Background Tracheostomy is a life-saving procedure whose outcomes may vary between hospitals based on disparities in their existing expertise. We aimed at establishing the indications, early tracheostomy-related complications and their associated factors in Uganda. Methods In a prospective cohort study, we consecutively enrolled one-hundred patients, both adults and children 2 h post-tracheostomy procedure. At baseline, information on patients’ socio-demographics, tracheostomy indications, pre- and post-procedural characteristics was collected through researcher administered questionnaires and from medical records. Clinical examination was performed at baseline but also at either day 7 or whenever a tracheostomy-related complication was suspected during the 7 days follow-up. Comparison of patients’ baseline characteristics, tracheostomy indications and complications across two hospitals was done using Pearson’s chi-square. For predictors of early tracheostomy complications, bivariate and multivariate analysis models were fitted using binomial regression in STATA 13.0 software. Results All patients underwent surgical tracheostomy. Majority were adults (84%) and males (70%). The commonest tracheostomy indications were; pulmonary toilet (58%) and anticipated prolonged intubation (42%). Overall, 53% (95% CI: 43.0 – 62.7) had early complications with the commonest being tube obstruction (52.6%). Independent predictors of early tracheostomy-related complications were; anticipated prolonged intubation as an indication (RR = 1.8, 95%CI: 1.19 – 2.76), Bjork flap tracheal incision (RR = 1.6, 95%CI: 1.09 – 2.43), vertical tracheal incision (RR = 1.53, 95%CI: 1.02 – 2.27), and age below 18 years (RR = 1.22, 95%CI: 1.00 – 1.47). Conclusion Pulmonary toilet is the commonest tracheostomy indication at major hospitals in Uganda. The incidence of early tracheostomy complications is high and majorly related to post-procedure tracheostomy tube management. Having anticipated prolonged intubation as an indication for tracheostomy, a Bjork flap or vertical tracheal incisions and being a child were associated with increased risk of complications. Emphasis on multidisciplinary team care, standardization of tracheostomy care protocols, and continuous collection of patient data as well as paying attention to patient quality of life factors such as early return to oral feeding, ambulation and normal speech may have great potential for improved quality of tracheostomy care in low resource settings.
Purpose: Hypothyroidism has been reported at a prevalence of 6% in children and adolescents with Sickle cell anemia. In this study, we determined the prevalence and factors associated with hypothyroidism among children with Sickle cell anemia attending the Sickle Cell Clinic, in Mulago hospital, Uganda. Methods: A cross-sectional study was conducted among children aged 6 months - 17 years with a confirmed diagnosis of Sickle Cell Anemia, with no prior diagnosis of hypothyroidism and in steady state attending the Sickle Cell Clinic in Mulago hospital. Data was collected using a structured questionnaire and a blood sample was used to measure thyroid stimulating hormone and free thyroxine. Results: Of the 332 children enrolled, sixty (18.1%) participants had sub-clinical hypothyroidism (95% CI: 14.3 - 22.6). Factors associated with hypothyroidism included constipation [adjusted odds ratio: 3.1, 95% CI:1.0 - 9.0, p = 0.043] and male sex [adjusted odds ratio:2.0, 95% CI:1.1- 3.5, p = 0.025]. Conclusion: Approximately 1 in 5 children (18.1%) had sub-clinical hypothyroidism. Males and children who presented with constipation were more likely to have sub-clinical hypothyroidism.
