Browsing by Author "Atuhairwe, Christine"

Now showing 1 - 9 of 9

COVID-19 vaccine uptake and associated factors among individuals living in a peri-urban area in Uganda: a cross-sectional study
(PubMed Central - Public Library of Science, 2024-11-04) Nanteza, Bridget Mary; Nanyonjo, Gertrude; Kyakuwa, Nasimu; Nakanjako, Flavia; Kalute, Hamza; Atuhairwe, Christine; Watera, Christine; Ssemwanga, Deogratius
Introduction: The Corona virus disease (COVID-19) is a respiratory illness that is caused by SARS-CoV-2 virus. This virus was first reported in China in December 2019. It then spread to all countries and from March 11, 2020, the World Health Organization declared the COVID-19 outbreak a pandemic. In Uganda, the disease was first reported in March 2020 and COVID-19 vaccines became available by January 2021. Although COVID-19 vaccines were available in Uganda, uptake remained low. The aim of this study was to establish COVID-19 vaccine uptake awareness in a peri-urban setting in Entebbe City, Uganda. Methods: This was a cross-sectional study conducted among 127 men and 263 women who reside in Entebbe City, Uganda. Data was collected on socio-behavioral characteristics, knowledge, attitude, and practice (KAP) about COVID-19 vaccine using interviewer administered questionnaires. Uptake of COVID-19 vaccine was defined as the proportion of participants who had received at least one dose of the COVID-19 vaccine. We used descriptive statistics to estimate awareness of COVID-19 vaccines. The 'chi-square test' and 'modified Poisson regression' were used to assess variations in uptake of COVID-19 vaccines among respondents and their socio-demographics as well as other characteristics. Results: Ninety-nine percent (388 out of 390) of the study population were aware of at least one brand of COVID-19 vaccines in the country. Thirty-five percent (138 out of 390) knew that the vaccine immunity was achieved 14 days after the 2nd dose and 98.7% (385 out of 390) admitted that observing the standard operating procedure for COVID-19 infection prevention was necessary after vaccination. There was a gap in knowledge on vaccine safety reported by 74.6% (291 out of 390) participants. Some participants 37.2% (145 out of 390) had concerns about the vaccine. Of these, 57.9% (84 out of 145) believed that the vaccines were not helpful; and 30.3% (44 out of 145) feared serious side effects. Sixty-six percent (257 out of 390) believed that vaccines were not working and 79.0% (308 out of 390) admitted that vaccines were promoted for financial gain. At the time of performing the study, 36.2% and 22.3% had received the 1st and 2nd dose respectively. The main sources of information on COVID-19 vaccine were television (TV) and social media (p-value 0.001). In a multivariate model, COVID-19 vaccine acceptability was associated with salaried and self-employment (p-value 0.046). The other predicative factors were awareness of the COVID-19 vaccine (p-value <0.001) and having vaccine concerns (p-value 0.013). Conclusion: Uptake of COVID-19 vaccination in Entebbe community was low, partly attributed to knowledge gaps and concerns about vaccine safety and effectiveness. This highlights the need to enhance dissemination of information about COVID-19 vaccine. The lessons learnt in this study would be relevant for other emerging infections by informing vaccination implementation programs in similar settings.
