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Nalugya A, Ssempebwa JC, Muleme J, Wafula ST, Tamale BN, Tigaiza A, Nakalembe D, Kansiime WK, Isunju JB, Ssekamatte T, Mugambe RK. Exposure behaviour to Escherichia coli among households in Imvepi refugee settlement, Terego district Uganda. BMC Public Health 2024; 24:2041. [PMID: 39080627 PMCID: PMC11290189 DOI: 10.1186/s12889-024-19525-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 07/18/2024] [Indexed: 08/02/2024] Open
Abstract
INTRODUCTION Exposure to Escherichia coli (E. coli) is a risk factor for diarrhoeal diseases, which pose a significant problem in refugee settlements. Refugee populations are exposed to faecal microorganisms through multiple pathways including sub-optimal sanitary facilities, contaminated drinking water, produce and food, flood water, bathing water, and soil among others. While these pathways are well-documented, specific exposure behaviours remain underexplored. We assessed exposure behaviour to E. coli among households in Imvepi refugee settlement, Uganda, and provided evidence-based recommendations for the design of interventions to reduce excreta-related disease in refugee settlements. METHODS Guided by the Sanitation Safety Planning approach, we surveyed 426 households in Imvepi refugee settlement, Uganda, using a digitized questionnaire and an observation checklist. We collected data on the background characteristics and exposure behaviour of women and emancipated girls (minors living on their own, having borne a child, married, or pregnant). The outcome variable, E. coli exposure behaviour, was measured using a five-point Likert scale, assessing behaviours that increase the risk of exposure. Data were cleaned in Microsoft Excel and analyzed in Stata version 17. Descriptive statistics were performed to summarize the data. We used modified Poisson regression to determine the factors associated with the outcome. RESULTS Over 59.4% (253) exhibited high-risk exposure behaviour. Residing in compound homes (Adjusted Prevalence Ratio (APR) = 0.72, 95% Confidence interval (CI): 0.58-0.90), being aged 35-49 years (APR = 0.76, 95% CI: 0.60-0.97), having household heads with post-primary education (APR = 0.54, 95% CI: 0.38-0.77), high knowledge (APR = 0.69, 95% CI: 0.59-0.80), and high-risk perceptions regarding exposure to E. coli (APR = 0.75, 95% CI: 0.64-0.88) were associated with a lower prevalence of high-risk E. coli exposure behaviours. Conversely, having sanitary facilities with excreta overflowing from the squat hole (APR = 1.26, 95% CI: 1.08-1.48) was associated with a higher prevalence of high-risk exposure behaviours. CONCLUSION The study indicates a substantial prevalence of high-risk E. coli exposure behaviours in the refugee settlement.. There's a need to implement behaviour change interventions targeted at preventing or minimizing exposure, especially among households whose heads have low education attainment, those with young caretakers and those with limited knowledge and low-risk perceptions regarding exposure to E. coli.
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Affiliation(s)
- Aisha Nalugya
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, P.O Box 7072, Kampala, Uganda.
- SWEEM Health Consult Limited, Kampala, Uganda.
