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  1. Home
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Browsing by Author "Ssekamatte, Tonny"

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    Alcohol use and associated factors among adolescent boys and young men in Kampala, Uganda
    (Substance Abuse Treatment, Prevention, and Policy, 2021) Ndugwa Kabwama, Steven; Matovu, Joseph K.B.; Ssenkusu, John M.; Ssekamatte, Tonny; Wanyenze, Rhoda K.
    Alcohol use leads to about 3 million deaths globally. The alcohol industry employs marketing strategies to establish their brands in the lives of young people at a time when addictive behaviors are initiated and reinforced. We conducted a survey among adolescent boys and young men (ABYM) to estimate the prevalence of alcohol use and associated factors using the Health Belief Model as the guiding framework. The study was conducted among ABYM in- or out-of-school aged 10–24 years in Kampala, Uganda. We used questions adopted from the Global School-based Student Health Survey and the WHO STEPwise approach to Surveillance questionnaire to collect data. The outcome of interest was alcohol use within 30 days before the interview. We also asked about characteristics such as alcohol use by siblings, parents/ guardians, school status among others. We used odds ratios obtained via a logistic regression model as the measure of association. A total of 2500 ABYM participated, of which 262 (10.5 %, 95 %CI 9.3–11.7) had consumed alcohol within 30 days before the interview. Out-of-school ABYM had higher odds of consuming alcohol compared with their inschool counterparts AOR 1.55 (95 %CI 1.09–2.20). Compared with ABYM whose parents/ guardians did not drink alcohol, ABYM whose both parents consumed alcohol had higher odds of consuming alcohol AOR 2.24 (95 %CI 1.38–3.64) as were those with only a mother or female guardian who consumed alcohol AOR 1.95 (95 %CI 1.11–3.41). ABYM with siblings that drink alcohol had higher odds of consuming alcohol AOR 2.25 (95 %CI 1.80–3.52). ABYM who possessed items with an alcohol brand logo had higher odds of consuming alcohol AOR 2.00 (95 %CI 1.33–3.01).
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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 to access and utilisation of HIV/STIs prevention and care services among transwomen sex workers in the greater Kampala metropolitan area, Uganda
    (BMC infectious diseases, 2020) Ssekamatte, Tonny; Isunju, John B.; Muyanga, Naume; Buregyeya, Esther; Mugambe, Richard K.; Wanyenze, Rhoda K.; Bukenya, Justine N.
    Trans-women sex workers bear the greatest brunt of HIV and other sexually transmitted infections (STI). Trans-women are 49 times more at risk of HIV infections compared to the general population. However, they remain underserved and continue to grapple with access to and utilization of HIV/STI prevention services. This study explored barriers to access and utilization of HIV/STI prevention services and associated coping mechanisms. This exploratory qualitative study was conducted among trans-women sex workers in the Greater Kampala Metropolitan area, Uganda. A total of 22 in-depth interviews, 6 key informant interviews and 9 focus group discussions were conducted to obtain data on barriers to access and utilization of HIV and other STI prevention and care services, and coping strategies of trans-women sex workers. Data were analyzed through thematic analysis using a hybrid of inductive and deductive approaches. Individual level barriers to access and utilization of HIV/STI prevention and care services included internalized stigma and low socio-economic status. Healthcare system barriers included social exclusion and lack of recognition by other key population groups; stigmatisation by some healthcare providers; breach of confidentiality by some healthcare providers; limited hours of operation of some key population-friendly healthcare facilities; discrimination by straight patients and healthcare providers; stockout of STI drugs; inadequate access to well-equipped treatment centres and high cost of drugs. At community level, transphobia hindered access and utilisation of HIV/STI prevention and care services. The coping strategies included use of substitutes such as lotions, avocado or yoghurt to cope with a lack of lubricants. Herbs were used as substitutes for STI drugs, while psychoactive substances were used to cope with stigma and discrimination, and changing the dress code to hide their preferred gender identity
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    COVID‑19 Awareness, Adoption of COVID‑19 Preventive Measures, and Effects of COVID‑19 Lockdown Among Adolescent Boys and Young Men in Kampala, Uganda
    (Journal of community health, 2021) Matovu, Joseph K. B.; Kabwama, Stephen N.; Ssekamatte, Tonny; Ssenkusu, John; Wanyenze, Rhoda K.
