Browsing by Author "Mugambe, Richard K"

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    Association between early life second-hand smoke exposure on child sleep and psychoactive substance use on adult sleep patterns in an urban informal settlement in Uganda
    (Public Library of Science, 2025-01) Wafula, Solomon T; Namakula, Lydia N; Isunju, John B; Mugambe, Richard K; Ssekamatte, Tonny; Musoke, David; Wanyenze, Rhoda K
    Psychoactive substance use in adults and second-hand smoke (SHS) exposure among children are leading contributors to sleeping problems. Despite this, there is limited data on how these exposures influence sleep patterns in informal settings. Our study assessed the associations between substance use, SHS exposure and sleep disturbances among adults and children in an urban informal settlement in Uganda.BACKGROUNDPsychoactive substance use in adults and second-hand smoke (SHS) exposure among children are leading contributors to sleeping problems. Despite this, there is limited data on how these exposures influence sleep patterns in informal settings. Our study assessed the associations between substance use, SHS exposure and sleep disturbances among adults and children in an urban informal settlement in Uganda.We conducted a cross-sectional study in an urban informal settlement in Kampala, Uganda. Data was collected on self-reported sleep problems among adults including sleep duration, insomnia and sleep dissatisfaction, as well, as sleep-disordered breathing (SDB) in children. We evaluated children's early-life SHS exposure and psychoactive substance use in adults using questionnaires. We modelled the associations between the exposures and sleep problems in adults and children using modified Poisson regression.METHODSWe conducted a cross-sectional study in an urban informal settlement in Kampala, Uganda. Data was collected on self-reported sleep problems among adults including sleep duration, insomnia and sleep dissatisfaction, as well, as sleep-disordered breathing (SDB) in children. We evaluated children's early-life SHS exposure and psychoactive substance use in adults using questionnaires. We modelled the associations between the exposures and sleep problems in adults and children using modified Poisson regression.Data were collected from 284 adults, who also reported on their children's sleep experience. Among adults, 59.2% reported insufficient sleep (less than 7 hours), 34.9% experienced insomnia, and 28.3% were dissatisfied with their sleep patterns. Active smoking was associated with insomnia (Prevalence Ratio (PR) = 2.74, 95% Confidence Interval (CI): 1.14-6.59), and alcohol use was associated with sleep dissatisfaction (PR = 1.81, 95% CI 1.23-2.69). In children, 40.0% (88/220) exhibited SDB problems. Those exposed to SHS either during pregnancy or within six months post-birth had a higher risk of SDB than unexposed children (PR = 1.78, 95% CI 1.21-2.61). The risk was also elevated for children exposed to SHS during both periods (PR = 1.48, 95% CI 1.02-2.13).RESULTSData were collected from 284 adults, who also reported on their children's sleep experience. Among adults, 59.2% reported insufficient sleep (less than 7 hours), 34.9% experienced insomnia, and 28.3% were dissatisfied with their sleep patterns. Active smoking was associated with insomnia (Prevalence Ratio (PR) = 2.74, 95% Confidence Interval (CI): 1.14-6.59), and alcohol use was associated with sleep dissatisfaction (PR = 1.81, 95% CI 1.23-2.69). In children, 40.0% (88/220) exhibited SDB problems. Those exposed to SHS either during pregnancy or within six months post-birth had a higher risk of SDB than unexposed children (PR = 1.78, 95% CI 1.21-2.61). The risk was also elevated for children exposed to SHS during both periods (PR = 1.48, 95% CI 1.02-2.13).Our findings suggest that smoking was associated with insomnia and alcohol with sleep dissatisfaction among adults. Early-life SHS exposure was associated with an increased risk of SDB in children. These results emphasize the need to support ongoing public health initiatives and maintain a smoke-free environment, particularly for children in their early life.CONCLUSIONSOur findings suggest that smoking was associated with insomnia and alcohol with sleep dissatisfaction among adults. Early-life SHS exposure was associated with an increased risk of SDB in children. These results emphasize the need to support ongoing public health initiatives and maintain a smoke-free environment, particularly for children in their early life. MEDLINE - Academic
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    Barriers and benefits of mHealth for community health workers in integrated community case management of childhood diseases in Banda Parish, Kampala, Uganda: a cross-sectional study
    (BioMed Central Ltd, 2024-05) Kansiime, Winnifred K; Atusingwize, Edwinah; Ndejjo, Rawlance; Balinda, Emmanuel; Ntanda, Moses; Mugambe, Richard K; Musoke, David
