpeSelect HSV-2 enzyme-linked immunosorbent assay (ELISA). Interviewer-administered questionnaires were used to collect socio-demographic characteristics and sexual history. Human immunodeficiency virus (HIV) serostatus was obtained from antenatal records. A total of 191 women completed follow-up and repeat HSV-2 serology by 38 weeks. Negative binomial regression analysis was used to estimate risk ratios for risk factors for HSV-2 seroconversion. Results: Of 191 women, 15 (7.9%) seroconverted during pregnancy. Having multiple sexual partners, being in polygamous unions, and having HIV-positive serostatus were found to be risk factors for HSV-2 seroconversion. Conclusions: The incidence of HSV-2 seroconversion during pregnancy in Uganda was high. Multiple sexual partners, polygamy, and HIV-positive serostatus were risk factors for HSV-2 seroconversion during pregnancy. Strengthening health education on the avoidance of multiple sexual partners during pregnancy is paramount in prevention of HSV-2 seroconversion.
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    Problem drinking and physical intimate partner violence against women: evidence from a national survey in Uganda
    (BMC public health, 2012) Mbona Tumwesigye, Nazarius; Bantebya Kyomuhendo, Grace; Greenfield, Thomas K.; Wanyenze, Rhoda K.
    Problem drinking has been identified as a major risk factor for physical intimate partner violence (PIPV) in many studies. However, few studies have been carried on the subject in developing countries and even fewer have a nationwide perspective. This paper assesses the patterns and levels of PIPV against women and its association with problem drinking of their sexual partners in a nationwide survey in Uganda. Methods: The data came from the women’s dataset in the Uganda Demographic and Health Survey of 2006. Problem drinking among sexual partners was defined by women’s reports that their partner got drunk sometimes or often and served as the main independent variable while experience of PIPV by the women was the main dependent variable. In another aspect problem drinking was treated an ordinal variable with levels ranging from not drinking to getting drunk often. A woman was classified as experiencing PIPV if her partner pushed or shook her; threw something at her; slapped her; pushed her with a fist or a harmful object; kicked or dragged her, tried to strangle or burn her; threatened/attacked her with a knife/gun or other weapon. General chi-square and chi-square for trend analyses were used to assess the significance of the relationship between PIPV and problem drinking. Multivariate analysis was applied to establish the significance of the relationship of the two after controlling for key independent factors. Results: Results show that 48% of the women had experienced PIPV while 49.5% reported that their partners got drunk at least sometimes. The prevalence of both PIPV and problem drinking significantly varied by age group, education level, wealth status, and region and to a less extent by occupation, type of residence, education level and occupation of the partner. Women whose partners got drunk often were 6 times more likely to report PIPV (95% CI: 4.6-8.3) compared to those whose partners never drank alcohol. The higher the education level of the women the less the likelihood of experiencing PIPV (ptrend<0.001). Similar relationship was found between wealth status and experiencing PIPV. Conclusions: Problem drinking among male partners is a strong determinant of PIPV among women in Uganda. PIPV prevention measures should address reduction of problem drinking among men. Longerterm prevention measures should address empowerment of women including ensuring higher education, employment and increased income.