    There is growing evidence of the challenges with adherence to COVID-19 prevention measures and the effect of the preventionmeasures on the health of populations in various parts of the world but with limited documentation in sub-Saharan Africa. We assessed COVID-19 awareness, adoption of COVID-19 prevention measures, and the effects of COVID-19 lockdown on the mental health status, socio-economic disruptions and engagement in unhealthy behaviours among 2500 in- and out-ofschool adolescent boys and young men (ABYM) aged 10–24 years in Kampala, Uganda. 74.8% (n = 1869) were in-school; nearly half (47.3%, n = 1182) were aged 15–19 years. Although > 80% were aware of at least two COVID-19 prevention measures, only 22.2% (n = 555) reported that they always wore a face mask while in a public place; 40.9% (n = 1023) always washed their hands with soap and running water while 17.6% (n = 440) always avoided gatherings of more than five people. COVID-19 lockdown led to: (a) increased mental health challenges (e.g. 1.2% [n = 31] contemplated committing suicide); (b) limited ability to meet basic needs (e.g. 62.0% [n = 1549] found it difficult to afford a diverse/balanced diet); (c) socioeconomic disruptions (e.g. 30.3% [n = 756] experienced a reduction in income) and (d) engagement in unhealthy behaviours (e.g. 62% [n = 1554] reported a sedentary life style such as excessive watching of TV). These effects were more pronounced among older adolescent boys (15–19 years) and young men (20–24 years) and out-of-school compared to in-school ABYM. Our findings suggest a need for appropriate health promotion, mental health and socio-economic interventions targeting ABYM in Kampala, Uganda.
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    Dietary diversity and associated factors among adolescents in eastern Uganda: a cross-sectional study
    (BMC Public Health, 2020) Isabirye, Nathan; Nnakate Bukenya, Justine; Nakafeero, Mary; Ssekamatte, Tonny; Guwatudde, David; Fawz, Wafaie
    Globally adolescents constitute over 16% but in SSA, they make up 23% of the population. While little is known about diets of these adolescents, rapid changes in physiological and social processes undergone require adequate diets. This study aimed to determine dietary diversity and associated factors among adolescents residing in the Iganga -Mayuge HDSS. Methods: As part of the African Research, Implementation Science, and Education (ARISE) Network, we analysed collected data among 598 adolescents to assess the health status and adolescents’ behaviour. Dietary diversity was scored using the 9 food group categories as per the Food and Agriculture Organization -WDDS. Crude and adjusted prevalence rate ratios were estimated using the modified Poisson regression model to identify associated factors. Results: Among the participants, 45.3% had a low dietary diversity score. Proportions of adolescents who consumed from the different food categories over a 24-h period were; cereals/roots/tubers (99.7%), fats & oils (87.0%), spices & beverages (84.1%), sweets (77.1%), legumes (66.2%), other non-vitamin A-rich vegetables (53.8%), dark green leafy vegetables (42.3%), meat/poultry/fish (33.1%), dairy products (32.9%), eggs (11.2%), vitamin A-rich fruits and vegetables (33.4%) and other fruits (8.2%). Staying with a single parent or guardian, low socio-economic class, and dependency on home meals was associated with low dietary diversity. Conclusions: Adolescents diets were low in diversity and characterised with low micronutrients source foods, but plenty of fats and oils. Interventions to address contributing factors to the burden ought to target the parenting contexts of the adolescents residing in rural eastern Uganda
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    Knowledge, Attitude and Practices Related to the Use of Personal Protective Equipment among Welders in Small-scale Metal Workshops in Nansana Municipality, Wakiso District, Uganda
    (Health Psychology and Behavioral Medicine, 2022) Nalugya, Aisha; Kiguli, Juliet; Wafula, Solomon T.; Nuwematsiko, Rebecca; Mugambe, Richard K.; Oputan, Patience; Tigaiza, Arnold; Isunju, John Bosco; Ssekamatte, Tonny
    Despite the risks involved in welding, there is limited evidence of the knowledge, attitude and practices related to the use of personal protective equipment (PPE) among welders in small-scale metal workshops. We assessed the level of knowledge, attitude and practices (KAP) related to PPE use among welders in small-scale workshops in Nansana Municipality, Wakiso district, Uganda.
