Browsing by Author "Oboth, Paul"

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    Bottlenecks and opportunities towards achieving the targeted 95-95-95 HIV services in a rural district in Eastern Uganda [version 1; peer review: awaiting peer review]
    (F1000Research, 2022) Namenkere, Monkya Samuel; Stella, Ayaa Mary; Linda, Sukuku; Kharono, Juliet; Mugabi, Charles; Chelangat; Chelangat, Benina; Abwola Olwedo, Mary; Nabasumba, Carol; Oboth, Paul; Osele, Julius; Nekaka, Rebecca; Iramiot, Jacob Stanley
    Background: Uganda has made progress in reducing its HIV prevalence from 7.3% in 2011 to 6% in 2017, however, more needs to be done to meet the World Health Organization (WHO) target of 95% of the population knowing their HIV status, 95% enrolled on treatment and 95% achieving viral suppression. This study aimed to assess the bottlenecks and opportunities towards achieving the 95 95 95 targeted HIV services in the Bukedea district. Methods: A mixed-methods cross-sectional study was conducted in the Bukedea district covering males and females aged 18-65 years who had consented to participate in the study. We used a purposive sampling procedure to select our study participants. Qualitative data was collected through focus group discussions, key informant interviews, and document reviews for quantitative data. Quantitative data were analyzed using STATA v 14 whereas qualitative data were analyzed using the thematic analysis approach. Results: The challenges were grouped as patient-related, medicationrelated, and facility-related. The patient-related challenges were stigma, fear of taking the medication, poor nutrition, long distances, alcoholism, busy working schedules, and domestic violence. The medication-related challenges were side effects and pill burden. The facility-related challenges were inadequate pretest counseling and stock-outs. The use of anti-retroviral drugs (ART) was common in piggery and poultry and the sources of these drugs were reported to be the people on ART and the health workers. The opportunities included home-based counseling, organizing more outreaches, counseling and health education, targeted testing, and strengthening the Village Health Teams (VHT) networks. Conclusions: The study revealed that the major challenges towards achieving the targeted 95-95-95 HIV services were stigma, inadequate pre-test counseling, fear of disclosure, and poor adherence due to alcoholism, sharing of drugs with animals and partners. The use of anti-retroviral drugs in animal husbandry was common in the Bukedea District.
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    Impact of Differentiated Service Delivery Models on Retention and Viral Load Suppression among Art Clients in Communities in Eastern Uganda
    (Research Square, 2022) Jemba, Brian; Waiswa, Sinani; Balinaine, Joseph; Lomuria, Rosaria; Nabutanyi, Gift Gloria; Ongala, Emmanuel; Opus, Benjamin; Iramiot, Jacob Stanley; Oboth, Paul; Anwola Olwedo, Mary; Nekaka, Rebecca
    Although Uganda rolled out Differentiated Service Delivery models in 2017 to improve retention and achieve viral load suppression, these have remained low relative to UNAIDs targets of 95-95-95 by 2030. We determined the impact of facility and community DSD Models on viral load suppression and retention among ART clients in Katakwi district in North Eastern Uganda. Methods; A retrospective cohort study of all ART clients in the different approaches of DSD models who were active by 2017, were followed up to 2020. The primary outcomes were retention and viral load suppression of ART clients in different approaches. Eight health facilities providing ART services were purposively sampled and 771 ART clients were sampled out by simple random sampling out of 4742 total population on ART in Katakwi district. We analysed retention, viral load suppression, and their determinants by logistic regression method using STATA. Results; A total of 771 participants were sampled of whom 42.7% were male and 57.3% were females, with the mean age being 40 years. While retention rates at 95% CI of participants were 99.35% at 12 months, 94.03 at 24 months, 89.88% at 36months, and 84.57% at 48months. The viral load suppression rates were57.3% at 12 months, 70.3% at 24 months, 70.3% at 36 months, and 69% at 48 months. Retention was higher in the community-based DSD model as compared with the facility-based model. Viral load suppression was higher in the community-based DSD models in which CDDP had the highest achievement (92%) followed by CCLAD (79%) compared to the facility-based DSD models in which FBIM performance (34.3%) was far below the set standard of 95%, followed by FBG (65%) with FTDR having relatively better performance (80.9%).Being 40–59 years, receiving care from the general hospital, being married, having good current adherence, being on the first line of the current regimen, and being a female as other predictors of viral load suppression whereas being 40–59 years of age, having good current adherence, being on the current first-line regimen, and having no comorbidities were predictors of good retention. Conclusions; Both facility and community-based DSD models have led to improved retention and viral load suppression however community-based models have shown to be more effective than facility-based models through mitigation of barriers to effective HIV/AIDS care of patients on ART. Viral load suppression remained low below the UNAIDs target of 95% by 2030 albeit it improved over time.