Exploring the correlates of health-related quality of life in older persons on HIV antiretroviral therapy attending the Aids Support Organisation in Uganda
(African Journals Online, 2025-09-24) Atuhairwe, Christine; Misinde, Cyprian; Atuhaire, Leonard
Despite advancements in Anti-retroviral Therapy (ART), older persons living with HIV (OPLWHIV) continue to face significant challenges, including poor health outcomes and lower quality of life. This study aimed to explore the correlates of health-related quality of life (HRQoL) for older persons on HIV ART attending the Aids Support Organization (TASO) in Uganda. Methods: We conducted a cross-sectional survey among OPLHIV enrolled in care at 11 stand-alone TASO centres between February to August 2024. Data was analyzed using STATA 15, employing an Ordinal Logistic Regression model to identify HRQoL correlates for individuals over 50 years old living with HIV. Results: Ordinal Logistic Regression results revealed that various demographic, social, and clinical indicators significantly correlated with different HRQoL domains. General health perception was associated with multiple sexual partners (p=0.038), advanced HIV disease (p=0.011), and a viral load >200 copies/ml (p=0.003). Physical functioning correlated with tertiary education (p=0.049), being separated (p=0.004), 11-15 years on ART (p=0.027), and WHO clinical stage II (p=0.050). Factors for role functioning included age 60+ (p=0.002), secondary education (p=0.021), unemployment (p=0.001), WHO clinical stage II (p=0.002), and TB history (p=0.037). Social functioning linked to secondary education (p=0.004), being widowed (p<0.001), viral load >200 copies/ml (p=0.008), and WHO clinical stage II (p=0.011). Pain was associated with age 60+ (p=0.014), tertiary education (p=0.004), and unemployment (p=0.005). Energy correlated with secondary education (p=0.062), being separated (p=0.021), viral load >200 copies/ml (p=0.003), and WHO clinical stage II (p=0.028). Health distress was tied to secondary education (p<0.001), tertiary education (p<0.001), unemployment (p=0.033), and WHO stage II (p<0.001). Finally, mental health was associated with secondary education (p=0.017), being widowed (p=0.043), multiple sexual partners (p=0.015), and WHO stage II (p=0.001). Overall HRQoL specifically correlated with age 60+ (p<0.001), secondary education (p<0.001), and WHO stage II (p=0.008). Conclusion: Significant correlates across multiple HRQoL domains consistently included age (60+ years), educational attainment (secondary and tertiary), unemployment, separated or widowed marital status, specific HIV markers (advanced HIV disease, viral load >200 copies/ml, ART duration), and WHO clinical stage II. Having multiple sexual partners and a history of TB also factored into certain domains. Given these findings, TASO Uganda, with its extensive regional presence, is exceptionally well-positioned to implement multifaceted interventions. These should prioritize comprehensive support for older adults, promote health education and social support, enhance comprehensive HIV care, and provide integrated geriatric HIV health services to improve the HRQoL of OPLWHIV in Uganda.
High uptake of COVID-19 vaccines among healthcare workers in urban Uganda
(PLOS, 2024-04-16) Kyakuwa, Nasimu; Kimbugwe, Geofrey; Nakanjako, Flavia; Kalute, Hamza; Mpooya, Simon; Atuhairwe, Christine; Perez, Laurent; Kikaire, Bernard
Objectives The aim of the study was to describe the facilitators, barriers to and level of uptake of COVID-19 vaccines among healthcare workers in primary healthcare facilities in an urban setting in Uganda. Materials and methods We conducted a cross-sectional study among HCWs in private and public health facilities in Entebbe municipality between July 2021 and August 2021. Data was collected using a structured questionnaire that was shared, via an online link, to consented participants. Uptake of the vaccines among healthcare workers was analysed as proportions, and logistic regression was used to analyse barriers and facilitators to uptake of COVID-19 vaccines. Results The study enrolled 360 participants, with 61.7% (n = 222) females. A total of 236 (65.6%) healthcare workers had received at least one dose of COVID-19 vaccine, with higher uptake among females 64% (n = 151). Age above 40 years (OR 2.16), working in a government healthcare facility (OR 3.12), participating in COVID-19 vaccine related activities (OR 4.62), and having tested for SARS-COV-2 (OR 3.05) increased the odds of having been vaccinated. Working in small roadside clinics reduced the odds of being vaccinated by almost 70%, while HCWs in government health services were 3.1 times more likely to have been vaccinated. History of having cared for a COVID-19 patient and having a positive SARS-COV-2 test result did not influence the uptake of the vaccines in the study population. Conclusion Vaccine uptake among HCWs was close to the World Health Organisation (WHO) recommended uptake of 70% by mid-2022
Maternal Health Care Seeking Behavior of Peri-Urban Women With Disability in Busiro South, Wakiso District, Uganda: a Community Based Study
(Research Square, 2020-08-10) Natukunda, Bonny; Musoke, David; Kiconco, Arthur; Mugambe, Samuel; Atuhairwe, Christine; Taremwa, Ivan Mugisha; Nanyingi, Miisa
In Uganda women with disabilities attend antenatal care (ANC) while pregnant, however, majority of these deliver from the hands of Traditional Birth Attendants (TBAs) due to due to fear of being mistreated by skilled birth attendants. We explored the determinants of the maternal health seeking behavior of women with disability in Busiro health sub district (HSD), Wakiso district, Uganda. A community based cross-sectional study involving quantitative and qualitative methods of data collection was conducted among 182 participants. Quantitative data were collected from disabled women, and qualitative data from six key informants (midwives and in-charges) at selected health facilities in Busiro HSD, Wakiso district. Logistic regression was used to determine the factors influencing the decision to seek maternal health care services (ANC and delivery at health facilities) among women with disability. Qualitative data were analyzed by content analysis. The findings revealed that 82.3% of women with disability attended ANC during pregnancy, and of these, 80.8% delivered their babies at health facilities. Attendance of ANC by the women with disability was influenced by parity (having 1-3 children) (AOR 7.7; 95% CI: 0.249-239.040), mode of delivery-normal delivery verses caesarian section (AOR 2.6, 95%CI: 0.296-22921), place visited during pregnancy TBA visa vie public health facilities (AOR 4.5, 95%CI: 0.922-22.576), and distance to the health facility being less than 5 Kilometres (AOR 2.3 95% CI: 0.695-7.661). There is need to intensify awareness of the use of skilled health workers during pregnancy and child birth to women with disability in the communities so as to improve uptake of maternal health care services.