Over time, the use of plant-derived agents in the management of various human health conditions has gained a lot of attention. The study assessed the hepatoprotective potential of ethyl acetate fraction Tamarindus indica leaves (EFTI) during prenatal aluminum chloride exposure. Pregnant rats were divided into 5 groups (n =4); Group I rats were administered 2 ml kg-1 of distilled water (negative control), Group II rats received only 200 mg kg-1 aluminum chloride (positive control), Group III rats were administered 200 mg kg-1 aluminum chloride and 400 mg kg-1 EFTI, Group IV rats were administered 200 mg kg-1 aluminum chloride and 800 mg kg-1 EFTI, Group V rats were administered 200 mg kg-1 aluminum chloride and 300 mg kg-1 Vit E (comparative control). On postnatal day 1, the pups were euthanized, and liver tissues were harvested for the biochemical study (tissue levels of malondialdehyde, caspase-3, tumor necrosis factor-alpha, aspartate aminotransferase, alkaline phosphatase, and alanine aminotransferases) and the liver histological examination. The administration of EFTI was marked with significant improvement in the tissue levels of malondialdehyde, caspase-3, tumor necrosis factor-alpha, aspartate aminotransferase, alkaline phosphatase, and alanine aminotransferases. There was a marked improvement in histopathological changes associated with prenatal aluminum chloride exposure. In conclusion, the administration of EFTI was protective during prenatal aluminum chloride exposure of the liver in Wistar rats, and is mediated by the anti-lipid peroxidative, antiapoptotic, and anti-inflammatory activity of EFTI.
Imperata cylindrica is a globally distributed plant known for its antiepileptic attributes, but there is a scarcity of robust evidence for its efficacy. The study investigated neuroprotective attributes of Imperata cylindrica root extract on neuropathological features of epilepsy in a Drosophila melanogaster mutant model of epilepsy. It was conducted on 10-day-old (at the initiation of study) male post-eclosion bang-senseless paralytic Drosophila (parabss1) involved acute (1-3 h) and chronic (6-18 days) experiments; n = 50 flies per group (convulsions tests); n = 100 flies per group (learning/memory tests and histological examination). Administrations were done in 1 g standard fly food, per os. The mutant flies of study (parabss1) showed marked age-dependent progressive brain neurodegeneration and axonal degeneration, significant (P < 0.05) bang sensitivity and convulsions, and cognitive deficits due to up-regulation of the paralytic gene in our mutants. The neuropathological findings were significantly (P < 0.05) alleviated in dose and duration-dependent fashions to near normal/normal after acute and chronic treatment with extract similar to sodium valproate. Therefore, para is expressed in neurons of brain tissues in our mutant flies to bring about epilepsy phenotypes and behaviors of the current juvenile and old-adult mutant D. melanogaster models of epilepsy. The herb exerts neuroprotection by anticonvulsant and antiepileptogenic mechanisms in mutant D. melanogaster due to plant flavonoids, polyphenols, and chromones (1 and 2) which exert antioxidative and receptor or voltage-gated sodium ion channels' inhibitory properties, and thus causing reduced inflammation and apoptosis, increased tissue repair, and improved cell biology in the brain of mutant flies. The methanol root extract provides anticonvulsant and antiepileptogenic medicinal values which protect epileptic D. melanogaster. Therefore, the herb should be advanced for more experimental and clinical studies to confirm its efficacy in treating epilepsy.
Firewood and charcoal are the most dominant sources of fuel for domestic cooking applications in sub-Saharan Africa. In this study, performance and emission characteristics of firewood and charcoal from five commonly used species, namely, Dichrostachys cinerea, Morus Lactea, Piliostigma thonningii, Combretum molle, and Albizia grandibracteata were obtained. The water boiling test and emissions monitoring system for CO, CO 2 , and PM 2.5 were used to determine fuel and energy consumption, thermal efficiency and emissions, and emissions' factors. The results showed that firewood combustion required higher energy consumption compared to charcoal combustion. High-power thermal efficiency was the highest (> 45%) for all charcoal derived from the firewood species. During hot-start, cold-start, and simmering operations, it was observed that thermal efficiencies were generally higher for charcoal fuels (≥ 80%) compared to the firewood (< 40%) from where they were pyrolyzed. Firewood has a much lower indoor CO emissions footprint when compared to using charcoal. Nonetheless , CO emission levels for both firewood and charcoal exceed the Environmental Protection Agency (EPA) guidelines of 35 ppm (1-h average). CO 2 emission factors are the most dominant and highest contributors to greenhouse gas emissions from household use of firewood and charcoal. Overall, this work reaffirms the need for proper ventilation when firewood and charcoal are used in combustion.