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    Malaria preventive practices and delivery outcomes: A cross-sectional study of parturient women in a tertiary hospital in Eastern Uganda
    (PloS one, 2020) Nekaka, Rebecca; Nteziyaremye, Julius; Oboth, Paul; Iramiot, Jacob Stanley; Wandabwa, Julius
    Uganda ranks third in the number of deaths attributable to malaria and has some of the highest recorded malaria transmission rates in the general population. Malaria in Pregnancy is associated with detrimental effects for the mother and unborn baby and these effects seem to have long term effects and consequences on the life of the baby. Despite the preventive measures put in place by the World Health Organization in antenatal care, the burden of malaria in pregnancy is still high. We determined the use of malaria preventive strategies during pregnancy and the presence of plasmodium infection, anemia, and low birth weight babies at delivery among parturient women at Mbale regional referral hospital in eastern Uganda. Methods A cross-sectional study was conducted among 210 women delivering at MRRH between July 2017 and January 2018. Information on demographics, antenatal care, and prevention practices was collected using an interviewer-administered questionnaire. Maternal venous blood and cord blood samples were screened for Plasmodium infection by both microscopy of Giemsa-stained blood films and Plasmodium falciparum rapid diagnostic test (pf. HPR2 mRDT). Polymerase Chain Reaction (PCR) was done on cord blood. The presence of anemia was determined by the use of an automated hemoglobin analyzer. Data were analyzed using descriptive and analytical statistics. Results Of the 210 women, 3 (1.4%) and 19(9.1%) tested positive for malaria by using Giemsa stained blood smear microscopy and malaria rapid diagnosticMRDT tests respectively. PCR detected 4(%) of Plasmodium in cord blood. Twenty-nine percent of the women had anaemia and 11 (5.2%) had low birth weight babies. Only 23.3% of the women received at least three doses of IPTp-SP and 57.9% reported sleeping under an Insecticide Treated Net the night before the survey. The women who reported sleeping under a mosquito net the previous night (OR 0.67, 95% CI: 0.24–1.86) and those who reported taking fansidar as a directly observed therapy (OR 0.31, 95% CI: 0.04–2.39) appeared to have few chances of getting plasmodium infection though the findings were not statistically significant. Conclusion The effective use of malaria preventive strategies (IPT-SP and Insecticide Treated Nets) was generally low. Most of the women took less than three doses of SP and there was no strict adherence to the recommended directly observed therapy. The prevalence of Plasmodium infection during pregnancy was low though maternal anaemia and low birth weight were relatively high.
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    Pneumococcal carriage and antibiotic susceptibility patterns in mother-baby pairs in a rural community in Eastern Uganda: a cross-sectional study
    (F1000Research, 2020) Madut Akech, Gabriel; Naloli, Mercy; Sebwami, Paul; Kazibwe, Patrick; Atwikiriize, Maureen; Onyait, Julius; Oboth, Paul; Nteziyaremye, Julius; Nekaka, Rebecca; Iramiot, Jacob Stanley
    Pneumonia poses a significant threat to the lives of children below five years old worldwide, contributing to a high number of hospitalizations and death. Morbidity and morbidity are especially common in children under five and the elderly, although any age group can be affected. This study aimed to estimate pneumococcal carriage and determine antibiotic susceptibility patterns of the pneumococci isolated from mother-baby pairs in Ngora district after the rollout of the pneumococcal vaccine. We hypothesized that high carriage of Streptococcus pneumoniae in mothers leads to carriage in their babies and hence a greater chance of contracting pneumonia. Methods: Consecutive sampling was used to select 152 mother-baby pairs from community visits and those seeking care at the health facility. We collected nasal swabs from both baby and mother for culture and sensitivity testing using the Kirby-Bauer’s agar disc diffusion method. Results: This study found that there was a low prevalence of pneumococcal carriage in the mother-baby pair in Ngora district. We also observed high rates of microbial resistance to penicillin, which is the first-line drug for the management of pneumonia in Uganda. Conclusions: The relationship between pneumococcal carriage and immunization status suggests that the pneumococcal vaccine is protective against pneumococcal carriage. Resistance of S. pneumoniae to commonly used antibiotics was high.
