NRU :: Browsing by Author "Ovuga, Emilio"

Browsing by Author "Ovuga, Emilio"

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Alcohol, Substance Use and Psychosocial Competence of Adolescents in Selected Secondary Schools in Uganda: A Cross Sectional Survey
(International neuropsychiatric disease journal, 2016) Abbo, Catherine; Okello, Elialilia S.; Muhwezi, Wilson; Akello, Grace; Ovuga, Emilio; Makinodan, Manabu
To determine the nature and extent of alcohol and substance use and 2) To describe the relationship between alcohol use and psychosocial competence among secondary school youths in Northern and Central Uganda. Study Design—This was a cross-sectional study. Place and Duration of study—Departments of Mental Health, Gulu University (Northern Uganda) and Department of Psychiatry, Makerere University College of Health Sciences (Central Uganda) between September 2011 and April 2012. Methodology—Four (4) and eight (8) secondary schools located in the rural and urban areas of Gulu and Kampala districts respectively were randomly selected to participate in the survey. A total of 3,200 students aged 12 to 24 years were recruited by proportionate multistage sampling. Data was collected using a socio-demographic questionnaire that included questions about nature and frequency of alcohol and substance use. A pre-tested self-administered survey questionnaire with scales to measure components of psychosocial competence (PSC) was administered. Data was entered in Epidata, and exported to SPSS version 16.0 for analysis. Psychosocial competence was classified as high or low depending on the responses in the sub-scales of decision making, self efficacy, empathy, emotional awareness, coping with stress and emotions, and accurate self-assessment and self-confidence. Results—A total of 2,902 questionnaires comprising of 2,502, (86.2%) from Kampala district and 400 (13.8%)) from Gulu district were analyzed. Male to female ratio was 1:1 with an age range of 12 to 24 years and a mean of 16.5. About 70.1% had ever used alcohol and substances. Only 39.1% used substances regularly. The commonest substance used was alcohol (23.3%), followed by kuber (10.8%), khat (10.5%), aviation fuel (10.1%), cannabis (9.2%) and cigarettes (5.9%). Respondents from the Gulu district were twice more likely to use all substances. Users and regular users from the North Northern Uganda had lower psychosocial competence. Factors significantly associated with non-use of alcohol were high levels of self-confidence, non-use of cannabis and kuber and age. In the alcohol user groups, a high level of coping was associated with discontinued and experimental use of drugs of abuse. Conclusion—More than two-thirds (70.1%) of young people in this study had ever used substances of abuse only once and slightly over a third had used it regularly. From the perspectives of service provision, mental health promotion and prevention of illicit substance use, school mental health programmes that target both non-users and users are recommended.
Burden of alcohol use in the Uganda Police in Kampala District
(African health sciences, 2006) Ovuga, Emilio; Madrama, Charles
Alcohol dependence is one of the leading causes of the global burden of disease. Among members of the Uganda Police Force, alcohol dependence has been a major contributor of poor mental health, poor work output and forced retirement. Objective: This study was carried out to determine the prevalence of alcohol dependence and associated psychosocial problems in the Uganda Police Force in Kampala District. Methods of Study: A sample of police officers selected by systematic sampling strategy from two large barracks in Kampala District participated. A semi-structured questionnaire designed to elicit information on the perceived impact of alcohol use was used. Prevalence rate was derived from ICD-10 criteria for alcohol dependence, and psychosocial problems in alcohol dependence. Results: Twenty respondents (19.2%) met criteria for alcohol use disorder, 26.0% met criteria for alcohol use problems and 9.6% reported that their health was poor. Alcohol use disorder or problems were significantly associated with lack of job satisfaction, poor health, problems in implementing personal plans, disciplinary problems, inability to save from personal earnings, debts, and absenteeism from work. Conclusion: One in five police officers met criteria for alcohol use disorder while one in four experienced psychosocial problems related to alcohol use. The results suggest serious implications for the quality of services provided by the Uganda Police. There is a need to establish measures to provide services for those affected, and a further need to establish preventative measures against alcohol dependence in the police force.
