Browsing by Author "Nabirye, Juliet"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Factors Associated with COVID-19 Vaccine Hesitancy in Uganda: A Population-Based Cross-Sectional Survey
    (International Journal of General Medicine, 2022) Kabagenyi, Allen; Wasswa, Ronald; Nannyonga, Betty K.; Nyachwo, Evelyne B.; Kagirita, Atek; Nabirye, Juliet; Atuhaire, Leonard; Waiswa, Peter
    Vaccination toward coronavirus disease (COVID-19) has been recommended and adopted as one of the measures of reducing the spread of this novel disease worldwide. Despite this, vaccine uptake among the Ugandan population has been low with reasons surrounding this being unknown. This study aimed to investigate the factors associated with COVID-19 vaccine hesitancy in Uganda. Methods: A cross-sectional study was conducted on a total of 1042 adults in the districts of Mukono, Kiboga, Kumi, Soroti, Gulu, Amuru, Mbarara and Sheema from June to November 2021. Data were analyzed using STATA v.15. Barriers to vaccination were analyzed descriptively, while a binary logistic regression model was used to establish the factors associated with COVID-19 vaccine hesitancy. Results: Overall, COVID-19 vaccine hesitancy was 58.6% (611). Respondents from urban areas and those in the eastern or northern region had increased odds of vaccine hesitancy. Further, higher education level and having knowledge on how COVID-19 is transmitted significantly reduced the odds of vaccine hesitancy. The study also noted individual perception such as COVID-19 kills only people with underlying medical conditions, as well as limited awareness on vaccine types or vaccination areas as the main reasons to vaccine hesitancy. Relatedly, other misconceptions like the ability of the vaccine to cause infertility, or spreading the virus into the body, and acknowledgment of alcohol as a possible cure were other reasons for vaccine hesitancy. Conclusion: The proportion of COVID-19 vaccine hesitancy is still high among the population with this varying across regions. This is driven by low education level and limited awareness on the vaccination as well as perceived myths and misconceptions. The study recommends mass sensitization of the population on the benefits of vaccination using various channels as well as rolling out community-based outreach vaccination campaigns across the country.
  • Thumbnail Image
    Item
    Health system factors influencing uptake of Human Papilloma Virus (HPV) vaccine among adolescent girls 9-15 years in Mbale District, Uganda
    (BMC Public Health, 2020) Nabirye, Juliet; Okwi, Livex Andrew; Nuwematsiko, Rebecca; Kiwanuka, George; Muneza, Fiston; Kamya, Carol; Babirye, Juliet N.
    Globally, cervical cancer is the fourth most common cancer in women with more than 85% of the burden in developing countries [1]. The majority of cervical cancer mortality occurs in developing countries, where screening and optimal treatment are not adequately available [2]. Cancer of the cervix constituted 22.2% of all cancers among women in Sub-Saharan Africa in 2012 [3]. In Uganda, cervical cancer is the number one cancer killer disease among women, this is followed by breast cancer [4]. With the incidence standing at 52 /100,000 women of reproductive age, it is one of the highest globally. Regrettably, more than half of these women die every year [5, 6]. The Kampala cancer registry shows that Uganda has an age standardized incidence rate of 47.5 per 100,000 against the global estimate of 15.8 per 100,000 [7]. Many of the Cervical cancer cases present with an advanced stage of the disease [8].
  • Thumbnail Image
    Item
    Missed opportunities for family planning counselling among HIV-positive women receiving HIV Care in Uganda
    (BMC Women's Health, 2020) Nabirye, Juliet; Matovu, Joseph K. B.; Bwanika, John B.; Makumbi, Fredrick; Wanyenze, Rhoda K.