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    Knowledge, perceptions and effects of Ebola virus disease outbreak on the pig value chain in the agro-pastoralist district of Luwero, Central Uganda
    (BMC infectious diseases,, 2021) Birungi, Doreen; Tumwine, Gabriel; Kato, Charles Drago; Ssekamatte, Tonny; Ocaido, Michael; Majalija, Samuel
    Ebola Virus Disease (EVD) outbreaks have a significant impact on the health and wellbeing, and livelihoods of communities. EVD response interventions particularly affect the food value chain, and income security of pig farmers in agro-pastoral communities. Despite the enormous effort of EVD response interventions, there is paucity of information towards EVD among those involved in the pig value chain, as well as the effect of EVD outbreaks on the pig value chain. This study therefore, assessed the knowledge, perceptions on the occurrence of Ebola and its effects on the pig value chain in the agro-pastoral district of Luweero, Central Uganda. A cross sectional study was conducted in two parishes of Ssambwe and Ngalonkulu, Luwero district. A total of 229 respondents were included in the study. Structured questionnaires, key informant interviews and focus group discussions were conducted to collect data. Quantitative data was analysed using SPSS version 22 while qualitative data was analysed using thematic content analysis. Of the 229 respondents, 95.6% could recall the occurrence of the last EVD outbreak in their locality. About 24.5% associated EVD with touching pigs or eating pork. Regarding knowledge, 194 (84.7%) correctly associated EVD with handling Ebola infected persons, 191 (83.4%) with migration of people from endemic areas, 148 (64.9%) eating monkey meat, 127 (55.5%) with eating bats, and 198 (64.9%) with conducting public meetings where there is an Ebola infected person. Out of 142 farmers, 55 (38.7%) believed that Ebola outbreaks affected demand and sale of pigs. The EVD outbreak significantly led to a reduction in the average number of pigs sold (P = 0.001), the average number of pigs bought by traders (P = 0.04), and the number of pigs sold/ slaughtered by butcher men at pork eating places (P = 0.03). This study showed that EVD outbreak negatively affected the pig value chain i.e., the demand and supply of pigs and pork. Therefore, there is need to sensitize the stakeholders in the pig value chain on EVD in order to minimize the negative economic impacts associated with EVD outbreaks.
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    Sexual behaviours among adolescents in a rural setting in eastern Uganda: a cross-sectional study
    (Tropical Medicine & International Health, 2020) Nnakate Bukenya, Justine; Nakafeero, Mary; Ssekamatte, Tonny; Isabirye, Nathan; Guwatudde, David; Fawzi, Wafaie W.
    Globally as adolescents transition into adulthood, some engage in risky sexual behaviours. Such risky behaviours expose adolescents to unintended pregnancy and sexually transmitted infections (STIs), including HIV infection. Our objective was to examine sexual practices of adolescents (aged 10–19 years) in eastern Uganda and identify factors associated with having ever had sexual intercourse. methods Face-to-face interviews were conducted using a standardised questionnaire among randomly selected adolescents residing within the Iganga-Mayuge Health and Demographic Surveillance Site in eastern Uganda. Crude and adjusted prevalence rate ratios (PRR) were estimated using the Modified Poisson regression model to identify factors associated with adolescents having ever had sex. results Of the 598 adolescents studied, 108 (18.1%) reported ever having had sexual intercourse, of whom 20 (18.5%) had ever gotten pregnant. Adolescents who reported to be out of school, 76 (12.7%), were more likely to have ever had sexual intercourse (PRR = 1.82, CI = 1.09–3.01). Females were less likely to ever have had sexual intercourse (PRR 0.69 (0.51–0.93) than males. History of ever having had sexual intercourse was associated with adolescents sexting (PRR = 1.54, CI: 1.14–2.08), watching sexually explicit films (PRR = 2.29 Cl: 1.60 - 3.29) and experiencing verbal jokes about sexual intentions (PRR = 1.76, Cl: 1.27 - 2.44). conclusions A majority of participants reported not being sexually active; however, interventions should be required for both sexually active and not sexually active adolescents. Programmes targeted at adolescents in this and similar communities should include comprehensive sex education, and contraceptive distribution among adolescents. In particular, urgent interventions are needed to guide adolescents as they use social media.

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