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Introduction
Skills and Expertise
Publications
Publications (104)
Background
Loss to follow-up (LTFU) of patients with presumed tuberculosis (TB) before completing the diagnostic process (pre-diagnosis LTFU) and before initiating treatment for those diagnosed (pre-treatment LTFU) is a challenge in the realization of the End TB Strategy. We assessed the proportion of pre-diagnosis and pre-treatment LTFU and associ...
BACKGROUND
Globally, TB programs have enhanced efforts to improve case detection, treatment initiation and monitoring of treatment outcomes. However, there is less attention on reducing the number of presumptive TB patients that never get tested for TB or the confirmed ones that never start treatment in endemic areas, such as Uganda. These losses s...
Background
Tuberculosis (TB) is the leading cause of death from a single infectious agent globally. The stigma associated with TB, encompassing self, anticipated, and public stigma, has significant negative effects on treatment adherence. In Uganda, limited data exist on the prevalence of stigma and its relationship with sex among patients with TB....
BACKGROUND
Growing evidence suggests that post-TB-related morbidity occurs often among TB survivors, but there is limited epidemiological data on the burden of symptoms and disability after successful completion of treatment. We evaluated the prevalence of TB-related symptoms, self-reported disability, and factors associated with disability among a...
Background
A recent systematic review shows high COVID-19 vaccine effectiveness in fully-vaccinated people in Africa. However, vaccine uptake has varied across populations. We assessed the uptake, perceptions of and willingness to take the COVID-19 vaccine among unvaccinated individuals at two Ugandan border points of entry.
Methods
This was a cro...
Introduction
Hand hygiene compliance is one of the key performance indicators for infection prevention and control programmes, patient safety and quality of health services. WHO guidelines and the patient centred approach stress the need to increase patient involvement in hand hygiene promotion in healthcare settings. Patients’ and health care work...
Background
Hand hygiene is known to reduce healthcare-associated infections. However, it remains suboptimal among healthcare providers. In this study, we used the Behaviour-centered Design approach to explore the facilitators and deterrents to hand hygiene among healthcare providers in the Kampala Metropolitan area, Uganda.
Methods
We conducted a...
Background
Loss to follow-up (LTFU) of presumptive tuberculosis (TB) patients before completing diagnosis (pre-diagnosis LTFU) and before initiating treatment for those diagnosed (pre-treatment LTFU) is a challenge in the realization of the End TB Strategy. We assessed the proportion of pre-diagnosis and pre-treatment LTFU and associated factors am...
Background: A recent systematic review shows that COVID-19 vaccines offer nearly universal protection against symptomatic and asymptomatic infections in fully-vaccinated people. However, vaccine uptake has varied across populations. We assessed the uptake, perceptions of and willingness to take the COVID-19 vaccine among unvaccinated high-risk popu...
BACKGROUND
Directly observed therapy (DOT) is the standard for monitoring adherence for tuberculosis (TB) treatment. However, the implementation of DOT is difficult for patients and providers due to a lack of financial and human resources. Mounting evidence suggests that video directly observed therapy (VDOT), an emerging digital adherence technolo...
Background
Directly observed therapy (DOT) is the standard method for monitoring adherence to tuberculosis (TB) treatment. However, implementing DOT poses challenges for both patients and providers due to limited financial and human resources. Increasing evidence suggests that emerging digital adherence technologies, such as video directly observed...
Background
Tuberculosis (TB) care could be considered as a continuum from symptom recognition, decision to seek care, diagnosis, treatment initiation and treatment completion, with care along the continuum influenced by several factors. Gender dimensions could influence TB care, and indeed, more men than women are diagnosed with TB each year. The s...
Background
Tuberculosis (TB) is one of the leading causes of death from a single infectious agent globally. Stigma associated with TB encompassing self-, anticipated-, and public-stigma has significant negative effects on treatment adherence. In Uganda, limited data exist on the prevalence of stigma and its relationship with sex among patients with...
Background
Loss to follow-up of presumptive TB patients is a major challenge towards the realization of the End-TB strategy. SMS reminders and mobile money (MM) incentives have shown promise by improving health outcomes. However, there is limited knowledge on whether these interventions can increase linkage to care/treatment for presumptive TB pati...
Multiple zoonotic disease outbreaks occurred in Uganda over the past two decades and have needed operationalization of the One Health (OH) Approach to respond effectively. Between 2016 and 2018, the African One Health University Network (AFROHUN) supported 61 students (25 females, 36 males) to join multisectoral and multidisciplinary government nat...
Ecological sanitation (Ecosan) by-products are inherently limited in their potential use as excreta resources. Disgust behind human excreta and derivatives continues to challenge the further use of Ecosan-by products. Although treated excreta, including Ecosan by-products, have gradually been adopted worldwide, diverse perspectives among users hind...