Soil erosion is one of the most critical hazards adversely affecting both environment and economy for all countries in the world. Several regions of Morocco suffer from the problem of soil erosion, notably the Rif and the Pre-Rif where the study area of this paper is located. The spectacular expansion of soil erosion processes in the Lahdar watershed is a worrying indicator of soil degradation. Geographic information systems and remote sensing are an excellent tool for analyzing and evaluating the risks of the expansion of soil degradation. The main objective of this paper is to assess spectral angle mapper (SAM) method and analyze their properties using geographic information system and image processing techniques in order to map the hazards of soil erosion. Land use and land cover dynamics demonstrate the relationship between human-induced development and the evolution of soil degradation and biodiversity conservation in a watershed. Therefore, an understanding of LULC factors is required for the implementation of environmental policies intended to foster a synergy between humans and the sustainability of their environment. The process of categorizing LULC was completed using the SAM technique, and the role of LULC in the dynamics of soil degradation was investigated using measurements of landscape fragmentation. For this purpose, Landsat 8 Operational Land Imager data (11 bands) with 30-m spatial resolution, 22 August-2017 were used, and classifiers for SAM were applied and evaluated. The findings of the study are seven main land cover categories: arboriculture (0.08%), cereal (35.05%), water (1.03%), forests (3.76%), residentials (4.61%), matorral-course (4.58%), and bare soils (50.89%). It should be noted that the bare soil class occupies half of the watershed area, making it vulnerable to the risks of soil degradation. Moreover, the results from this study will aid decision makers in better conservation planning of soil and water resources.
Background Health care workforce is one of the six core components of a well-functioning and sufficient health system. The WHO highlights improving education and training of health workforce as one of the areas of focus for improving health. Medical education is a pillar of the health care workforce. Educational environment, the physical circumstances or conditions under which learning takes place is an important factor that determines the effectiveness of medical education. It’s academic and clinical effects are significant determinants of medical students’ attitudes, knowledge, skills, progression and behaviours. To ensure strong health systems, there is need for improvement in medical education. This has to be contextual and informed by locally relevant data. This study aimed at assessing Ugandan medical students’ perception of their learning environment. Methods This was a quantitative cross-sectional study among medical students across five medical schools in Uganda between December 2021 and February 2022. Participants filled an online questionnaire with a demographics section and the Dundee Ready Education Environment Measure (DREEM) tool. The data was analyzed using R Studio version 2021.09.0 + 351. The average score for each of the DREEM sub-scales and total DREEM score were calculated in addition to their relationship with demographic characteristics Results The average total DREEM score of the 335 participants was 112.27/200 (56.12%). We found that 69% (231/335) of the students had a positive perception while 31% had a negative perception of their learning environment. The sub-scale mean scores were as follows; Perception of Atmosphere – 25.14/48(52%), Social Self-perception − 14.94/28 (53%), Perception of Teachers − 24.86/44 (56%), Perception of Learning − 28.8/48 (59%) and Academic Self-perceptions – 19.04/32 (60%). “There is a good support system for students who get stressed” was the item with the lowest mean score (1.41/5) Conclusions The perception of medical students on their learning environment is just above average. This could negatively impact the quality of the health workforce. To ensure training of a robust health workforce, there is need for improvement in learning environment especially the atmosphere and social support.