Childhood and adolescent injuries in elementary schools in north-western Uganda: extent, risk and associated factors
(International journal of injury control and safety promotion, 2012) Lawokob, Stephen Emilio Ovugac and Leif Svanstromb; Mutto, Milton; Lawoko, Stephen; Ovuga, Emilio; Svanstrom, Leif
Childhood injuries remain understudied in Uganda. The objective of this study was to determine the extent, nature and determinants of school-related childhood injury risk in north-western Uganda. A cohort of 1000 grade fives from 13 elementary schools was followed-up for one term. Survival and multi-level modelling techniques compared the risk rates across gender, schools and locations. Childhood injuries are common in north-western Uganda. Most of them occur during travel, breaks, practical classes and gardening, while walking, playing, learning and digging. Most injuries result from collisions with objects, sports and falls. Two-thirds of children receive first aid and hospital care. Times to injury were 72.1 and 192.9 person days (p¼0.0000). Gender differences in time to event were significant (p¼0.0091). Girls had better survival rates: cumulative prevalence of childhood injury was 36.1%; with significant gender differences (p¼0.007). Injury rate was 12.3/1000 person days, with a hazard ratio of 1.4. Compared to girls, boys had a 37% higher injury rate (p¼0.004). Rates varied among schools. Associated factors include sex and school. Rural–urban location and school differences do influence childhood injury risk. Childhood injuries are common: the risk is high, gender- and school-specific. Determinants include gender and school. Location and school contexts influence injury risk.
Cohort profile: mental health following extreme trauma in a northern Ugandan cohort of War-Affected Youth Study (The WAYS Study)
(SpringerPlus, 2013) Amone-P’Olak, Kennedy; Jones, Peter B.; Abbott, Rosemary; Meiser-Stedman, Richard; Ovuga, Emilio; Croudace, Tim J.
War experiences are associated with the risk of long-term mental health problems. The War-affected Youths (WAYS) Study comprises a cohort of 539 youths (61% male) aged between 18 to 25 (at baseline) randomly sampled from the population of war-affected youths in northern Uganda. The study aims to chart the trajectory of long-term mental health consequences of war and the roles of individual, family, and community contextual risk and protective factors in influencing the course of mental health using Social Ecology Model, thus, addressing both the individual and its social ecology. Knowledge of postwar contexts may inform policy and guide interventions on postwar psychosocial adjustment and reintegration in conflict-prone Great Lakes region of Africa (Rwanda, Burundi, DR Congo, Uganda, Central African Republic, and South Sudan). Two waves of data collection have been conducted and more data collection is planned. At baseline, information on demographic characteristics, pre-war experiences, psychosocial outcomes, coping, stigma/discrimination, family and community acceptance and relationship, family functioning, and post-war experiences were obtained. At follow-up, information on general health, gender-based violence, PTSD, social skills, trauma memory quality, rumination, self-esteem, and psychosocial outcomes were collected. Approval to access the data can be obtained on application to the Principal Investigator upon submission of a research proposal with ethical approval from the applicant's institution. This research is funded by Wellcome Trust and Gulu University.
A Consortium Approach to Competency‑based Undergraduate Medical Education in Uganda: Process, Opportunities and Challenges
(Educ Health, 2014) Kiguli, Sarah; Mubuuke, Roy; Baingana, Rhona; Kijjambu, Stephen; Maling, Samuel; Waako, Paul; Obua, Celestino; Ovuga, Emilio; Kaawa‑Mafigiri, David; Nshaho, Jonathan; Kiguli‑Malwadde, Elsie; Bollinger, Robert; Sewankambo, Nelson
Uganda, like the rest of Africa, is faced with serious health challenges including human immunodeficiency virus infection/ acquired immunodeficiency syndrome (HIV/AIDS), other infectious diseases and increasing non‑communicable diseases, yet it has a significant shortage of health workers. Even the few health workers available may lack desired competencies required to address current and future health challenges. Reducing Uganda’s disease burden and addressing health challenges requires Ugandan medical schools to produce health workers with the necessary competencies. This study describes the process which a consortium of Ugandan medical schools and the Medical Education Partnership for Equitable Services to all Ugandans (MESAU) undertook to define the required competencies of graduating doctors in Uganda and implement competency‑based medical education (CBME).