| | - John C Ssempebwa
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, P.O Box 7072, Kampala, Uganda
| | - James Muleme
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Solomon T Wafula
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, P.O Box 7072, Kampala, Uganda
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Bridget Nagawa Tamale
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, P.O Box 7072, Kampala, Uganda
- SWEEM Health Consult Limited, Kampala, Uganda
| | - Arnold Tigaiza
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Doreen Nakalembe
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, P.O Box 7072, Kampala, Uganda
- SWEEM Health Consult Limited, Kampala, Uganda
| | - Winnifred K Kansiime
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, P.O Box 7072, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Tonny Ssekamatte
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, P.O Box 7072, Kampala, Uganda
- SWEEM Health Consult Limited, Kampala, Uganda
| | - Richard K Mugambe
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, P.O Box 7072, Kampala, Uganda
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Ssekamatte T, Nalugya A, Mugambe RK, Wagaba B, Nakalembe D, Mutebi A, Bagonza RA, Tigaiza A, Kansiime WK, Ssempala R, Wafula ST, Isunju JB, Buregyeya E. Prevalence and predictors of sex under the influence of psychoactive substances among young people in informal settlements in Kampala, Uganda. BMC Public Health 2023; 23:801. [PMID: 37131127 PMCID: PMC10152422 DOI: 10.1186/s12889-023-15679-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 04/14/2023] [Indexed: 05/04/2023] Open
Abstract
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 relationships, there is limited data on sex under the influence of psychoactive substances among young people. This study aimed to investigate the prevalence and predictors of sex under the influence of psychoactive substances among young people in informal settlements in Kampala, Uganda. METHODS A cross-sectional study was conducted among 744 sexually active young psychoactive substance users in informal settlements in Kampala, Uganda. Data were collected through face-to-face interviews using a digitalized structured questionnaire, preloaded on the Kobocollect mobile application. The questionnaire captured data on the socio-demographic characteristics of the respondents, history of psychoactive substance use, and sexual behaviours. Data were analysed using STATA Version 14.0. A modified Poisson regression model was used to determine the predictors of sex under the influence of psychoactive substances.. Adjusted prevalence ratios at a p-value value ≤ 0.05 with a 95% confidence interval were considered. RESULTS About 61.0% (454/744) of the respondents had had sex under the influence of psychoactive substances in the last 30 days. The predictors of sex under the influence of psychoactive substances were being female (PR 1.18, 95% CI: 1.04-1.34), being 20-24 years of age (PR: 1.22, 95% CI: 1.04-1.44), being married (PR 1.15, 95% CI: 1.01-1.31) or divorced/separated (PR 1.43, 95% CI: 1.26-1.61), not living with biological parents or guardians (PR 1.22, 95% CI: 0.99-1.50), earning 71 USD and below (PR 0.86, 95% CI: 0.79-1.03) and using alcohol (PR 1.43, 95% CI: 1.25-1.69), marijuana (PR 1.16, 95% CI: 1.02-1.31) and khat (PR 1.25, 95% CI: 1.10-1.42) in the last 30 days. CONCLUSION The study found that a high proportion of sexually active young people in informal settlements in Kampala, Uganda had engaged in sex under the influence of psychoactive substances in the past 30 days. The study also identified several factors associated with sex under the influence of psychoactive substances, including being female, being aged 20-24 years, being married or divorced or separated, not living with biological parents or guardians, and using alcohol, marijuana, or khat in the past 30 days. Our findings suggest the need for targeted sexual and reproductive health programs that incorporate risk-reduction interventions aimed at reducing sex under the influence of psychoactive substances, especially among females and those who do not live with their parents.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Richard K. Mugambe
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Brenda Wagaba
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Doreen Nakalembe
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Aloysius Mutebi
- Department of Health Policy Planning and Management, School of Public Health, College of Health Sciences, Makerere University, P.o Box 7072, Kampala, Uganda
| | - Richard Asaba Bagonza
- School of Women & Gender Studies, College of Humanities and Social Sciences, Makerere University, P.o Box 7062, Kampala, Uganda
| | - Arnold Tigaiza
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Winnifred K. Kansiime
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Richard Ssempala
- Department of Economic Theory and Analysis, School of Economics, College of Business and Management Sciences, Makerere University, P.o Box 7062, Kampala, Uganda
| | - Solomon T. Wafula