The safety of tea AgNPs Physiology of nanoparticles Green tea synthesis silver nanoparticles antibiotic resistance Camellia sinensis prunus africana A B S T R A C T Information on the basic changes associated with green tea small molecules in acute inflammation is deficient. The purpose of the study was to characterize and establish the effects of green tea silver nanoparticles (AgNPs) following inflammation in BALB/c male mice. In this study, green tea silver nitrate nanoparticles were characterized and the extract were made up to constitute high (100%), medium (10%), and low (1%) concentrations for administration. Acute inflammation was induced in groups I-V of the experimental rodents by injecting 0.5 ml/kg of fresh egg albumin on the subplantar surface of the right hind paw and animals were monitored for 36 h. Group I-III were administered 100%, 10%, 1% green tea nanoparticles extract while group IV was given diclofenac. Group V was the positive control while group VI was the negative control that received the vehicle. Paw edema was measured at a 2 h interval for 3 days, while the pain was assessed by measuring the locomotion activity using the voluntary wheel running and the anxiety-like behavior. Hypersensitivity was measured through the temperature sensation experiment and a non-linear regression analysis was done. Here, synthesized green tea AgNPs registered an
Countries around the world are engaged in various activities toward achieving the SDGs ahead of the 2030 target date. One of the challenges of the SDG is its global nature which poses implementation challenges particularly at a country level. As a result, the progress of implementing the SDGs is slow, and there is a likelihood that they may not be achieved. Six years since adopting the SDGs, it is imperative to reflect on the progress of implementation of specific SDGs in different contexts as this may inform a realignment of the implementation strategies and documentation of best practices that can be replicated elsewhere. Uganda is struggling to achieve the SDGs because its economy is largely donor funded and its programs are restricted by the ties of funders. Resources for implementing the SDGs therefore are limited, and with the emergency of COVID-19 in early 2020, attention shifted to fighting the pandemic, dropping the focus on the implementation of the SDGs. However, Uganda (a member state of United Nations and signatory to the SDGs) is strenuously localizing the SDGs which is a critical step in the translation of the SDGs and the 2030 Agenda for Sustainable Development into local actions and impacts. Localizing the SDGs involves defining, implementing, and monitoring the SDGs at the local level. Critical steps to localize SDG 13 (Climate Action) have been taken as climate is central in achieving economic, social, and environment sustainability. Uganda is an agricultural country largely relying on rainfed agriculture. Therefore, climate is a determining factor for the economic development trajectory of the country as well as the reduction of hunger, poverty, malnutrition, disease, and pests and access to clean water and sanitation. This chapter examines the progress with the localization of SDG 13 in Uganda and suggests strategies for achieving it by 2030.
There has been increasing search for the ameliorative properties of seed oils against toxicants. Bisphenol A acts as an estrogenic endocrine-disrupting chemical capable of causing male infertility. This study aimed to explore Cucumeropsis mannii seed oil effects against mitochondrial damage in rats using bisphenol A. Forty-eight (48) rats were randomly assigned to six groups (n = 6) of 8 rats each, and fed the same food and water for six weeks. The group A rats were given 1 ml olive oil, while the ones in group B were given bisphenol A at 100 ml/kg body weight via oral route. Group C received Cucumeropsis mannii seed oil 7.5 ml/kg body weight Cucumeropsis mannii seed oil, while group D, group E, and group F were pre-administered bisphenol A at 100 ml/kg body weight, followed by treatment with Cucumeropsis mannii seed oil at 7.5 ml/kg body weight, 5 ml/kg body weight, and 2.5 ml/kg body weight, respectively. Antioxidant enzymes, glutathione, reactive oxygen species, testicular volume, malondialdehyde, body weight, and testicular studies were done using standard methods. The results of the bisphenol A-administered group showed a significant decrease in the antioxidant enzymes, glutathione, body weight, and testicular volume with elevation in the levels of reactive oxygen species, malondialdehyde, and testicular indices. BPA + CMSO treated group showed a significant increase in GPx activity compared with BPA-exposed rats. CMSO treatment significantly increased catalase activity in comparison to that of rats exposed to BPA. Remarkably, Cucumeropsis mannii seed oil and bisphenol A co-administration significantly reversed the abnormalities observed in the dysregulated biochemical biomarkers. Our findings suggest that Cucumeropsis mannii seed oil has considerable antioxidant potential which can be explored in therapeutic development against systemic toxicity induced by exposure to bisphenol A. Cucumeropsis mannii seed oil protects against bisphenol A induced testicular mitochondria damages.