Depression and Suicidal Behavior in Uganda
(Makere University., 2005) Ovuga, Emilio
Depression and suicide ideation are prevalent in the general population but their recognition and detection in primary care is problematic. The present study investigated the reliability and validity of the RISLE and its potential use in detecting depressed and/or suicidal individuals in the general population. Methods of study Members of the general population in two districts of Uganda, Adjumani and Bugiri, and fresh students at Makerere University, participated in the study. Two pilot studies were conducted before the collection of data: at Makerere University among fresh students sampled from all faculties in 2001, and in each of the districts in the course of interviewer and research assistants’ training in 2002. Makerere University, Uganda National Council for Science and Technology and the Ethical Committee at Karolinska Institutet approved the study. The Dean of Students and the health and civic leaderships of the respective study sites granted further permission for the study. Analysis Data analysis comprised of general descriptive analysis. Principal component analysis and discriminant function analysis were used to refine the RISLE and construct a shorter 36-item version. Receiver operating characteristic curve was constructed to determine sensitivity and specificity of the short RISLE. The determination of sensitivity, specificity, predictive values, and likelihood ratios, and Cohen’s kappa values at several cut-off points were made to determine the level of agreement between the RISLE and clinical interview method as the gold standard in the study. Validity was assessed by comparing results obtained with the RISLE to results obtained with the 13- item Beck Depression Inventory (BDI) and the 21-item Beck Scale for Suicide ideation (BSS). Results Results revealed good concurrent validity and reliability of both the longer and shorter versions of the RISLE and high correlations between both versions. The probability of a correct detection of an individual with current depressive disorder was 79%, any current psychiatric disorder was 83% and past month suicidality was 83%. Cut-off points varied according to the nature of population studied. The cut-off point for the population in Adjumani district was 10 for any current psychiatric disorder, and 6 for any psychiatric disorder among students. Sensitivity and specificity of the RISLE at cut-off points 10 and 6 were 74.6% and 77.1%, and 88.1% and 60.4% respectively. Positive predictive values for current psychiatric disorder were 82.0% and 75.6% at cut-off points of 10 and 6 respectively. Agreement between the RISLE and clinical interview method was 0.508 at cutoff point 10 for the general population and 0.501 at cut-off point 6 for students. Thirty six percent of the respondents in the general population reported a lifetime experience of suicide ideation and 13% had experienced this in the previous week. The overall prevalence of probably clinically significant depression (BDI score of 20-39) in the general population was 17.4%. Higher rates of suicide ideation and depressed mood were found in females and residents of Adjumani district. Students entering Makerere University showed high prevalence of mental health problems. Conclusions The results of the present study show that the RISLE may be used in conjunction with clinical interview method in the detection and confirmation of individuals with current psychiatric illness and suicidal feelings in the general population. Further work is required to establish its worth as a screening device and its performance in different populations.