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
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Zewede EN, Bekele NT, Negussie YM, Getahun MS, Gurara AM. A Community-Based Cross-Sectional Study on Latrine Utilization and Associated Factors Among Rural Community of East Meskan District, Gurage Zone, Southern Ethiopia. SAGE Open Nurs 2023; 9:23779608231177540. [PMID: 37223222 PMCID: PMC10201159 DOI: 10.1177/23779608231177540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/28/2023] [Accepted: 05/06/2023] [Indexed: 05/25/2023] Open
Abstract
Background Using sanitary facilities is proven to enhance health and halt the spread of fecal-to-oral disease. Despite efforts to improve the availability of latrine facilities in developing countries like Ethiopia, finding a village that is entirely free of open defecation remains difficult. To determine the need for intervention programs and promote regular latrine usage, local data is essential. Objectives This study aimed to assess latrine utilization and associated factors among households in East Meskan District, Southern Ethiopia. Methods A community-based cross-sectional study was conducted among 630 households from April 15 to May 30, 2022. A simple random sampling technique was used to select the study households. Data were collected using an interviewer-administered structured questionnaire and an observational checklist. The collected data were then entered into Epi-Info version 7.1 and analyzed using SPSS version 21. In binary logistic regression analysis, independent variables with a P-value < .25 were considered candidates for multiple logistic regression analysis. The association was expressed in odds ratio with a 95% confidence interval (CI), and significance was declared at P-value < .05 in the final model. Results The magnitude of latrine utilization was 73.3% (95% CI: 69.7, 76.8) in the study district. Husband being family head (adjusted odds ratio [AOR] = 12.9; 95% CI: 5.78 ,28.90), being female (AOR = 16.4; 95% CI: 6.52, 41.27), family size less than 5 (AOR = 24.2; 95% CI: 11.49, 51.09), absence of school children (AOR = 0.3; 95% CI: 0.13, 0.51), and greater than 2 years since latrine was constructed (AOR = 14; 95% CI: 7.18, 27.41) had a significant association with latrine utilization. Conclusion In this study, utilization of latrines was low compared to the national target plan. Family head, sex, family size, presence of school children, and length of years in which the latrine was constructed were factors associated with latrine utilization. Thus, regular supervision of early latrine construction and utilization in communities is essential.
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Ssekamatte T, Mugambe RK, Nalugya A, Isunju JB, Matovu JK, Kansiime WK, Balugaba BE, Oputan P, Tigaiza A, Wafula ST, Kibira SP, Wanyenze RK. Predictors of consistent condom use among young psychoactive substance users in Kampala's informal settlements, Uganda. DIALOGUES IN HEALTH 2022; 1:100080. [PMID: 38515898 PMCID: PMC10953897 DOI: 10.1016/j.dialog.2022.100080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/30/2022] [Accepted: 11/13/2022] [Indexed: 03/23/2024]
Abstract
Introduction The use of psychoactive substances increases the likelihood of unprotected sexual intercourse with individuals whose health status is not known, and consequently sexually transmitted infections, especially among young people. Despite this risk, there is limited evidence of the predictors of consistent condom use among young psychoactive substance users (YPSUs) in informal settings. This study examined the predictors of condom use among YPSUs in Kampala's informal settlements, Uganda. Methods A cross-sectional study was conducted among 768 YPSUs. Respondent-driven sampling was used to recruit respondents. A structured questionnaire was used to collect respondent data on condom use. Data were analysed using Stata version 15.0. Prevalence ratios (PR) were used to determine the predictors of consistent condom use. Results Out of the 744 YPSUs, only 37.4% of the respondents reported consistent condom use in the last 30 days. The prevalence of condom use was statistically lower among young people aged 20-24 years (35.4%) compared to those aged 18-19 years (43.7%), and among the married (17.3%) compared to respondents with a "single" marital status (43.0%). Being married (PR 0.42, 95% CI: 0.30-0.59), longer duration between meeting the most recent partner and having initial sexual contact with them (7 months to 1 year: PR 0.56, 95% CI: 0.36-0.88; more than a year: PR 0.36, 95% CI: 0.17-0.75) was negatively associated with consistent condom use. Spending less than 24 h between meeting the most recent partner and having initial sexual contact was positively associated with consistent condom use (PR 1.60, 95% CI: 1.24-2.08). Conclusion The prevalence of consistent condom use in the last 30 days among YPSUs was low. Marital status and the duration between meeting the most recent partner and initial sexual contact predicted consistent condom use. There is a need to intensify awareness on the importance of consistent condom use among young people.