The concept of environmental justice is well established in the literature; however, scholars still battle to agree on what it really means. This concept has become more relevant to the studies of informal settlements amongst others. The location and environmental variables in informal settlements suggests a variety of injustices that comes with location, limited access to water, poor or lack of sanitation, challenges with transport availability, accessibility, affordability, and lack of other social amenities. These and many other socio-economic needs forms part of the value chain of environmental justice debates across the world. This paper deals with environmental justice in the informal settlements of Kosmos, in the Madibeng Local Municipality, Bojanala Region in the North-West Province of South Africa. The paper highlights some of the environmental challenges faced by the informal settlement residents such as pollution, waste management (landfill sites, waste collection) sanitation and water provision. The paper explores how the Kosmos informal settlement community has been excluded from decision making processes regarding their own environment and considers the levels of environmental injustices commonly associated with this kind of practice.
The excessive application of mineral fertilizers in maize cultivation leads to progressive soil contamination in the long term and increases the cost of production. An alternative to reduce over-fertilization is to perform a partial replacement with microbes that promote nutrition and growth, such as Arbuscular Mycorrhizal Fungi (AMF). A pot experiment which was followed by two field experiments was performed with and without the application of indigenous AMF in combination with five nitrogen–phosphorus–potassium (NPK) fertilization rates (100% NPK = N120P60K60; 75% NPK = N90P45K45; 50% NPK = N60P30K30; 25% NPK = N30P15K15; control = N0P0K0). The objective was to investigate whether the soil application of indigenous mycorrhizal fungi inoculum combined with NPK fertilization can provide higher maize yields and soil-available N, P, and K than chemical fertilization can alone. The greenhouse results showed that the application of AMF with a 50% NPK treatment significantly increased the plant’s growth, root colonization, leaf chlorophyll content, and N, P, and K tissue content. The results from the field conditions showed that there was a highly significant yield after the treatment with AMF + 50% NPK. The study also revealed that mycorrhizal fungi inoculation increased the available soil N and P concentrations when it was combined with a 50% NPK dose. This suggests that the inoculation of fields with AM fungi can reduce the chemical fertilizer application by half, while improving soil chemistry. The results suggested that AMF inoculation can be used in integrated soil fertility management strategies.
Background Sex work is a global driver of the HIV epidemic, and the risk of acquiring HIV is 13 times higher for female sex workers (FSWs) compared to the general population. The enrollment and retention of FSWs in HIV care is a challenge and has been a major contributing factor to increased new HIV infections. Methods We conducted a qualitative study among 30 FSWs and 21 healthcare workers (HCWs) working in antiretroviral therapy (ART) clinics at the selected three primary health facilities in Mbarara City, Southwestern Uganda. The study participants were enrolled by both purposive and snowball sampling techniques. We obtained informed consent from all the participants, and data were collected using in-depth interviews and thematically analyzed. Results Three themes emerged as facilitators toward enrollment and retention of FSWs into HIV care, namely, (1) good health living, (2) receptive HCWs and availability of health services, and (3) community outreach services and peer support. The barriers are summarized into four major themes: (1) stigma, community discrimination, and beliefs; (2) social obstacles; (3) adverse effects of ART; and (4) inadequate services at the health facilities. Conclusion FSWs are challenged by unsupportive environments and communities where they live and work, which hinders their enrollment and retention in HIV care. Creating awareness of the utilization of HIV care services and extending such services to hotspot communities could enhance the response of HIV-positive FSWs to ART.
