Browsing by Author "Kiyimba Kenedy"

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A descriptive-multivariate analysis of community knowledge, confidence, and trust in COVID-19 clinical trials among healthcare workers in Uganda
(MDPI , St Alban-Anlage 66, Basel, Switzerland, Ch-4052, 2020) Kasozi Keneth Iceland; Laudisoit Anne; Osuwat Lawrence Obado; Batiha Gaber El-Saber; Al Omairi Naif E; Aigbogun Eric; Ninsiima Herbert Izo; Usman Ibe Michael; DeTora Lisa M; MacLeod Ewan Thomas; Nalugo Halima; Crawley Francis P; Bierer Barbara E; Mwandah Daniel Chans; Kato Charles Drago; Kiyimba Kenedy; Ayikobua Emmanuel Tiyo; Lillian Linda; Matama Kevin; Mak Shui Ching Nelly; Onanyang David; Pius Theophilus; Nalumenya David Paul; Ssebuufu Robinson; Rugambwa Nina Olivia; Musoke Grace Henry; Bardosh Kevin; Ochieng Juma John; Ssempijja Fred; Kyamanywa Patrick; Tumwine Gabriel; Alzahrani Khalid J; Welburn Susan Christina
Background—misinformation and mistrust often undermines community vaccine uptake, yet information in rural communities, especially of developing countries, is scarce. This study aimed to identify major challenges associated with coronavirus disease 2019 (COVID-19) vaccine clinical trials among healthcare workers and staff in Uganda. Methods—a rapid exploratory survey was conducted over 5 weeks among 260 respondents (66% male) from healthcare centers across the country using an online questionnaire. Twenty-seven questions assessed knowledge, confidence, and trust scores on COVID-19 vaccine clinical trials from participants in 46 districts in Uganda. Results—we found low levels of knowledge (i.e., confusing COVID-19 with Ebola) with males being more informed than females (OR = 1.5, 95% CI: 0.7–3.0), and mistrust associated with policy decisions to promote herbal treatments in Uganda and the rushed international clinical trials, highlighting challenges for the upcoming Oxford–AstraZeneca vaccinations. Knowledge, confidence and trust scores were higher among the least educated (certificate vs. bachelor degree holders). We also found a high level of skepticism and possible community resistance to DNA recombinant vaccines, such as the Oxford–AstraZeneca vaccine. Preference for herbal treatments (38/260; 14.6%, 95% CI: 10.7–19.3) currently being promoted by the Ugandan government raises major policy concerns. High fear and mistrust for COVID-19 vaccine clinical trials was more common among wealthier participants and more affluent regions of the country. Conclusion—our study found that knowledge, confidence, and trust in COVID-19 vaccines was low among healthcare workers in Uganda, especially those with higher wealth and educational status. There is a need to increase transparency and inclusive participation to address these issues before new trials of COVID-19 vaccines are initiated.
Prevalence and predictors of delayed initiation of breastfeeding among postnatal women at a tertiary hospital in Eastern Uganda: a cross-sectional study
(Springer Link, 2023-04-14) Kusasira Loyce; Mukunya David; Obakiro Samuel; Kiyimba Kenedy; Rebecca Nekaka; Ssenyonga Lydia; Immaculate Mbwali; Napyo Agnes
The rates for the delayed initiation of breastfeeding in Uganda remain unacceptably high between 30% and 80%. The reasons for this are not well understood. We aimed to determine the prevalence and predictors for the delayed initiation of breastfeeding in Eastern Uganda. Methods This study employed a cross-sectional study design. A total of 404 mother-infant pairs were enrolled onto the study between July and November, 2020 at Mbale regional referral hospital (MRRH). They were interviewed on socio-demographic related, infant-related, labour and delivery characteristics using a structured questionnaire. We estimated adjusted odds ratios using multivariable logistic regression models. All variables with p<0.25 at the bivariate level were included in the initial model at the multivariate analysis. All variables with p<0.1 and those of biological or epidemiologic plausibility (from previous studies) were included in the second model. The variables with odds ratios greater than 1 were considered as risk factors; otherwise they were protective against the delayed initiation of breastfeeding. Results The rate of delayed initiation of breastfeeding was 70% (n=283/404, 95% CI: 65.3 – 74.4%). The factors that were associated with delayed initiation of breastfeeding were maternal charateristics including: being single (AOR=0.37; 95%CI: 0.19–0.74), receiving antenatal care for less than 3 times (AOR=1.85, 95%CI: 1.07–3.19) undergoing a caesarean section (AOR=2.07; 95%CI: 1.3–3.19) and having a difficult labour (AOR=2.05; 95%CI: 1.25–3.35). Infant characteristics included: having a health issue at birth (AOR=9.8; 95%CI: 2.94–32.98). Conclusions The proportion of infants that do not achieve early initiation of breastfeeding in this setting remains high. Women at high risk of delaying the initiation of breastfeeding include those who: deliver by caesarean section, do not receive antenatal care and have labour difficulties. Infants at risk of not achieving early initiation of breastfeeding include those that have a health issue at birth. We recommend increased support for women who undergo caesarean section in the early initiation of breastfeeding. Breastfeeding support can be initiated in the recovery room after caesarean delivery or in the operating theatre. The importance of antenatal care attendance should be emphasized during health education classes. Infants with any form of health issue at birth should particularly be given attention to ensure breastfeeding is initiated early.
A qualitative exploration of the psychosocial factors affecting antiretroviral therapy adherence among HIV infected young adults in Eastern Uganda
(medRxiv preprint, 2023-02-07) Twekambe Easton; Epuitai Joshua; Kawala Enid Kagoya; Namanya Vian; Ayikobua Emmanuel Tiyo; Obakiro Samuel Baker; Napyo Agnes; Kiyimba Kenedy
The use of anti-retroviral therapy (ART) in management and prevention of HIV/AIDS epidemic is a globally accepted strategy. In Uganda, despite the efforts to increase uptake of ART, adherence remains a huge challenge. This study, therefore, was conducted to explore psychosocial factors which influenced non-adherence to ART among young adults in Eastern Uganda. This was an exploratory qualitative study conducted at the ART clinic of Mbale Regional Referral Hospital. A total of in-depth interviews with young adults who had defaulted from taking ART drugs were conducted. Also, five key-informant interviews were conducted among the healthcare workers in the hospital. Thematic analysis approach was followed to analyze the data using NVIVO software (version 11). Non-adherence to ART was perceived to result from poor social support, poor coping mechanisms, unpredictable and busy work schedules, poverty, incompatible religious beliefs and practices. The poor social support factors included poor caregiver support, non-disclosure of HIV status, stigma and discrimination while factors linked to poor coping mechanisms included alcohol and substance abuse, psychosocial stress, depression, forgetfulness and feelings of self-hatred. Poverty limits access to treatment and basic needs including transportation to health facilities. Long waiting time at the ART clinic was the healthcare system factor which was thought to cause non-adherence among young adults Non-adherence to ART at Mbale Regional Referral Hospital in Eastern Uganda is attributed to various psychosocial factors such as stigma and discrimination, mental health problems, work related problems and low socio-economic status, religious beliefs and poor knowledge, long waiting time in ART clinic and poor family support. Psychosocial counselling should therefore target the perceived causes of ART non-adherence so as to improve the adherence /compliance to ART.