NRU :: Browsing by Author "Tindyebwa, Denis"

Browsing by Author "Tindyebwa, Denis"

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Family Caregivers in Rural Uganda: The Hidden Reality
(Health Care for Women International, 2007) Kipp, Walter; Tindyebwa, Denis; Rubaale, Tom; Karamagi, Ednah; Bajenja, Ellen
Kabarole, Kyenyoyo, and Kamwenge districts have a home-based care program that consists of formal and informal parts. The formal part is made up of professional, government-paid nurses who are based at the nearest health center and who visit the homes of patients who have been admitted to the program. The informal part of the program is composed of family members who are the principle caregivers for the AIDS patients at home. Home care nurses deal only with the care for the AIDS patients and not with personal issues of the family caregiver. In the past few years, home visits of professional nurses have declined due to funding shortages of the Kabarole Health Department. Before funding cuts were introduced, the home-based care program coverage reached only an estimated 35% of homes requiring care. The HIV prevalence in the sexually active population is high and estimated to be around 14% in the districts. An estimated 4,200 AIDS patients require clinical care in the Kabarole district alone. The districts are typical for sub-Saharan Africa, with a high burden of infectious diseases, including malaria, tuberculosis, and parasitic infections. All homes visited during this study had no running water and no electricity, and were built poorly, with thatched roofs, mud walls, and earthen floors. Generally, home-based care programs are very much limited in Uganda and, to the best of our knowledge, there was no information on any formal programs targeting family caregiver support.
Family Caregiving to AIDS Patients: The Role of Gender in Caregiver Burden in Uganda
(Journal of International Women's studies, 2006) Kipp, Walter; Tindyebwa, Denis; Karamagi, Ednah; Rubaale, Tom
The objectives of the study were: 1) What is the burden of care for male and female family caregivers of AIDS patients? and 2) Which factors influence the family care burden for AIDS patients at home? A questionnaire was completed by 29 male and 91 female family caregivers of AIDS patients living in four rural areas in western Uganda. Participating caregivers were selected from a patient list of the home-based care program for AIDS patients and then interviewed. The responses from the questionnaire were used to calculate care burden scores for caregivers of both genders and the scores in each group were compared. In addition, other factors relevant to the burden of family care were extracted and tested in bivariate and multivariate analysis to test whether they were predictors of the care burden. Results show that the care burden scores were high in all domains, except those regarding relationship within the families and substance abuse. Both male and female caregivers reported a similar care burden. Caregivers for spouses had higher care burden scores compared to those who cared for other relatives. The intensity of care was also a significant predictor of the care burden, while other factors
Handbook on Counselling and Psychosocial Care for Children and Adolescents Living with and Affected by HIV in Africa
(African Network for the Care of Children Affected by HIV/AIDS – ANECCA, 2013) Nasaba, Rosemary; Tindyebwa, Denis; Musiime, Victor; Iriso, Robert; Ingabire, Resty; Nansera, Denis; Etima-Kizito, Monica; Kasule, Joseylee; Duffy, Malia
In 2013, the Joint United Nations Programme on HIV/AIDS (UNAIDS) proposed the ambitious “fasttrack” goals to end the global HIV epidemic by 2030, including reducing new HIV infections among children and adolescents from 500,000 annually to 200,000 annually (2014). Donor- and countrydriven investments have dramatically strengthened the HIV response around the world. Despite these major commitments and advances, HIV incidence is on the rise in young people; and in Africa, AIDS remains a leading cause of death in adolescents. The proportion of HIV-positive children and adolescents receiving HIV services, including ART, has also continued to lag well behind that of adults. Evidence of this gap from the World Health Organization (WHO) shows that 52% of children compared to 59% of adults were on ART in 2017 (2018). Controlling the epidemic, within countries and globally, must include preventing, testing for, and treating HIV in children and adolescents, including addressing psychosocial issues experienced by these populations to enhance their ability to manage the disease and live positively. To improve access to HIV services, several African countries have decentralised HIV care to primary health facilities. However, health care providers (HCPs) in many primary care settings do not have access to up-to-date clinical resources to build their knowledge so they can provide comprehensive HIV care for children and adolescents. HIV care for children and adolescents is complex, and requires not only addressing their medical needs, but also caring for their psychological wellbeing— to keep them healthy, retain them in care, and enable them to live positively. HCPs often have limited skills to counsel and provide psychosocial support (PSS) to children and adolescents living with HIV. While there have been specific in-service training courses designed to address this challenge, high staff turnover reduces their impact. The Handbook on Counselling and Psychosocial Care for Children and Adolescents Living with and Affected by HIV in Africa seeks to address this gap and serves as a comprehensive reference to provide HCPs with practical information to provide effective counselling and PSS for children and adolescents living with and affected by HIV.