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Affiliation(s)
- Tonny Ssekamatte
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Richard K. Mugambe
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Aisha Nalugya
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - John Bosco Isunju
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Joseph K.B. Matovu
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Winnie K. Kansiime
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Bonny E. Balugaba
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Patience Oputan
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Arnold Tigaiza
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Solomon Tsebeni Wafula
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Simon P.S. Kibira
- Makerere University College of Health Sciences, School of Public Health, Department of Community Health and Behavioural Sciences, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Rhodah K. Wanyenze
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
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Kansiime WK, Mugambe RK, Atusingwize E, Wafula ST, Nsereko V, Ssekamatte T, Nalugya A, Coker ES, Ssempebwa JC, Isunju JB. Use of biomass fuels predicts indoor particulate matter and carbon monoxide concentrations; evidence from an informal urban settlement in Fort Portal city, Uganda. BMC Public Health 2022; 22:1723. [PMID: 36089579 PMCID: PMC9464485 DOI: 10.1186/s12889-022-14015-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Poor indoor air quality (IAQ) is a leading cause of respiratory and cardiopulmonary illnesses. Particulate matter (PM2.5) and carbon monoxide (CO) are critical indicators of IAQ, yet there is limited evidence of their concentrations in informal urban settlements in low-income countries.
Objective
This study assessed household characteristics that predict the concentrations of PM2.5 and CO within households in an informal settlement in Fort Portal City, Uganda.
Methodology
A cross-sectional study was conducted in 374 households. Concentrations of PM2.5 and CO were measured using a multi-purpose laser particle detector and a carbon monoxide IAQ meter, respectively. Data on household characteristics were collected using a structured questionnaire and an observational checklist. Data were analysed using STATA version 14.0. Linear regression was used to establish the relationship between PM2.5, CO concentrations and household cooking characteristics.
Results
The majority (89%, 332/374) of the households used charcoal for cooking. More than half (52%, 194/374) cooked outdoors. Cooking areas had significantly higher PM2.5 and CO concentrations (t = 18.14, p ≤ 0.05) and (t = 5.77 p ≤ 0.05), respectively. Cooking outdoors was associated with a 0.112 increase in the PM2.5 concentrations in the cooking area (0.112 [95% CI: -0.069, 1.614; p = 0.033]). Cooking with moderately polluting fuel was associated with a 0.718 increase in CO concentrations (0.718 [95% CI: 0.084, 1.352; p = 0.027]) in the living area.
Conclusions
The cooking and the living areas had high concentrations of PM2.5 and CO during the cooking time. Cooking with charcoal resulted in higher CO in the living area. Furthermore, cooking outdoors did not have a protective effect against PM2.5, and ambient PM2.5 exceeded the WHO Air quality limits. Interventions to improve the indoor air quality in informal settlements should promote a switch to cleaner cooking energy and improvement in the ambient air quality.
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Mugambe RK, Nuwematsiko R, Ssekamatte T, Nkurunziza AG, Wagaba B, Isunju JB, Wafula ST, Nabaasa H, Katongole CB, Atuyambe LM, Buregyeya E. Drivers of Solid Waste Segregation and Recycling in Kampala Slums, Uganda: A Qualitative Exploration Using the Behavior Centered Design Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10947. [PMID: 36078663 PMCID: PMC9518474 DOI: 10.3390/ijerph191710947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
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 low-income countries. This cross-sectional qualitative study, therefore, used the behavioral-centered design model to understand the drivers of recycling in Kampala slums. Data were coded using ATLAS ti version 7.0, and content analysis was used for interpreting the findings. Our findings revealed that the study practices were not yet habitual and were driven by the presence of physical space for segregation containers, and functional social networks in the communities. Additionally, financial rewards and awareness related to the recycling benefits, and available community support were found to be critical drivers. The availability of infrastructure and objects for segregation and recycling and the influence of politics and policies were identified. There is, therefore, need for both the public and private sector to engage in developing and implementing the relevant laws and policies on solid waste recycling, increase community awareness of the critical behavior, and create sustainable markets for waste segregated and recycled products.