Missed Opportunity for Neonates to Live: A Cross-sectional study on Utilization of Peri-natal Death Audits to address the Causes of Peri-Natal Mortality in District Hospitals of East–Central Uganda.
(Students journal of health research Africa, 2022-09-10) Waako, Christopher Knox; Nanyingi, Miisa; Katongole, Simon Peter; Atuhairwe, Christine; Konso, Jennipher Mariam; Maniple, Everd
Aim: To assess the utilization of PDAs in addressing the avoidable causes of perinatal mortality in the eastern region of Uganda. Methodology: A cross-section design using a mixed method was conducted between 2014-2015 at Iganga, Bugiri, and Kamuli general hospitals in the East-Central region of Uganda. The interviews involved 115 health workers who included Doctors, Nurses/Midwives, Clinical officers, and Laboratory and Theatre staff. These were drawn from four departments including the Maternity ward, Outpatient department, Theatre, and paediatric ward. Hospital top and departmental managers formed the key informants for this study. Annual reports for the period 2009/10-2012/13 were reviewed. In addition, monthly reports for the calendar year 2013 together with patients’ clinical case notes and patients’ registers were also reviewed to determine the magnitude and causes of perinatal mortality. Factors contributing to perinatal death were assessed and categorized into foetal, maternal, and health facility factors. Results: Results revealed a high and rising perinatal mortality rate of 70/1,000 live births and a decreasing maternal mortality ratio of 363/100,000 live births. Most perinatal deaths were fresh stillbirths 48/88 which occurred during the intrapartum period and the majority of early neonatal death was due to birth asphyxia. None of the health facilities was conducting perinatal death audits and the quality of data used for perinatal death audits was inadequate and was scored poorly. Challenges hindering utilization of perinatal death audits included: lack of staff sensitization and training, work overload, lack of motivation, fear of blame and litigation, political interference, and lack of support from the community. Conclusion: There was a high prevalence of perinatal deaths in east-central Uganda yet none of the hospitals was conducting perinatal death reviews. Recommendations: Health workers should be trained on perinatal death audit tools and guidelines and the records departments are revitalized with tools and personnel for effective data management.
Non-uptake of COVID-19 vaccines and reasons for non-uptake among healthcare workers in Uganda: a cross-sectional study
(BioMed Central Ltd - Springer Nature, 2024-05-25) Kyakuwa, Nasimu; Abaasa, Andrew; Mpooya, Simon; Kalutte, Hamza; Atuhairwe, Christine; Perez, Laurent; Kikaire, Bernard
Background Vaccines play a crucial role in eradicating and containing disease outbreaks. Therefore, understanding the reasons behind vaccine refusal and associated factors is essential for improving vaccine acceptance rates. Our objective was to examine the determinants of COVID-19 vaccine non-uptake and explore the reasons for non-uptake among healthcare workers (HCWs) in Uganda. Methods Between July and August 2021, we conducted a cross-sectional study among healthcare workers in primary healthcare facilities (private and government) in Entebbe Municipality, Uganda. Participants were recruited using convenience sampling, and consenting individuals received credentials to access an electronic database and complete a structured questionnaire. There were no established HCWs contact registers in the municipality, and the study was conducted during a national lock down, therefore, the HCWs who were on duty at the time of the study were approached. The survey questions were based on the ‘3Cs’ model of vaccine hesitancy and focused on confidence, convenience, and complacency factors. Non-uptake of vaccines was defined as not having received any of the available vaccines in the country. We employed counts, percentages, and simple logit models to summarize the reasons for non-uptake of COVID-19 vaccines and to identify associated factors. Results The study recruited 360 HCWs, 61.7% of whom were female, with an average age of 31 years (SD = 7.9). Among them, 124 (34.4%) healthcare workers did not receive any COVID-19 vaccine. Non-uptake of COVID-19 vaccines was independently associated with several factors, including age [35 + years adjusted odds ratio (aOR) = 0.30, 95% CI: 0.13–0.66 compared with 18–24 years], facility ownership [government, aOR = 0.22 (0.10–0.49) compared with private not-for-profit], previous testing for coronavirus [yes, aOR = 0.35 (0.19–0.65)], and previous involvement in COVID-19 vaccine activities [yes, aOR = 0.17 (0.10–0.29)]. The primary reasons cited for non-uptake of COVID-19 vaccines were related to a lack of confidence in the vaccines, such as concerns about side effects (79.8%) and the need for more time to understand the vaccines (89.5%), as well as the importance of weighing benefits and risks (84.7%) before being vaccinated. A smaller proportion, approximately 23%, cited reasons related to complacency and lack of convenience in accessing vaccination services. Conclusion The high proportion of non-uptake of COVID-19 vaccines among this population primarily stems from a lack of confidence and trust in the vaccines, coupled with insufficient time allowed for users to make informed decisions. This underscores the urgent need for ongoing monitoring and trend analysis of vaccine non-uptake to guide the development and implementation of strategies aimed at building and sustaining vaccine confidence. Adequate time should be allowed to explain benefits of vaccination to the population to allay fears that might exist before actual vaccination is rolled out.