Background
Extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-Ec) represents a significant global public health concern. The epidemiology of ESBL-Ec in Uganda is not well understood although it is harbored by humans, animals, and the environment. This study explains the epidemiology of ESBL-Ec using a one health approach in selected...
Background
The use of psychoactive substances such as alcohol, heroin and marijuana is associated with negative health outcomes such as sexual violence and unintended pregnancies, and risky sexual behaviours. Although there is evidence linking psychoactive substance use and risky sexual behaviours such as inconsistent condom use and multiple sexual...
BACKGROUND
Nonadherence to treatment remains a barrier to tuberculosis (TB) control. The standard Directly observed therapy (DOT) for monitoring medication to combat adherence has several structural and systemic challenges that limit its implementation. Digital adherence technologies such as Video DOT (VDOT) have recently emerged as alternative way...
Background
In tuberculosis (TB) control, nonadherence to treatment persists as a barrier. The traditional method of ensuring adherence, that is, directly observed therapy, faces significant challenges that hinder its widespread adoption. Digital adherence technologies such as video directly observed therapy (VDOT) are emerging as promising solution...
Introduction
Uganda has implemented lifelong antiretroviral therapy for the prevention of mother-to-child HIV transmission since September 2012. Implementation of this strategy has been met with health provider and client challenges which have persisted up to date. This study explored providers’ perspectives on the challenges and countermeasures of...
Background
Extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-PE) represents a significant global public health concern. Much as humans, animals and environments harbor ESBL-PE, its epidemiology in Uganda is still not well understood. This study explains the epidemiology of ESBL-PE using the one health approach in selected farming ho...
Ecological sanitation (Ecosan) technology was introduced to improve sanitation through the reuse of excreta resources, particularly in developing countries. However, the adoption of Ecosan technology is low which makes its diffusion complex, especially in diverse spatial and socio-cultural contexts. This review of literature aimed to use the innova...
Background
The One Health (OH) approach integrates multiple competencies in the prevention and control of disease outbreaks. Through a range of OH competence-based activities, the Africa One Health University Network (AFROHUN) built the capacity of selected students at Makerere University and Mbarara University of Science and Technology. This study...
Solid-waste management is a challenge in many cities, especially in low-income countries, including Uganda. Simple and inexpensive strategies such as solid-waste segregation and recycling have the potential to reduce risks associated with indiscriminate waste management. Unfortunately, these strategies have not been studied and adopted in slums in...
Background
The utilization of “on-site excreta decomposition technology” known as “Ecological sanitation (Ecosan)” has a rational use of human excreta. It is a resource-oriented sanitation mostly feasible in areas with rocky soil and prone to agriculture. This technology was implemented in Rwanda for more than a decade. However, little is known abo...
Background
Healthcare providers (HCPs) are at an elevated occupational health risk of hepatitis B virus infections. Post-exposure prophylaxis (PEP) is one of the measures recommended to avert this risk. However, there is limited evidence of HCPs’ awareness of hepatitis B PEP. Therefore, this study aimed to establish awareness of hepatitis B PEP amo...
Background
Young psychoactive substance users exhibit high-risk behaviours such as unprotected sexual intercourse, and sharing needles and syringes, which increases their risk of Hepatitis B infection. However, there is limited evidence of screening, and vaccination status of this subgroup. The aim of this study was to establish the predictors of s...
The postnatal period is critical to the delivery of interventions aimed at improving maternal health outcomes. This study examined the timing to resumption of sexual intercourse and associated factors among postnatal women living with HIV (WLWH) in Uganda. A sample of 385 women was drawn from a larger prospective cohort study conducted between 2013...
Background
Hand hygiene is known to reduce healthcare-associated infections. However, it remains suboptimal among healthcare providers. In this study, we used the Behaviour Centered Design to explore the facilitators and deterrents of hand hygiene among healthcare providers in the greater Kampala Metropolitan area, Uganda.
Methods
A formative quali...
Background
Globally, displaced populations face an increased burden of tuberculosis (TB). Uganda is currently hosting unprecedented big numbers of refugees from the East African region. Recent evidence shows increased spread of multi-drug resistant TB (MDR-TB) across East Africa as a result of migrants from Somalia- a high MDR-TB prevalent country,...
Background
Psychoactive substance use has an impact on risky sexual behaviour. Globaly, over 275 million people use psychoactive substances, however evidence on the predictors of sex under the influence of these substatnces is scanty. We investigated the prevalence and predictors of sex under the influence of psychoactive substances among young peo...
Background
Psychoactive substance use has an impact on risky sexual behaviour. Globaly, over 275 million people use psychoactive substances, however evidence on the predictors of sex under the influence of these substatnces is scanty. We investigated the prevalence and predictors of sex under the influence of psychoactive substances among young peo...