    HIV-positive women who are still in the reproductive years need adequate sexual and reproductive health information to make informed reproductive health choices. However, many HIV-positive women who interface with the health system continue to miss out on this information. We sought to: a) determine the proportion of HIV-positive women enrolled in HIV care who missed family planning (FP) counselling; and b) assess if any association existed between receipt of FP counselling and current use of modern contraception to inform programming. Methods: Data were drawn from a quantitative national cross-sectional survey of 5198 HIV-positive women receiving HIV care at 245 HIV clinics in Uganda; conducted between August and November 2016. Family planning counselling was defined as provision of FP information (i.e. available FP methods and choices) to an HIV-positive woman by a health provider during ANC, at the time of delivery or at the PNC visit. Analyses on receipt of FP counselling were done on 2760 HIV-positive women aged 15–49 years who were not currently pregnant and did not intend to have children in the future. We used a modified Poisson regression model to determine the Prevalence Ratio (PR) as a measure of association between receipt of any FP counselling and current use of modern contraception, controlling for potential confounders. Analyses were performed using STATA statistical software, version 14.1. Results: Overall, 2104 (76.2%) HIV-positive women reported that they received FP counselling at any of the three critical time-points. Of the 24% (n = 656) who did not, 37.9% missed FP counselling at ANC; 41% missed FP counselling during delivery; while 54% missed FP counselling at the post-natal care visit. HIV-positive women who received any FP counselling were significantly more likely to report current use of modern contraception than those who did not (adjusted PR [adj. PR] = 1.21; 95% Confidence Interval [CI]: 1.10, 1.33).
  • Thumbnail Image
    Item
    Retention of HIV infected pregnant and breastfeeding women on option B+ in Gomba District, Uganda: a retrospective cohort study
    (BMC Infectious Diseases, 2018) Kiwanuka, George; Kiwanuka, Noah; Muneza, Fiston; Nabirye, Juliet; Oporia, Frederick; Odikro, Magdalene A.; Castelnuovo, Barbara; Wanyenze, Rhoda K.
    Lifelong antiretroviral therapy for HIV infected pregnant and lactating women (Option B+) has been rapidly scaled up but there are concerns about poor retention of women initiating treatment. However, facilitybased data could underestimate retention in the absence of measures to account for self-transfers to other facilities. We assessed retention-in-care among women on Option B+ in Uganda, using facility data and follow-up to ascertain transfers to other facilities. Methods: In a 25-month retrospective cohort analysis of routine program data, women who initiated Option B+ between March 2013 and March 2015 were tracked and interviewed quantitatively and qualitatively (in-depth interviews). Kaplan Meier survival analysis was used to estimate time to loss-to-follow-up (LTFU) while multivariable Cox proportional hazards regression was applied to estimate the adjusted predictors of LTFU, based on facility data. Thematic analysis was done for qualitative data, using MAXQDA 12. Quantitative data were analyzed with STATA® 13. Results: A total of 518 records were reviewed. The mean (SD) age was 26.4 (5.5) years, 289 women (55.6%) attended primary school, and 53% (276/518) had not disclosed their HIV status to their partners. At 25 months post-ART initiation, 278 (53.7%) were LTFU based on routine facility data, with mean time to LTFU of 15.6 months. Retention was 60.2 per 1000 months of observation (pmo) (95% CI: 55.9–64.3) at 12, and 46.3/1000pmo (95% CI: 42.0–50.5) at 25 months. Overall, 237 (55%) women were successfully tracked and interviewed and 43/118 (36.4%) of those who were classified as LTFU at facility level had self-transferred to another facility. The true 25 months post-ART initiation retention after tracking was 71.3% (169/237). Women < 25 years, aHR = 1.71 (95% CI: 1.28–2.30); those with no education, aHR = 5.55 (95% CI: 3.11– 9.92), and those who had not disclosed their status to their partners, aHR = 1.59 (95% CI: 1.16–2.19) were more likely to be LTFU. Facilitators for Option B+ retention based on qualitative findings were adequate counselling, disclosure, and the desire to stay alive and raise HIV-free children. Drug side effects, inadequate counselling, stigma, and unsupportive spouses, were barriers to retention in care. Conclusions: Retention under Option B+ is suboptimal and is under-estimated at health facility level. There is need to institute mechanisms for tracking of women across facilities. Retention could be enhanced through strategies to enhance disclosure to partners, targeting the uneducated, and those <25 years.