Perceived quality of life and associated lifestyle practices among older people living with HIV in Uganda. a cross‑sectional study
(Springer, 2025-09-03) Atuhairwe, Christine; Misinde, Cyprian; Ochieng, Titus; Atuhaire, Leonard
Perceived quality of life (QoL) is a critical element for older persons living with HIV-positive diagnosis. The intersection of aging, chronic illness, and the complexities of managing HIV significantly influences their quality of life. This study investigated the relationship between perceived QoL and lifestyle factors among older adults living with HIV in Uganda. This cross-sectional survey was conducted with older adults (above 50 years) living with HIV attending The AIDS Support Organization centres across the major regions in Uganda. Data were cleaned and analyzed using STATA 15, with modified Poisson regression assessing factors associated with perceived quality of life. A total of 440 participants were interviewed. While 52% reported poor perceived quality of life before initiating antiretroviral therapy (ART), this decreased to 35% after ART initiation. This suggests a substantial improvement in the health of older adults living with HIV. Before ART initia tion, poor quality of life was significantly associated with being aged 60 years or older (adjusted risk ratio [aRR] 1.17, 95% CI 0.94-1.46), adhering to the Seventh-day Adventist (SDA) faith (aRR 1.89, 95% CI 1.12-3.21), being a casual labourer (aRR 0.62, 95% CI 0.41-0.94), being married (aRR 0.65, 95% CI 0.42-1.01), having one sexual partner (aRR 1.50, 95% CI 1.16-1.93), alcohol consumption (aRR 0.71, 95% CI 0.15-0.85), infrequent fruit consumption (aRR 1.75, 95% CI 0.99 3.09), consuming white meat 1-3 times per week (aRR 1.61, 95% CI 1.23-2.10), engaging in sports 4-7 days per week (aRR 0.25, 95% CI 0.08-0.75), walking 4-7 days per week (aRR 0.79, 95% CI 0.62-1.00), and having diabetes (aRR 1.57, 95% CI 1.13-2.19). After ART initiation, poor quality of life remained significantly associated with being 60 years or older (aRR 1.34, 95% CI 0.98-1.83) and being a salaried employee (aRR 0.38, 95% CI 0.21-0.81). Additionally, frequent white meat consumption (4-7 days per week) (aRR 2.01, 95% CI 1.18-3.42) and moderate sports engagement (1-3 days per week) (aRR 1.94, 95% CI 1.47-2.55) were significantly associated with poorer quality of life after ART initiation. No significant asso ciations were observed with other variables. Perceived quality of life in older persons living with HIV was poorer among those aged over 60 years. The risk of poor QoL was lower among those who eat white meat and participate in sports weekly. Increasing physical activity through regular exercise routines in older adults can help reduce the risk of age-related diseases, improve energy levels, reduce stress, enhance appetite and sleep quality, boost cardiovascular and pulmonary endurance, and enhance overall quality of life.