Background Codonopsis pilosula (Franch.) Nannf. is a medicinal plant traditionally used in China, Korea, and Japan to treat many diseases including poor gastrointestinal function, low immunity, gastric ulcers, and chronic gastritis. The increasing therapeutic and preventive use of C. pilosula has subsequently led to depletion of the natural populations of this species thus necessitating propagation of this important medicinal plant. Here, we developed an efficient and effective in vitro propagation protocol for C. pilosula using apical shoot segments. We tested various plant tissue culture media for the growth of C. pilosula and evaluated the effects of plant growth regulators on the shoot proliferation and rooting of regenerated C. pilosula plants. Furthermore, the tissues (roots and shoots) of maternal and in vitro-regenerated C. pilosula plants were subjected to Fourier-transform near-infrared (FT-NIR) spectrometry, Gas chromatography-mass spectrometry (GC–MS), and their total flavonoids, phenolics, and antioxidant capacity were determined and compared. Results Full-strength Murashige and Skoog (MS) medium augmented with vitamins and benzylaminopurine (1.5 mg·L⁻¹) regenerated the highest shoot number (12 ± 0.46) per explant. MS medium augmented with indole-3-acetic acid (1.0 mg·L⁻¹) produced the highest root number (9 ± 0.89) and maximum root length (20.88 ± 1.48 mm) from regenerated C. pilosula shoots. The survival rate of in vitro-regenerated C. pilosula plants was 94.00% after acclimatization. The maternal and in vitro-regenerated C. pilosula plant tissues showed similar FT-NIR spectra, total phenolics, total flavonoids, phytochemical composition, and antioxidant activity. Randomly amplified polymorphic DNA (RAPD) test confirmed the genetic fidelity of regenerated C. pilosula plants. Conclusions The proposed in vitro propagation protocol may be useful for the rapid mass multiplication and production of high quality C. pilosula as well as for germplasm preservation to ensure sustainable supply amidst the ever-increasing demand.
Background Foreign body ingestion is common pediatric population with more than 55% from ingestion of coins. Over 80% pass spontaneously through the digestive tract, but substantial amount lodge in the UES causing esophageal perforation. Failure to recognize and treat as an emergency can cause significant complications and mortality aggravated by longer duration of impaction. Impacted FB can be retrieved by endoscopy with over 95% success rate. In the event of failed endoscopic retrieval, surgery offers safe alternative. The latter usually indicated in perforation, stricture, esophago-aortic and trachea-esophageal fistulas. Clinical case A 12-year old female patient with a coin impaction in the cervical esophagus for over four years managed for recurrent respiratory infection. Conclusion Foreign body – coins ingestion is common in pediatric population. Timely recognition and treatment is required to prevent severe complications and mortality. Diagnosis involves a triad of clinical history, X-ray appearances and esophagoscopy.
Isoflavones were synthesized via Suzuki-Miyaura coupling of 3-iodochromones and para-methoxybenzene- and para-phenolboronic acid. In our hands, conditions commonly used for similar cross couplings turned out to be unsuccessful or difficult to reproduce, for example, due to the unplanned partial cleavage of MOM-protecting groups. Using Pd(dba)2 as a precatalyst and tricyclohexylphosphine as an activating ligand, reliable cross-coupling conditions were identified. In all cases, notably higher yields of isoflavones were obtained with para-phenolboronic acid than with para-methoxybenzene boronic acid. This observation and the commercial availability of para-phenolboronic acid suggest that for the synthesis of the important 3'-prenyl- or 3',5'-diprenylisoflavone substitution pattern a synthetic route that introduces the prenyl substituents after the Pd-catalyzed cross-coupling step, thereby avoiding laborious and protecting-group-intensive multistep syntheses of C-prenylated arene boronic acids, is advantageous.
Mathematical models have been widely used to explain the system originating from human-nature interaction, investigate the impacts of various components, and forecast system behaviour. This paper provides a profound reference to the current state of the art regarding the application of mathematical models to study the impact of human population and population pressure on forest biomass and forest-dependent wildlife. The review focused on two aspects, namely, model formulation and model analysis. In model formulation, the review revealed that socioeconomic status influences forest resource consumption patterns, thus, stratification of the human population based on economic status is a critical phenomenon in modelling human-nature interactions; however, this component has not been featured in the reviewed models. Regarding model analysis, in most of the reviewed work, single parameter approach was utilized to perform uncertainty quantification of the model parameter; this approach has been proven to be inadequate in measuring the uncertainty and sensitivity of the parameter. Thus, the use of correlation or variance based methods, which are multidimensional parameter space methods are of significant importance. Generally, despite the limitations of many assumptions in mathematical modelling, it is revealed that mathematical models demonstrate the ability to handle complex systems originating from interactions between humans and nature.