The effects of sexual violence on psychosocial outcomes in formerly abducted girls in Northern Uganda: the WAYS study
(BMC psychology, 2015) Amone-P’Olak, Kennedy; Ovuga, Emilio; Jones, Peter Brian
The objective of this study is to investigate the effects of sexual violence on the odds of different psychosocial outcomes (depression, psychotic symptoms, somatic complaints, conduct problems, daily functioning, community relations, and stigma) among formerly abducted girls in Uganda. Methods: Data from an on-going War-Affected Youth Study (WAYS) in Uganda was used to compute the prevalence of psychosocial problems (scores ≥ 75th percentile) among three categories of formerly abducted girls (1) no history of sexual violence without children, 2) a history of sexual violence without children, and 3) a history of sexual violence with children as a consequence) among 210 women (age 22.06, SD = 2.06, range 18–25). Multiple logistic regression analyses were used to examine differences in psychosocial outcomes by the different categories of formerly abducted girls. Results: Compared to participants with no history of sexual violence and without any children, the odds of adverse psychosocial outcomes were increasingly higher for all psychosocial dimensions for those who reported sexual violence with or without children. Those with a history of sexual violence and with children as a consequence had more than five times the odds of reporting depressive symptoms (OR, 5.37; 95 % CI (1.45–19.90), somatic complaints (OR, 6.59; 95 % CI (1.80 – 24.11), and stigma (OR, 13.85; 95 % CI (3.73 – 51.42) compared to those who did not report sexual violence. Conclusion: This study highlighted the risks of psychosocial problems among different categories of formerly abducted girls regarding sexual violence. Vulnerability to psychosocial problems among formerly abducted girls is further compounded by sexual violence, child care, stigma, and poverty.
Endocannabinoid Concentrations in Hair are Associated with PTSD Symptom Severity
(Psychoneuroendocrinology, 2016) Wilker, Sarah; Pfeiffer, Anett; Elbert, Thomas; Ovuga, Emilio; Karabatsiakis, Alexander; Krumbholz, Aniko; Thieme, Detlef; Schelling, Gustav; Kolassa, Iris-Tatjana
The endocannabinoid system has been implicated in the regulation of the stress response, fear memory formation, and inflammatory processes. Posttraumatic stress disorder (PTSD) can result from exposure to extreme stress and is characterized by strong, associative memories for the traumatic events experienced. Furthermore, an elevated physical disease risk has been observed in PTSD, likely to be mediated by inflammatory processes. Therefore, altered endocannabinoid regulation can be expected in individuals with PTSD. However, attempts to assess PTSD-associated differences in the endocannabinoid system from human blood samples have provided inconsistent results, possibly due to fluctuating levels of endocannabinoids. In hair, these neuromodulators are accumulated over time and thus give access to a more stable and reliable assessment. We therefore investigated PTSD-associated differences in hair concentrations of endocannabinoids (Nacyl- ethanolamides palmitoylethanolamide [PEA], oleoylethanolamide [OEA] and stearoylethanolamide [SEA]) in 38 rebel war survivors from Northern Uganda suffering from PTSD and N = 38 healthy rebel war survivors without current and lifetime PTSD. PTSD diagnosis and symptom severity were assessed in structured clinical interviews employing the Posttraumatic Diagnostic Scale (PDS). A significant group difference was observed for OEA, with PTSD patients showing reduced hair concentrations. Regression analyses further revealed strong negative relationships between all investigated N-acyl-ethanolamides and symptom severity of PTSD. The observed reductions in endocannabinoids might account for the increased inflammatory state as well as for the failure to extinguish fear memories observed in PTSD. Our findings add to the accumulating evidence suggesting the endocannabinoid system as a target for pharmacological enhancement of exposure-based psychotherapy for PTSD.
Erratum to: Trends in HIV counseling and testing uptake among married individuals in Rakai, Uganda
(BMC public health, 2013) Matovu, Joseph K.B.; Denison, Julie; Wanyenze, Rhoda K.; Ssekasanvu, Joseph; Makumbi, Fredrick; Ovuga, Emilio; McGrath, Nuala; Serwadda, David
Following publication of this article [1], it has come to our attention that the total number of observations (21,798) has been mistakenly cited as the number of respondents in some paragraphs within the paper. This number appears within the abstract, in the analysis sub-section, within the opening paragraph of the results section, and in the section on HIV prevalence. The number that should have been cited is 11,268 - the total number of respondents in the dataset. 21,798 refers to the total number of observations over the study period. The percentages estimated out of 21,798 have been recalculated. Of the 11,268 individuals enrolled in this study, 81.2% (9,220) were in monogamous marital unions while 18.2% (2,048) were in polygamous marital unions. Of those in polygamous marital unions (n = 2,048), 52.8% were females while 47.2% were males. Thirty eight per cent of the participants (4,236) reported that they had ever received HCT (i.e. individual or couples’ HCT). Overall HIV prevalence was 11.9% (1,337 of 11,268). However, it is important to note that since serial cross-sectional analyses of each of the 4 study visits were used under consideration, the findings shown in Tables 1 and 2 as well as Fig. 2 (A,B,C) are not affected by this error.