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    Prevalence and clinical outcomes of Plasmodium falciparum and intestinal parasitic infections among children in Kiryandongo refugee camp, mid-Western Uganda: a cross sectional study
    (BMC infectious diseases, 2019) Oboth, Paul; Gavamukulya, Yahaya; Barugahare, Banson John
    The prevalence of Plasmodium falciparum and Intestinal Parasitic Infections (IPIs) - with the corresponding pathogenesis among children remain uncertain. This study aimed at determining the prevalence and the outcomes (including anaemia) of the respective infections and co-infections. Anaemia is a condition in which the number of red blood cells transporting oxygen to the various body parts is not sufficient to meet the needs of the body. Methods: This was a cross sectional study conducted among 476-refugee camp school children. Kato-Katz technique was used to screen stool samples for intestinal parasites. Microscopy was used for malaria testing while the portable Haemoglobin (Hb) calorimeter was used to measure haemoglobin concentration. Results: The overall prevalence of the mixed infections was 63.03%. Plasmodium falciparum was most prevalent of the single infections 262(55.04%) followed by Taenia spp. 14 (2.9%), Schistosoma mansoni 12(2.5%), Giardia lamblia 7 (2.9%), Trichuris trichiura 2(0.4%), Hookworm 2(0.4%) and Strongyloides stercoralis 1(0.2%). The odds of developing simple or uncomplicated malaria infection or anaemia was 14 times higher in individuals with dual co-infection with Plasmodium falciparum + Taenia sp. compared to single parasitic infection (Odds = 14.13, P = 0.019). Co-infection with Plasmodium falciparum + Taenia spp, was a strong predictor of Malaria and anaemia. Conclusion: This study shows that Plasmodium falciparum and Taenia spp. co-infections is a stronger predictor of malaria and anaemia. The prevalence of malaria and anaemia remains higher than the other regions in Uganda outside restricted settlements. The findings of this study underline the need for pragmatic intervention programmes to reduce burden of the co-infections in the study area and similar settlements.
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    Sero-Prevalence and Factors Associated with Helicobacter pylori Infection in a Rural Population in Eastern Uganda: A Community Cross-sectional Study
    (Primary Health Care: Open Access, 2021) Nekaka, Rebecca; Oboth, Paul; Nteziyaremye, Julius; Gavamukulya, Yahaya; Ssenyonga, Lydia V. N.; Iramiot, Jacob Stanley
    Globally, 50% or more of the world’s population is infected with Helicobacter pylori making it the most widely spread bacteria across the world. The low developed countries are more overburdened by Helicobacter pylori infection than the developed countries. H. pylori infection is associated with duodenal ulcer, chronic atrophic gastritis (CAG), lymphomas, and adenocarcinoma. This study reports the prevalence of H. pylori and its associated factors in Eastern Uganda. Materials and methods: A cross-sectional study involving 275 participants was carried out in eastern Uganda. H. pylori serology was done and face to face interviewer-administered questionnaire were used for data collection. Data were entered in Microsoft Excel and imported to Stata version 14 for analysis and a P value of <0.05 was considered statistically significant. Results: The seroprevalence of H. pylori was 27.3% (75/275) with 28.4% (50/176) of the females being positive compared to 25.3% (25/99) of the males. Consumption of animal products (meat, milk, and eggs) was the only statistically significant factor associated with H. pylori seropositivity (P <0.001, 95% CI =1.934-4.209, AOR=2.85). Conclusion: The H. pylori seroprevalence is high in eastern Uganda. Consumption of animal products was a positive predictor of infectivity.