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Affiliation(s)
- Richard K. Mugambe
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
| | - Rebecca Nuwematsiko
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
| | - Tonny Ssekamatte
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
| | - Allan G. Nkurunziza
- Department of Public Health, Kampala Capital City Authority, Kampala P.O. Box 7072, Uganda
| | - Brenda Wagaba
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
| | - Solomon T. Wafula
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
| | - Herbert Nabaasa
- Environmental Health Department, Ministry of Health, Plot 6, Lourdel Road, Nakasero, Kampala P.O. Box 7272, Uganda
| | - Constantine B. Katongole
- Department of Agricultural Production, College of Agricultural and Environmental Sciences, Makerere University, Kampala P.O. Box 7062, Uganda
| | - Lynn M. Atuyambe
- Department of Community Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
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Ssekamatte T, Isunju JB, Mutyoba JN, Tetui M, Mugambe RK, Nalugya A, Kansiime WK, Kitchen C, Brenda W, Oputan P, Bukenya JN, Buregyeya E, Kibira SPS. Predictors of Hepatitis B screening and vaccination status of young psychoactive substance users in informal settlements in Kampala, Uganda. PLoS One 2022; 17:e0267953. [PMID: 35588113 PMCID: PMC9119510 DOI: 10.1371/journal.pone.0267953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 04/19/2022] [Indexed: 11/19/2022] Open
Abstract
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 screening and completion of the hepatitis B vaccination schedule. METHODS A cross-sectional study using respondent driven sampling was used to enrol respondents from twelve out of fifty-seven informal settlements in Kampala city. Data were collected using an electronic structured questionnaire uploaded on the KoboCollect mobile application, and analysed using Stata version 14. A "modified" Poisson regression analysis was done to determine the predictors of screening while logistic regression was used to determine the predictors of completion of the Hepatitis B vaccination schedule. RESULTS About 13.3% (102/768) and 2.7% (21/768) of the respondents had ever screened for Hepatitis B, and completed the Hepatitis B vaccination schedule respectively. Being female (aPR 1.61, 95% CI: 1.11-2.33), earning a monthly income >USD 136 (aPR 1.78, 95% CI: 1.11-2.86); completion of the Hepatitis B vaccination schedule (aPR 1.85, 95% CI: 1.26-2.70); lack of awareness about the recommended Hepatitis B vaccine dose (aPR 0.43, 95% CI: 0.27-0.68); and the belief that the Hepatitis B vaccine is effective in preventing Hepatitis B infection (aPRR 3.67, 95% CI: 2.34-5.73) were associated with "ever screening" for Hepatitis B. Knowledge of the recommended Hepatitis B vaccine dose (aOR 0.06, 95% CI: 0.01-0.35); "ever screening" for hepatitis B (aOR 9.68, 95% CI: 2.17-43.16) and the belief that the hepatitis B vaccine is effective in preventing Hepatitis B infection (aOR 11.8, 95% CI: 1.13-110.14) were associated with completion of the hepatitis B vaccination schedule. CONCLUSIONS Our findings indicate a low prevalence of Hepatitis B screening and completion of the Hepatitis B vaccination schedule among young psychoactive substance users in informal settings. It is evident that lack of awareness about Hepatitis B is associated with the low screening and vaccination rates. We recommend creation of awareness of Hepatitis B among young people in urban informal settlements.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Joan Nankya Mutyoba
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | - Moses Tetui
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | - Richard K. Mugambe
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Winnifred K. Kansiime
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Chenai Kitchen
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
| | - Wagaba Brenda
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Patience Oputan
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Justine Nnakate Bukenya
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Simon P. S. Kibira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
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Ssekamatte T, Kibira SPS, Tetui M, Isunju JB, Mugambe RK, Wafula ST, Buregyeya E, Nalwadda CK, Bukenya JN, Wanyenze RK. Do sexual expectancies and inhibitions predict high-risk sexual behaviours? Evidence from a cross-sectional survey among young psychoactive substance users in informal settlements in Kampala, Uganda. BMC Public Health 2021; 21:1506. [PMID: 34348701 PMCID: PMC8336356 DOI: 10.1186/s12889-021-11536-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/23/2021] [Indexed: 01/05/2023] Open