From war to classroom: PTSD and depression in formerly abducted youth in Uganda
(Frontiers in psychiatry, 2015) Winkler, Nina; Ruf-Leuschner, Martina; Ertl, Verena; Pfeiffer, Anett; Schalinski, Inga; Ovuga, Emilio; Neuner, Frank; Elbert, Thomas
Trained local screeners assessed the mental-health status of male and female students in Northern Ugandan schools.The study aimed to disclose potential differences in mental health-related impairment in two groups, former child soldiers (n D354) and other war-affected youth (nD489), as well as to separate factors predicting mental suffering in learners. Methods: Participants were randomly selected. We used the Post-Traumatic Diagnostic Scale to assess symptoms of post-traumatic stress disorder (PTSD) and for potential depression the respective section of the Hopkins Symptom Checklist with a locally validated cut-off. Results: Almost all respondents had been displaced at least once in their life. 30% of girls and 50% of the boys in the study reported past abduction history. Trauma exposure was notably higher in the group of abductees. In former child soldiers, a PTSD rate of 32% was remarkably higher than that for non-abductees (12%). Especially in girls rates of potential depression were double those in the group of former abductees (17%) than in the group of non-abductees (8%). In all groups, trauma exposure increased the risk of developing PTSD. A path-analytic model for developing PTSD and potential depression revealed both previous trauma exposure as well as duration of abduction to have significant influences on trauma-related mental suffering. Findings also suggest that in Northern Ugandan schools trauma spectrum disorders are common among war-affected learners. Conclusions: Therefore, it is suggested the school context should be used to provide mental-health support structures within the education system for war-affected youth at likely risk of developing war-related mental distress.
Gender and age disparities in adult undernutrition in northern Uganda: high-risk groups not targeted by food aid programmes
(Tropical Medicine & International Health, 2016) Schramm, Stine; Ocaka Kaducu, Felix; Smedemark, Siri Aas; Ovuga, Emilio; Sodemann, Morten
To determine the prevalence of adult malnutrition and associated risk factors in a postconflict area of northern Uganda. methods A cross-sectional community survey was performed from September 2011 to June 2013. All registered residents in Gulu Health and Demographic Surveillance System aged 15 years and older were considered eligible. Trained field assistants collected anthropometric measurements (weight and height) and administered questionnaires with information on sociodemographic characteristics, food security, smoking and alcohol. Nutritional status was classified by body mass index. results In total, 2062 men and 2924 women participated and were included in the analyses. The prevalence of underweight was 22.3% for men and 16.0% for women, whereas the prevalence of overweight was 1.5% for men and 7.6% for women. In men, underweight was associated with younger (15–19 years) and older age (>55 years) (P < 0.001), being divorced/separated [odds ratio (OR) = 1.91 (95% confidence interval (CI): 1.21–2.99] and smoking (OR = 2.13, 95% CI: 1.67– 2.73). For women, underweight was associated with older age (P < 0.001) and hungry-gap rainy season (May–July) (OR = 1.33, 95% CI: 1.04–1.69). Widowed or divorced/separated women were not more likely to be underweight. No association was found between education, alcohol consumption or food security score and underweight. conclusions Our findings are not in line with the conventional target groups in nutritional programmes and highlight the importance of continuous health and nutritional assessments of all population groups that reflect local social determinants and family structures.