Predictors of survival among older adults with HIV in Uganda’s AIDS support organization centers of excellence (1987 2023): a retrospective longitudinal study
(Springer Nature Link, 2025-02-26) Atuhairwe, Christine; Atuhaire, Leonard; Wandera, Ojambo Stephen; Amongin, Dinah; Ochieng, Titus; Misinde, Cyprian
The growing number of older adults living with HIV, facilitated by wider access to antiretroviral therapy (ART), presents unique challenges. This study aims to identify predictors of survival among older persons living with HIV receiving ART in Uganda’s AIDS Support Organization Centers of Excellence (1987–2023). Understanding these predictors can inform effective clinical interventions to improve outcomes for this population. This study conducted a retrospective analysis of medical records from 11 TASO centers of excellence in Uganda (1987–2023). Using Cox proportional hazards regression, we identified factors associated with survival among older adults living with HIV. TASO centers of excellence in Entebbe, Gulu, Jinja, Masaka, Masindi, Mbale, Mbarara, Mulago, Rukungiri, Soroti, and Tororo. Cox proportional hazards regression analysis identified factors influencing survival among older persons living with HIV (OPLHIV). Of the 30,758 OPLHIV medical records analyzed (1987–2023), 72.5% were active on ART, 5.9% had died, 15.2% were lost to follow-up, and 5.6% transferred to other facilities. Survival was significantly associated with: gender (female, HR = 1.19, p < 0.001), marital status (married, HR = 0.99, p < 0.001; separated/divorced, HR = 0.85, p < 0.001), WHO clinical stage (II, HR = 1.66, p < 0.001), viral load (> 200 copies/ml, HR = 1.49, p < 0.001), and ART adherence (fair, HR = 0.94, p = 0.157). Key predictors of survival among Older Adults Living with HIV (OPLHIV) include: female gender, age 50–59, weight 51–70 kg, married status, viral load > 200 copies/ml, WHO HIV clinical stage II, paid employment, and ART adherence. To improve survival outcomes, consistent clinical screenings of WHO clinical stages, viral load, and ART adherence are essential. These measures can guide healthcare providers in making informed treatment decisions to enhance survival and quality of life for OPLHIV in Uganda. Strengthen routine monitoring of viral load, ART adherence, and WHO clinical staging. Provide targeted support to married and separated/divorced adults to improve their survival chances. Address gender disparities in care to enhance outcomes for females. Focus on maintaining ART adherence and viral suppression to reduce mortality risks.
Risk perception and usage of non-occupational post-exposure prophylaxis among fisherfolk in Ggulwe parish on the shores of Lake Victoria in central Uganda
(Frontiers, 2023-11-08) Bahikire1, Daraus; Nanyingi, Miisa; Atuhairwe, Christine; Matama, Catherine; Ninsiima, Lesley Rose; Bbuye, Mudarshiru
The use of non-occupational post-exposure prophylaxis (nPEP) to prevent HIV acquisition among those exposed as an approach to HIV prevention has expanded in Uganda. Although there are increased eorts to avail nPEP services among most at-risk populations, the usage of nPEP medicines remains low. Therefore, this study examined the risk perception and usage of non-occupational post-exposure prophylaxis (nPEP) among fisherfolk in the Ggulwe fishing parish, Bussi sub-county, Wakiso district. A cross-sectional study among adults was carried out from October 2020 to January 2021 in Ggulwe parish, Bussi sub-county, Wakiso district, to examine the usage of nPEP and factors influencing the usage. Data were collected using semi-structured questionnaires, and key informants’ interviews were conducted among healthcare providers and the local leadership. The quantitative data were summarized using bivariate and multivariate logistic regression, while the qualitative data were analyzed thematically to enrich the quantitative results. Overall, 248 fisherfolk encountered an event that required the use of nPEP, and of these, 55/248 (22.2%) were able to use nPEP to prevent them from acquiring HIV. The usage of nPEP among adults in the Bussi sub-county, Wakiso district, was associated with not knowing that HIV can be prevented using nPEP medicines (AOR:0.1, 95% CI 0.03–0.36, p < 0.001), lack of knowledge of the existence of nPEP (AOR: 0.3, 95% CI 0.13–0.76, p = 0.01), the perception that nPEP can eectively prevent HIV infection after exposure (AOR 0.0586, 95% CI: 0.0177–0.1944, p < 0.001), and the community’s opinion aecting the willingness to take nPEP (AOR 0.1924, 95% CI: 0.0380–0.9727, p = 0.0462). The usage of nPEP among fisherfolk was low (22.2%). The low usage of nPEP was associated with a lack of knowledge and awareness about nPEP. This eort to improve the usage of nPEP should include community sensitization and HIV infection prevention using nPEP to raise awareness about HIV infection exposures and the risk of HIV infection during non-occupational exposur