Abstract
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-risk sexual behaviours among young psychoactive substance users (PSUs) in informal settlements in Kampala, Uganda. METHODS This cross-sectional study recruited 744 young PSUs from informal settlements in Kampala. Respondent driven sampling was used to recruit respondents. A 'modified' Poisson regression model was used for inferential statistics. Data were analysed using the Stata 14 software. RESULTS Of the 744 study participants, 45.6% believed that psychoactive substance use improves sexual performance; 43.3% believed that psychoactive substances make sex more pleasurable, and 53.3% believed that psychoactive substances give courage or confidence to approach a partner for sex. The belief that psychoactive substance use improves sexual performance (PR 1.14, 95% CI: 1.01-1.30), increases the likelihood of engaging in sex (PR 1.20, 95% CI: 1.04-1.40) or gives courage or confidence to approach a sexual partner (PR 1.21, 95% CI: 1.05-1.39) were associated with having sex while under the influence of psychoactive substances. The belief that a psychoactive substance user under the influence of psychoactive substances is more likely to engage in sex (PR 1.48, 95% CI: 1.15-1.90), and likely to find it difficult to refuse sex (PR 1.28, 95% CI: 1.06-1.55) were positively associated with engaging in multiple sexual partnerships. The belief that one easily forgets to use a condom when under the influence of psychoactive substances was positively associated with inconsistent condom use (PR 1.26, 95% CI: 1.09-1.45). CONCLUSION Psychoactive substance use expectancies associated with high-risk sexual behaviours included the belief that psychoactive substances improve sexual performance and improve confidence in approaching a sexual partner. Psychoactive substance use inhibitions associated with high-risk sexual behaviours included an increased likelihood of engaging in sexual intercourse, difficulties in refusing to engage in sexual intercourse, and forgetting to use condoms while intoxicated. Interventions targeting a reduction in high-risk sexual behaviour should integrate the impact of psychoactive substance use on sexual behaviour.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Simon P. S. Kibira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Moses Tetui
- School of Pharmacy, University of Waterloo, Waterloo, Canada
- Departement of Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Richard K. Mugambe
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Solomon Tsebeni Wafula
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Christine Kayemba Nalwadda
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Justine Nnakate Bukenya
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Rhoda K. Wanyenze
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
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Yan R, Cheng S, Chen J, Li X, Sharma S, Nazim Uddin SM, Mang HP, Chen C, Li Z, Li T, Wang X. Operating status of public toilets in the Hutong neighborhoods of Beijing: An empirical study. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2021; 287:112252. [PMID: 33714043 PMCID: PMC8075803 DOI: 10.1016/j.jenvman.2021.112252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/10/2021] [Accepted: 02/20/2021] [Indexed: 06/12/2023]
Abstract
The provision of sanitation services for fast-growing urban populations is one of the world's urgent challenges. Hutong neighborhoods in Beijing, capital of China, cannot be rebuilt due to the protection of historical heritage, while residents still need to keep the habit of defecating in public toilets. One hundred public toilets with non-sewered sanitation in the Hutong neighborhoods of Beijing were visited to investigate the actual operating status in response to the "toilet revolution" campaign. The fault tree approach was used to identify the barriers toward a decent and environment-friendly public toilet and evaluate potential risks from the malfunction of various components. Four subsystems are defined and elaborated to calculate the fault possibility. These subsystems are environment- and user-friendly, regarded as ancillary facilities, and used for fecal sludge (FS) management. Statistical analysis of targeted cases indicated that fault probabilities of environmental considerations, user-friendly considerations, ancillary facilities, FS management are calculated as 0.79, 0.96, 0.96, and 0, respectively. The subsystems were weighted using a Delphi method concept. Results showed that the well operation ratio of Beijing Hutong public toilets is only 32%, and the sanitation service value chain can be further optimized. This study also provides references for other countries, which are dedicated to promoting urban sanitation and public health.