“I Forgive to Forget”: Implications for Community Restoration and Unity in Northern Uganda
(Journal of African Conflicts and Peace Studies, 2018) Obika, Julaina A.; Ovuga, Emilio
Northern Uganda has experienced over ten years of relative peace since the beginning of the peace talks and cessation of hostilities between the incumbent government and the Lord’s Resistance Army in 2006. Although a final peace agreement has not been signed, the internally displaced persons’ (IDP) camps were decommissioned and people told to return home. The war in northern Uganda has been well documented – its causes and the actors (see Allen 2006; Allen & Vlassenroot 2010; Atkinson 2009; Finnstrom 2008), as well as the untold suffering that unarmed civilians, men, women and children have gone through as a result (see de Temmerman 2001; Dolan 2009; Eichsraedt 2009; Green 2008; Ovuga, Oyok & Moro 2008).
ICD-11 Trauma Questionnaires for PTSD and Complex PTSD: Validation among Civilians and Former Abducted Children in Northern Uganda
(Journal of Psychiatry, 2015) Dokkedah, Sarah; Oboke, Henry; Ovuga, Emilio; Elklit, Ask
ICD-11 is expected to introduce a new diagnosis of C-PTSD, along with a revision of the current PTSD diagnosis. Are the suggested diagnostic tools for PTSD and C-PTSD valid in a developing country? Method: The tools have been tested on former abducted and regular civilians in northern Uganda (n=314), who have been influenced by the civil war that lasted for more than two decades. Results: The prevalence of either PTSD or C-PTSD was 36.6% and PTSD and C-PTSD was further found to correlate with symptoms of depression, anxiety and somatic complaints. Conclusion: Based on its findings the study concludes that the ICD-11 tools for PTSD and C-PTSD both appear to be valid as suggested by both discriminant and convergent validation of the tools. However, future research can benefit from studying cultural aspects of these diagnoses.
Influence of Climatic Factors on Malaria Epidemic in Gulu District, Northern Uganda: A 10-Year Retrospective Study
(Malaria research and treatment, 2018) Simple, Ouma; Mindra, Arnold; Obai, Gerald; Ovuga, Emilio; Igwaro Odongo-Aginya, Emmanuel
Globally, 15 countries, mainly in Sub-Saharan Africa, account for 80% of malaria cases and 78% of malaria related deaths. In Uganda, malaria is endemic and the mortality and morbidity due to malaria cause significant negative impact on the economy. In Gulu district, malaria is the leading killer disease among children <5 years. In 2015, the high intensity of malaria infection inNorthernUganda revealed a possible link between malaria and rainfall.However, available information on the influence of climatic factors onmalaria are scarce, conflicting, and highly contextualized and therefore one cannot reference such information to malaria control policy in Northern Uganda, thus the need for this study. Methods and Results. During the 10 year’s retrospective study period a total of 2,304,537 people suffered frommalaria in Gulu district.Malaria infection was generally stable with biannual peaks during the months of June-July and September-October but showed a declining trend after introduction of indoor residual spraying. Analysis of the departure of mean monthly malaria cases from the long-term mean monthly malaria cases revealed biannual seasonal outbreaks before and during the first year of introduction of indoor residual spraying. However, there were two major malaria epidemics in 2015 following discontinuation of indoor residual spraying in the late 2014. Children <5 years of age were disproportionally affected bymalaria and accounted for 47.6% of the totalmalaria cases. Both rainfall (P=0.04) and relative humidity (P=0.003) had significant positive correlations with malaria.Meanwhile, maximumtemperature had significant negative correlation with malaria (P=0.02) but minimum temperature had no correlation with malaria (P=0.29). Conclusion. Malaria in Gulu disproportionately affects children under 5 years and shows seasonality with a generally stable trend influenced by rainfall and relative humidity. However, indoor residual spraying is a very promising method to achieve a sustained malaria control in this population.