Background Tamarindus indica (TI) extract is known to possess important phytochemical composition. The study aimed to assess the effects of ethyl acetate fraction of TI leaves (EATI) on memory and learning, traced element and brain sialic acid levels, and hippocampal Nissl substance expression following prenatal (PN) AlCl3 exposure in Wistar rat pups. Methods Pregnant rats were divided into 5 groups (n =4); Group I received distilled water (negative control), Group II-V were experimental groups treated with 200 mg/kg of AlCl3. Group II (positive control), Groups III, and IV received 400 mg kg⁻¹ and 800 mg kg⁻¹ of EATI, respectively, and Group V received 300 mg kg⁻¹ of Vitamin E (comparatively control) for 2 weeks (PN day 7-21). On postnatal (PoN) day 19, male pups were subjected to novel object recognition test (n=5). Some pups were euthanized on PoN days 7 and 21; and samples were collected for quantification of trace element (n=5), brain sialic acid concentration (n=5), and Nissl staining using cresyl fast (n=3). Results The results of the trace elements quantification on PoN days 7 and 21 revealed significantly lower mean copper, zinc, and iron, and significantly higher calcium level in the group treated with 400 and 800 mg kg⁻¹ of EATI when compared with the positive control group. EATI at a dose of 800 mg kg⁻¹ showed improvement in memory and increased brain sialic acid. EATI 400 mg kg⁻¹ increased only free sialic acid and had no effect on memory. Improvement in Nissl staining was observed in the EATI treated group on PoN day 7 and 21. Conclusion The administration of EATI ameliorated AlCl3-induced neural toxicity.
Background COVID-19 vaccination is the latest preventive intervention strategy in an attempt to control the global pandemic. Its efficacy has come under scrutiny because of break through infections among the vaccinated and need for booster doses. Besides, although health workers were prioritized for COVID-19 vaccine in most countries, anecdotal evidence points to high levels of reluctance to take the vaccine among health workers. We assessed COVID-19 vaccine hesitancy among health workers in Dokolo district, northern Uganda. Methods This was a mixed-method, cross-sectional descriptive study. A customised self-administered data collection tool was used to collect quantitative data on characteristics, vaccination status and factors for or rejection of vaccine uptake. We conducted multivariable logistic regression to assess the association between selected exposures and vaccine hesitancy using Stata version 15. Conversely, qualitative data were collected using key informant interviews (KIIs) among 15 participants that were purposively selected. Data were analysed using thematic content analysis with the help of NVivo 12.0. Results Of the 346 health workers enrolled, (13.3% [46/346]) were vaccine hesitant. Factors associated with vaccine hesitancy included fear of side effects (Adjusted Odds Ratio [AOR]: 2.55; 95% Confidence Interval [95%CI]: 1.00, 6.49) and health workers’ lack of trust in the information provided by health authorities (AOR: 6.74; 95% CI: 2.43, 18.72). Similar factors were associated with vaccine hesitancy when we used the vaccine hesitancy score. Fear of side effects, distrust in vaccine stakeholders, and lack of trust in the vaccine were barriers to COVID-19 vaccination among health workers. Conclusion A small proportion of health workers were found to be hesitant to take the COVID-19 vaccine in this study. The paucity of COVID-19 vaccine safety information, which eroded the health workers’ trust in the information they received on the vaccine, was responsible for health workers hesitancy to take up the vaccine in Uganda.
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Plot 364 Block 3 Kikungiri Hill, Kabale Municipality, Kabale District, 256, Kabale, Western Region, Uganda
Head of institution
Prof. Joy C. Kwesiga