Browsing by Author "Riolexus, Alex A."

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    Comparative epidemiologic analysis of COVID-19 patients during the first and second waves of COVID-19 in Uganda
    (IJID Regions, 2022) Elayeete, Sarah; Nampeera, Rose; Nsubuga, Edirisa J.; Nansikombi, Hildah T.; Kwesiga, Benon; Kadobera, Daniel; Amanya, Geofrey; Ajambo, Miriam; Mwanje, Wilbrod; Riolexus, Alex A.; Harris, Julie R.
    Introduction: Uganda was affected by two major waves of coronavirus disease 2019 (COVID-19). The first wave during late 2020 and the second wave in late April 2021. This study compared epidemiologic characteristics of hospitalized (HP) and non-hospitalized patients (NHP) with COVID-19 during the two waves of COVID-19 in Uganda. Methods: Wave 1 was defined as November–December 2020, and Wave 2 was defined as April–June 2021. In total, 800 patients were included in this study. Medical record data were collected for HP (200 for each wave). Contact information was retrieved for NHP who had polymerase-chain-reaction-confirmed COVID-19 (200 for each wave) from laboratory records; these patients were interviewed by telephone. Findings: A higher proportion of HP were male in Wave 1 compared with Wave 2 (73% vs 54%; P = 0.0001). More HP had severe disease or died in Wave 2 compared with Wave 1 (65% vs 31%; P < 0.0001). NHP in Wave 2 were younger than those in Wave 1, but this difference was not significant (mean age 29 vs 36 years; P = 0.13). HP were significantly older than NHP in Wave 2 (mean age 48 vs 29 years; P < 0.0001), but not Wave 1 (mean age 48 vs 43 years; P = 0.31). Interpretation: Demographic and epidemiologic characteristics of HP and NHP differed between and within Waves 1 and 2 of COVID-19 in Uganda.
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    Individual and household risk factors for COVID-19 infection among household members of COVID-19 patients in home-based care in western Uganda, 2020
    (IJID Regions, 2022) Amanya, Geofrey; Elyanu, Peter; Kadobera, Daniel; Riolexus, Alex A.; Harris, Julie R.; Mugisha, Richard
    To investigate factors associated with COVID-19 among household members of patients in home-based care (HBC) in western Uganda. Methods: We conducted a case-control and cohort study. Cases were RT-PCR-confirmed SARS-CoV-2 diagnosed 1-30 November 2020 among persons in HBC in Kasese or Kabarole Districts. We compared 78 case-households (≥1 secondary case) to 59 control-households (no secondary cases). The cohort included all case-household members. Data were captured by in-person questionnaire. We regressed to calculate odds and risk ratios. Results: Case-households were larger than control-households (mean 5.8 vs 4.3 members, p<0.0001). Having ≥1 household member per room (aOR=4.5, 95%CI 2.0-9.9) or symptom development (aOR=2.3, 95%CI 1.1-5.0), interaction (aOR=4.6, 95%CI 1.4-14.7) with primary case-patient increased odds of case-household status. Households assessed for suitability for HBC reduced odds of case-household status (aOR=0.4, 95%CI=0.2-0.8). Interacting with primary case-patient (aRR=1.7, 95%CI 1.1-2.8) increased the risk of individual infection among household members. Conclusion: Household and individual factors influence secondary infection risk in HBC. Decisions about HBC should be made with these in mind
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    Risk perception and psychological state of healthcare workers in referral hospitals during the early phase of the COVID‑19 pandemic, Uganda
    (BMC psychology, 2021) Migisha, Richard; Riolexus, Alex A.; Kwesiga, Benon; Bulage, Lilian; Kadobera, Daniel; Kabwama, Steven N.; Katana, Elizabeth; Ndyabakira, Alex; Wadunde, Ignatius; Byaruhanga, Aggrey; Amanya, Geofrey; Harris, Julie R.; Fitzmaurice, Arthur G.
    Safeguarding the psychological well-being of healthcare workers (HCWs) is crucial to ensuring sustainability and quality of healthcare services. During the COVID-19 pandemic, HCWs may be subject to excessive mental stress. We assessed the risk perception and immediate psychological state of HCWs early in the pandemic in referral hospitals involved in the management of COVID-19 patients in Uganda. Methods: We conducted a cross-sectional survey in five referral hospitals from April 20–May 22, 2020. During this time, we distributed paper-based, self-administered questionnaires to all consenting HCWs on day shifts. The questionnaire included questions on socio-demographics, occupational behaviors, potential perceived risks, and psychological distress. We assessed risk perception towards COVID-19 using 27 concern statements with a four-point Likert scale. We defined psychological distress as a total score > 12 from the 12-item Goldberg’s General Health Questionnaire (GHQ-12). We used modified Poisson regression to identify factors associated with psychological distress. Results: Among 335 HCWs who received questionnaires, 328 (98%) responded. Respondents’ mean age was 36 (range 18–59) years; 172 (52%) were male. The median duration of professional experience was eight (range 1–35) years; 208 (63%) worked more than 40 h per week; 116 (35%) were nurses, 52 (14%) doctors, 30 (9%) clinical officers, and 86 (26%) support staff. One hundred and forty-four (44%) had a GHQ-12 score > 12. The most common concerns reported included fear of infection at the workplace (81%), stigma from colleagues (79%), lack of workplace support (63%), and inadequate availability of personal protective equipment (PPE) (56%). In multivariable analysis, moderate (adjusted prevalence ratio, [aPR] = 2.2, 95% confidence interval [CI] 1.2–4.0) and high (aPR = 3.8, 95% CI 2.0–7.0) risk perception towards COVID-19 (compared with low-risk perception) were associated with psychological distress. Conclusions: Forty-four percent of HCWs surveyed in hospitals treating COVID-19 patients during the early COVID- 19 epidemic in Uganda reported psychological distress related to fear of infection, stigma, and inadequate PPE. Higher perceived personal risk towards COVID-19 was associated with increased psychological distress. To optimize