The influence of different types of war experiences on depression and anxiety in a Ugandan cohort of war-affected youth: the WAYS study
(Social psychiatry and psychiatric epidemiology, 2014) Amone-P’Olak, Kennedy; Ovuga, Emilio; Croudace, Tim J.; Jones, Peter B.; Abbott, Rosemary
Background War experiences (WE) are frequently associated with mental health problems. Whether different types of WE vary in predicting which problem, or how severe, in former child soldiers (FCS) remains unknown. Methods Using data from the first wave of an on-going longitudinal cohort study (the WAYS study), we investigated relations between types of WE and symptoms of depression/anxiety among FCS in Northern Uganda (N = 539, baseline age = 22.39; SD = 2.03, range 18–25). Using robust Maximum Likelihood estimation in SEM, regression analyses were performed to relate binary indicators of types of WE to a single latent factor capturing symptoms of depression/anxiety. Results SEM results showed that ‘‘direct personal harm’’, ‘‘witnessing violence’’, ‘‘deaths’’, ‘‘threat to loved ones’’, ‘‘involvement in hostilities’’, and ‘‘sexual abuse’’ indicators were related to reported symptoms of depression/anxiety irrespective of gender and age. Multivariable models revealed independent associations of ‘‘witnessing violence’’ (b = 0.29, SE = 0.09, p\0.001) and ‘‘deaths’’ (b = 0.14, SE = 0.05, p\0.001) with symptoms of depression/anxiety in both sexes. ‘‘Sexual abuse’’ (b = 0.32, SE = 0.16, p\0.001) independently predicted symptoms of depression/anxiety for female but not male youths whilst ‘‘threat to loved ones’’ (b = 0.13, SE = 0.07, p\0.05) independently predicted symptoms of depression/anxiety in male but not female youths. Conclusions Dimensions of WE predicted symptoms of depression/anxiety differently, but it is hard to establish their causal status. Our findings suggest that it might be fruitful to consider such exposure variations of WE when designing interventions to mitigate the symptoms of depression/anxiety on male and female FCS.
The influence of types of war experiences on conduct problems in waraffected youth in Northern Ugandan: Findings from the WAYS study
(Psychiatry research, 2017) Amone-P′Olaka, Kennedy; Ovuga, Emilio
Exposure to war is associated with poor psychosocial outcomes. Yet the effects of different types of war events on various psychosocial outcomes such as conduct problems remain unknown. This study aims to assess whether various war events differ in predicting conduct problems. Using data from an on-going longitudinal research project, the WAYS study, the current article examined the relationship between specific war events and conduct problems in war-affected youth in Northern Uganda (N=539, baseline age=22.39; SD=2.03, range 18– 25). Regression analyses were conducted to relate each type of war experience to conduct problems. War categories of “witnessing violence”, “deaths”, “threat to loved ones” and “sexual abuse” were associated with reporting conduct problems. Multivariable models yielded independent effects of ‘‘witnessing violence’’ (β=0.09, 95% CI: 0.01, 0.18) and ‘‘Sexual abuse’’ (β=0.09, 95% CI: 0.02, 0.19) on conduct problems while “duration in captivity” independently and negatively predicted conduct problems (β=−0.14, 95% CI: −0.23, −0.06). Types of war events vary in predicting conduct problems and should be considered when designing interventions to alleviate negative consequences of exposure to war. Moreover, longer duration in captivity appear to protect war-affected youth from conduct problems.
Integrating mental health into primary health care: local initiatives from Uganda
(World Psychiatry, 2007) Ovuga, Emilio; Boardman, Jed; Wasserman, Danuta
Uganda has passed through political and bloody civil strife stretching over 40 years. Since 1987 the HIV/AIDS pandemic has compounded the problems of the country. The present paper describes some initiatives to develop mental health services in one district of the country. A bottom-up approach in the district resulted in the formation of a community-led mental health program with strong support from two self-help groups, district political leaders and district representatives in parliament. Primary health care providers at all levels of health care in the district were trained in order to make services accessible to the rural population. Further plans based on initial exploratory discussions aim to involve the education department, the welfare and probation office, prisons and police, the military, church and cultural leaders and traditional healers. These initiatives show that it is possible to empower communities to participate in the development of mental health programs in a low-income country.
Is nodding syndrome in northern Uganda linked to consumption of mycotoxin contaminated food grains?