Background
Psychoactive substance use has an impact on risky sexual behaviour. Globaly, over 275 million people use psychoactive substances, however evidence on the predictors of sex under the influence of these substatnces is scanty. We investigated the prevalence and predictors of sex under the influence of psychoactive substances among young peo...
Background
The One Health (OH) approach integrates multiple competencies in the prevention and control of disease outbreaks. Through a range of OH competence-based activities, the Africa One Health University Network (AFROHUN) built the capacity of selected students at Makerere University and Mbarara University of Science and Technology. This study...
Background
The Africa One Health University Network (AFROHUN) with support from the United States Agency for International Development (USAID), has since 2012 conducted pre and in-service One health (OH) trainings with the objective of improving global health security through a well-trained multidisciplinary health workforce. These trainings aim to...
Background
Despite the development and enforcement of preventive guidelines by governments, COVID-19 continues to spread across nations, causing unprecedented economic losses and mortality. Public places remain hotspots for COVID-19 transmission due to large numbers of people present; however preventive measures are poorly enforced. Supermarkets ar...
Introduction: Heterosexual couples are at high risk for HIV acquisition in sub-Saharan Africa, and HIV self-testing (HST) is an additional approach to expand access to HIV testing services. However, it is not well known how gender equality is associated with HST.
Methods: We used intervention-arm data from a cluster-randomised controlled HST interv...
Background
Psychoactive substance use is a public health challenge among young people in informal settlements. Though rarely examined, psychoactive substance use is linked to sexual expectancies and inhibitions, and consequently high-risk sexual behaviours. This study examined the association between sexual expectancies and inhibitions, and high-ri...
Rationale
Convalescent plasma (CCP) has been studied as a potential therapy for COVID-19, but data on its efficacy in Africa are limited.
Objective
In this trial we set out to determine the efficacy of CCP for treatment of COVID-19 in Uganda.
Measurements
Patients with a positive SARS-CoV-2 reverse transcriptase (RT)-PCR test irrespective of dise...
Introduction
Evidence that supports the use of COVID-19 convalescent plasma (CCP) for treatment of COVID-19 is increasingly emerging. However, very few African countries have undertaken the collection and processing of CCP. The aim of this study was to assess the feasibility of collecting and processing of CCP, in preparation for a randomized clini...
Background
High uptake and optimal adherence to Option B+ antiretroviral therapy (ART) increase effectiveness in averting mother-to-child transmission of HIV. Option B+ ART uptake, early adherence, and associated factors need to be evaluated in Central Uganda.
Methods
A mixed approaches study was carried out in six health facilities in Masaka, Mit...
Since the introduction of antibiotics into mainstream health care, resistance to these drugs has become a widespread issue that continues to increase worldwide. Policy decisions to mitigate the development of antimicrobial resistance are hampered by the current lack of surveillance data on antibiotic product availability and use in low-income count...
Background:
Although proper management of electronic waste (e-waste) is key to preventing disease and protecting the environment, there is no clear mechanism for its management in Uganda. This study assessed knowledge, perceptions, and practices of e-waste management among consumers in Kampala city, Uganda.
Methods:
We conducted a cross-sectiona...
Introduction:
Understanding and following HIV self-testing (HIVST) instructions is a critical step in the use of HIVST kits. We analyzed data on pregnant women and their partners' self-assessment on the usability of kits delivered by their pregnant women.
Methods:
Quantitative data were collected on 399 pregnant women and 238 male partners enrol...
Background
Makerere University implemented a One Health Institute (OHI) in 2016 involving undergraduate students selected from different disciplines. The students were first taken through theoretical principles of One Health followed by a field attachment in communities. The field attachment aimed to expose students to experiential educational oppo...
Background
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 utilisation of HIV/STI prevention services. This study explored bar...
The interconnections of humans, domestic animals, wildlife and the environment have increasingly become complex, requiring innovative and collaborative approaches (One Health approach) for addressing global health challenges. One Health is a multidisciplinary and multi-sectoral collaborative approach to human, animal, plant and environmental health...
Background
Improved Water, Sanitation and Hygiene (WASH) in Healthcare facilities (HCFs) is of significant public health importance. It is associated with a reduction in the transmission of healthcare acquired infections (HAIs), increased trust and uptake of healthcare services, cost saving from infections averted, increased efficiency and improve...
Background
Improved Water, Sanitation and Hygiene (WASH) in Healthcare facilities (HCFs) is of significant public health importance. It is associated with a reduction in the transmission of healthcare-acquired infections (HAIs), increased trust and uptake of healthcare services, cost-saving from infections averted, increased efficiency and improved...