Handbook on Pædiatric AIDS in Africa by the African Network for the Care of Children Affected by AIDS
(African Network for the Care of Children Affected by AIDS (ANECCA)., 2004) Tindyebwa, Denis; Kayita, Janet; Musoke, Philippa; Eley, Brian; Nduati, Ruth; Coovadia, Hoosen; Bobart, Raziya; Mbori-Ngacha, Dorothy; Kieffer, Mary Pat
HIV/AIDS is a major cause of infant and childhood mortality and morbidity in Africa. In children under five years of age, HIV/AIDS now accounts for 7.7% of mortality worldwide. AIDS already accounts for a rise of more than 19% in infant mortality and a 36% rise in underfive mortality. Together with factors such as declining immunisation, HIV/AIDS is threatening recent gains in infant and child survival and health. Yet, for the most part, HIV infection in children is preventable. In industrialised countries in North America and Europe, paediatric HIV infection has largely been controlled. In these settings, HIV testing as part of routine antenatal care, combinations of antiretroviral (ARV) drug regimens, elective caesarean section, and complete avoidance of breast-feeding have translated into mother-to-child transmission (MTCT) rates of less than 2%. In Africa, on the other hand, high rates of maternal HIV infection, high birth rates, lack of access to currently available and feasible interventions, and the widespread practice of prolonged breast-feeding translate into a high burden of paediatric HIV disease. The transmission risk for a child born to an HIV-infected mother in an African setting without interventions for prevention of mother-to-child transmission (PMTCT) is about 30–40%. The other 60–70% of children, although not HIV-infected, still have a 2- to 5-fold risk of mortality as a direct consequence of the mother’s HIV disease, when compared to children born to uninfected mothers.
How Much Should We Expect? Family Caregiving of AIDS Patients in Rural Uganda
(Journal of Transcultural Nursing, 2007) Kipp, Walter; Tindyebwa, Denis; Karamagi, Edna; Rubaale, Tom
The aim of this study was to measure the burden of care for family caregivers of AIDS patients. A cross-sectional exploratory design was used to describe the care experiences of family caregivers of AIDS care recipients. A questionnaire was used to interview 120 family caregivers of AIDS patients from four rural areas in western Uganda. The questions asked were related to 12 domains of family caregiving. Care burden scores of caregivers were calculated. It was found that care burden scores were high in all domains except those regarding relationships within the families and substance abuse. Serious work overload and low health status were reported. The high burden of caregiving puts family caregivers at risk for decreased health status and increased social isolation and depression.
PEPFAR Scale-up of Pediatric HIV Services: Innovations, Achievements, and Challenges
(Journal of acquired immune deficiency syndromes, 2012) Abrams, Elaine J.; Simonds, R. J.; Modi, Surbhi; Rivadeneira, Emilia; Vaz, Paula; Kankasa, Chipepo; Tindyebwa, Denis; Phelps, B. Ryan; Bowsky, Sara; Teasdale, Chloe A.; Koumans, Emilia; Ruff, Andrea J.
HIV/AIDS has had a profound impact on children around the world since the start of the epidemic. There are currently 3.4 million children under the age of 15 years living with HIV globally, and more than 450,000 children currently receiving lifesaving antiretroviral treatment. This article describes efforts supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) to expand access to treatment for children living with HIV in high-burden countries. The article also highlights a series of case studies that illustrate the impact that the PEPFAR initiative has had on the pediatric HIV epidemic. Through its support of host governments and partner organizations, the PEPFAR initiative has expanded HIV testing and treatment for pregnant women to reduce vertical transmission of HIV, increased access to early infant diagnosis for HIV-exposed infants, improved training and resources for clinicians who provide pediatric care and antiretroviral treatment, and, through public–private partnerships with pharmaceutical manufacturers, helped increase the number of medications available for the treatment of HIV-infected children in resource-limited settings.

Browsing by Author "Tindyebwa, Denis"

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