(BMC Research Notes, 2018) Echodu, Richard; Edema, Hilary; Malinga, Geoffrey Maxwell; Hendy, Adam; Colebunders, Robert; Kaducu, Joyce Moriku; Ovuga, Emilio; Haesaert, Geert
Nodding syndrome (NS) is a type of epilepsy characterized by repeated head-nodding seizures that appear in previously healthy children between 3 and 18 years of age. In 2012, during a WHO International Meeting on NS in Kampala, Uganda, it was recommended that fungal contamination of foods should be investigated as a possible cause of the disease. We therefore aimed to assess whether consumption of fungal mycotoxins contributes to NS development. Results: We detected similar high levels of total aflatoxin and ochratoxin in mostly millet, sorghum, maize and groundnuts in both households with and without children with NS. Furthermore, there was no significant association between concentrations of total aflatoxin, ochratoxin and doxynivalenol and the presence of children with NS in households. In conclusion, our results show no supporting evidence for the association of NS with consumption of mycotoxins in contaminated foods.
Knowledge and Attitude towards Cervical Cancer Screening among Females Attending out Patient Department in Health Centre IIIs in Oyam District
(Open Journal of Preventive Medicine, 2017) Waiswa, Ali; Nsubuga, Ronald; Muwasi, Margret; Kimera, Isaac; Ndikabona, Geofrey; Tusingwire, Pliers D.; Mshilla, Maghanga; Ovuga, Emilio; Akera, Peter
Cervical cancer is a serious health concern in Uganda. Early screening and detection certainly improves chances of survival and treatment outcome. Sound knowledge and positive attitudes highly influence acceptability and uptake of screening methods. This descriptive cross-sectional study determines knowledge and attitudes towards Cervical Cancer screening amongst female out-patients aged 15 - 49 years, attending Health Centre IIIs in Oyam District, Northern Uganda. A systematically obtained sample of 445 respondents was interviewed using semi-structured questionnaires and focused group discussions. Quantitative data was analyzed using SPSS 16.0. Directed content analysis of themes of transcribed qualitative data was conducted manually. Of the 445 respondents, only 62.7% (n = 279) had heard of cervical cancer amongst which only 35.1% (n = 85) had been screened; 13.7% (n = 34) did not know what screening was; 3.7% (n = 9) were not sure and 5.8% (n = 14) knew it as removal of the cervix. Only 39.1% (n = 174) believed that cervical cancer can be prevented. There is still limited knowledge and lots of misconceptions about cervical cancer screening in the communities, which requires massive sensitization of the population at risk to change negative attitudes and maximize acceptability to screening methods.
Knowledge and attitudes of doctors towards e-health use in healthcare delivery in government and private hospitals in Northern Uganda: a cross-sectional study
(BMC medical informatics and decision making, 2015) Tabo Olok, Geoffrey; Onen Yagos, Walter; Ovuga, Emilio
E-health is an essential information sharing tool in healthcare management and delivery worldwide. However, utilization of e-health may only be possible if healthcare professionals have positive attitudes towards e-health. This study aimed to determine the relationships between healthcare professionals’ attitudes towards e-health, level of ICT skills and e-Health use in healthcare delivery in government and private hospitals in northern Uganda. Methods: Cross-sectional survey design was used. Sixty-eight medical doctors in three government hospitals and four private hospitals in Northern Uganda participated in the study. A pretested self-administered questionnaire was used to collect the required data. Data was analysed using SPSS software Version 19. Results: Out of the 68 respondents, 39 (57.4 %) reported access to computer and 29 (48.5 %) accessed Internet in the workplace. Majority of healthcare professionals had positive attitudes towards e-health attributes (mean 3.5). The level of skills was moderate (mean 3.66), and was the most important and significant predictor of ICT use among healthcare professionals (r = .522, p < .001); however, attitudes towards e-health attributes did not contribute significantly in predicting e-health use. Conclusions: The findings suggest need for hospitals managements to strengthen e-health services in healthcare delivery in Northern Uganda.

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