    Abstract BACKGROUNDLow-quality data presents a significant challenge for community health workers (CHWs) in low and middle-income countries (LMICs). Mobile health (mHealth) applications offer a solution by enabling CHWs to record and submit data electronically. However, the barriers and benefits of mHealth usage among CHWs in informal urban settlements remain poorly understood. This study sought to determine the barriers and benefits of mHealth among CHWs in Banda parish, Kampala.METHODSThis qualitative study involved 12 key informant interviews (KIIs) among focal persons from Kampala City Council Authority (KCCA) and NGOs involved in data collected by CHWs, and officials from the Ministry of Health (MOH) and two mixed-sex Focused Group Discussions (FGDs) of CHWs from Banda parish, Kampala district. Data analysis utilised Atlas Ti Version 7.5.7. Thematic analysis was conducted, and themes were aligned with the social-ecological model.RESULTSThree themes of institutional and policy, community and interpersonal, and individual aligning to the Social ecological model highlighted the factors contributing to barriers and the benefits of mHealth among CHWs for iCCM. The key barriers to usability, acceptability and sustainability included high training costs, CHW demotivation, infrastructure limitations, data security concerns, community awareness deficits, and skill deficiencies. Conversely, mHealth offers benefits such as timely data submission, enhanced data quality, geo-mapping capabilities, improved CHW performance monitoring, community health surveillance, cost-effective reporting, and CHW empowering with technology.CONCLUSIONDespite limited mHealth experience, CHWs expressed enthusiasm for its potential. Implementation was viewed as a solution to multiple challenges, facilitating access to health information, efficient data reporting, and administrative processes, particularly in resource-constrained settings. Successful mHealth implementation requires addressing CHWs' demotivation, ensuring reliable power and network connectivity, and enhancing capacity for digital data ethics and management. By overcoming these barriers, mHealth can significantly enhance healthcare delivery at the community level, leveraging technology to optimize resource utilization and improve health outcomes. mHealth holds promise for transforming CHW practices, yet its effective integration necessitates targeted interventions to address systemic challenges and ensure sustainable implementation in LMIC contexts. MEDLINE - Academic
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    Low Back Pain Effects, Management and Coping Strategies among Pregnant Women Attending Antenatal Clinic in Eastern Uganda: A Cross- Sectional Study.
    (Research Square, 2021) ZAVUGA, Robert; Waako, Susan; Twimukye, Moses; Mugambe, Richard K; Isunju, John Bosco; Muwonge, Haruna; Masete, Ivan; Kusasira, Stephen; Guwatudde, David
    17AbstractBackgroundDespite Low back pain (LBP) being one of the most common complaints among pregnant women,healthcare workers write it off as a normal experience of the pregnancy, thus remaining untreated. It isknown to affect the daily functionality of many pregnant women in activities including those that involvesitting, walking, standing and lifting. The inadequacy of information on LBP among pregnant women inUganda may have led to the unavailability of obstetric guidelines for its diagnosis and management. Thisstudy established the effects of LBP effects on daily performance, management and coping strategiesamong pregnant women attending an antenatal clinic in Eastern Uganda.MethodsThis was a cross-sectional study that enrolled 341 pregnant women attending antenatal care. Theprimary outcome measure was LBP. The study enrolled pregnant women who reported having LBP andcorrectly located the site of the pain using the pain and body chart as having LBP. Data onsociodemographic characteristics, pain intensity, functional disability, effects of LBP on dailyperformance, management and coping strategies were collected.ResultsOf the 341 respondents, (105, 30.8%) reported LBP. Majority of the women with LBP (71, 67.6%) hadminimal disability with an Owestry Disability Index (ODI) score of 0-20%. The activities that were mostaffected with mild interference on daily routine activities were lifting 81%, standing 74%, personal care74% and traveling 74%. Majority of the respondents (80, 76.19%) reported their LBP during the Antenatalcare (ANC) visits at the hospital and of these 62 (79.49%) were given painkillers, 13 (16.67%) receivedcounselling and patient education, 3 (3.85%). For the respondents who did not receive any treatment fromthe ANC visits, the majority (23, 60.53%) used herbs and others used self-medication (5, 13.16%)ConclusionLBP affects most of the daily functional activities of pregnant women with minimal and moderatedisability. Although the disability is not severe, it affects their quality of life and productivity. The pregnant women managed their LBP mainly by conservative means of treatment, especially by the use ofpharmacological management and rest from activities.