Introduction
Evidence that supports the use of COVID-19 convalescent plasma (CCP) for treatment of COVID-19 is increasingly emerging. However, very few African countries have undertaken the collection and processing of CCP. The aim of this study was to assess the feasibility of collecting and processing of CCP, in preparation for a randomized clini...
Background
Multiple sexual partnerships increase the risk of transmission of HIV and can be exacerbated by substance abuse. However, the association between psychoactive substance use and multiple sexual partnerships among young people in informal settlements of low-income countries is not well known. This study established the prevalence of multip...
The interconnections of humans, domestic animals, wildlife and the environment have increasingly become complex, requiring innovative and collaborative approaches (One Health approach) for addressing global health challenges. One Health is a multidisciplinary and multi-sectoral collaborative approach to human, animal, plant and environmental health...
Rationale:
Detailed data on the characteristics and outcomes of patients with COVID-19 in sub-Saharan Africa are limited.
Objective:
We determined the clinical characteristics and treatment outcomes of patients diagnosed with COVID-19 in Uganda.
Measurements:
As of the 16 May 2020, a total of 203 cases had been confirmed. We report on the firs...
Uganda is considered as a 'hot spot' for emerging and re-emerging infectious disease epidemics. The country has experienced several epidemics including; Ebola, Marburg, plague, Rift Valley fever, yellow fever and Crimean Congo haemorrhagic fever. Epidemics overwhelm health systems, devastate economies and cause global health insecurity. These publi...
Background
Screening and vaccination against Hepatitis B virus (HBV) infection remains the most effective intervention in curbing the disease. However, there is limited evidence on the factors associated with the uptake of these services in Uganda. This study determined the uptake of HBV screening and vaccination status, and associated factors amon...
Background 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 challenges in access to and utilisation of HIV/STI prevention services. Our study...
Background
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 utilisation of HIV/STI prevention services. This study explored bar...
This report describes findings of a qualitative study on tuberculosis (TB)-related stigma among community members from two regions in Uganda. This research is part of a broader Quality of Tuberculosis Services Assessment (QTSA) conducted in Uganda in 2019 by MEASURE Evaluation, which is funded by the United States Agency for International Developme...
The Quality of Tuberculosis Services Assessment (QTSA) in Uganda was conducted with the support of five tools: the Facility Audit, the Provider Interview, the Patient Interview, the Register Review, and the Focus Group Discussion Guide. MEASURE Evaluation—a project funded by the United States Agency for International Development (USAID)—developed t...
The Quality of Tuberculosis Services Assessment (QTSA) in Uganda was conducted with the support of five tools: the Facility Audit, the Provider Interview, the Patient Interview, the Register Review, and the Focus Group Discussion Guide. MEASURE Evaluation—a project funded by the United States Agency for International Development (USAID)—developed t...
Background
The use of psychoactive substances is a public health challenge among young people in informal settlements. Though rarely examined, the use of psychoactive substances is linked to sexual expectancies and inhibitions, and consequently high-risk sexual behaviours. This study examined the association between sexual expectancies and inhibiti...
Background: Improved Water, Sanitation and Hygiene (WASH) services in Health Care Facilities (HCFs) is of significant public health importance. It is associated with a reduction in the transmission of hospital acquired infections (HAIs), increased trust and uptake of healthcare services, cost saving from infections averted, increased efficiency and...
Background: Improved Water, Sanitation and Hygiene (WASH) in Healthcare facilities (HCFs) is of significant public health importance. It is associated with a reduction in the transmission of healthcare acquired infections (HAIs), increased trust and uptake of healthcare services, cost saving from infections averted, increased efficiency and improve...
Background: Improved Water, Sanitation and Hygiene (WASH) in Healthcare facilities (HCFs) is of significant public health importance. It is associated with a reduction in the transmission of healthcare acquired infections (HAIs), increased trust and uptake of healthcare services, cost saving from infections averted, increased efficiency and improve...
Background Young psychoactive substance users exhibit high-risk behaviours which can increase their risk to Hepatitis B infection. However, there is limited information on screening, and completion of the Hepatitis B vaccination schedule among young psychoactive substance users in informal settlements. Therefore, this study determined the factors a...
Background:
In Uganda, HIV testing rates are approximately 90% among women in antenatal care, with male rates much lower. The WHO has recommended HIV self-testing (HIVST), and one promising model is for women in antenatal care to deliver HIVST kits to their male partners. We investigated the impact of this model on male partner testing rates.
Set...
Makerere University implemented a One Health Institute (OHI) in 2016 involving undergraduate students selected from different disciplines. The students were first taken through theoretical principles in One Health followed by a field attachment in communities. The field attachment aimed to expose students to experiential educational opportunities i...