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Affiliation(s)
- Rui Yan
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Xueyuan Road No.30, Haidian District, Beijing, 100083, PR China.
| | - Shikun Cheng
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Xueyuan Road No.30, Haidian District, Beijing, 100083, PR China.
| | - Jingang Chen
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Xueyuan Road No.30, Haidian District, Beijing, 100083, PR China.
| | - Xiangkai Li
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Xueyuan Road No.30, Haidian District, Beijing, 100083, PR China.
| | - Sumit Sharma
- Cologne University of Applied Science, Hahnen Str. 31c, 50354, Huerth-Efferen, Germany.
| | | | - Heinz-Peter Mang
- German Toilet Organization, Paulsenstr. 23/12163, Berlin, Germany.
| | - Cong Chen
- School of Economics and Management, University of Science and Technology Beijing, Xueyuan Road No.30, Haidian District, Beijing, 100083, PR China.
| | - Zifu Li
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Xueyuan Road No.30, Haidian District, Beijing, 100083, PR China.
| | - Tianxin Li
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Xueyuan Road No.30, Haidian District, Beijing, 100083, PR China.
| | - Xuemei Wang
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Xueyuan Road No.30, Haidian District, Beijing, 100083, PR China.
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Kayiwa D, Mugambe RK, Mselle JS, Isunju JB, Ssempebwa JC, Wafula ST, Ndejjo R, Kansiime WK, Nalugya A, Wagaba B, Zziwa JB, Bwire C, Buregyeya E, Radooli MO, Kimbugwe C, Namanya E, Bateganya NL, McGriff JA, Wang Y, Ssekamatte T, Yakubu H. Assessment of water, sanitation and hygiene service availability in healthcare facilities in the greater Kampala metropolitan area, Uganda. BMC Public Health 2020; 20:1767. [PMID: 33228619 PMCID: PMC7682765 DOI: 10.1186/s12889-020-09895-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 11/16/2020] [Indexed: 11/10/2022] Open
Abstract
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 staff morale. Despite these benefits, there is limited evidence on availability of WASH services in HCFs in the Greater Kampala Metropolitan Area (GKMA). This study assessed the availability and status of WASH services within HCFs in the GKMA in order to inform policy and WASH programming. METHODS A cross-sectional study was conducted in 60 HCFs. Availability of WASH services in the study HCFs was assessed using a validated WASH Conditions (WASHCon) tool comprising of structured interviews, HCF observations and microbial water quality analysis. Data were analysed using Stata 14 software and R software. RESULTS Overall, 84.5% (49/58) and 12.1% (7/58) of HCFs had limited and basic WASH service respectively. About 48.3% (28/58) had limited water service, 84.5% (49/58) had limited sanitation service, 50.0% (29/58) had limited environmental cleanliness service, 56.9% (33/58) had limited hand hygiene service, and 51.7% (30/58) had limited waste management service. About 94.4% of public HCFs had limited WASH service compared to only 68.2% of private not for profit facilities. More health centre IIIs, 92.5% and health centre IVs (85.7%) had limited WASH service compared to hospitals (54.5%). CONCLUSIONS Our findings indicate that provision of water, sanitation, hand hygiene, environmental cleanliness, and health care waste management services within HCFs is largely hindered by structural and performance limitations. In spite of these limitations, it is evident that environmental cleanliness and treatment of infectious waste can be attained with better oversight and dedicated personnel. Attaining universal WASH coverage in HCFs will require deliberate and strategic investments across the different domains.
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Affiliation(s)
- Denis Kayiwa
- Programs Department, WaterAid Uganda, P.O. Box 11759, Kampala, Uganda
| | - Richard K Mugambe
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | | | - John Bosco Isunju
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - John C Ssempebwa
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Solomon Tsebeni Wafula
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Winnie K Kansiime
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Brenda Wagaba
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
| | - Jude B Zziwa
- Department of Public Health, Kampala Capital City Authority, P.O Box 7010, Kampala, Uganda
| | - Constance Bwire
- Programs Department, WaterAid Uganda, P.O. Box 11759, Kampala, Uganda
| | - Esther Buregyeya
- Programs Department, WaterAid Uganda, P.O. Box 11759, Kampala, Uganda
| | | | - Ceaser Kimbugwe
- Programs Department, WaterAid Uganda, P.O. Box 11759, Kampala, Uganda
| | - Emily Namanya
- Department of Public Health, Kampala Capital City Authority, P.O Box 7010, Kampala, Uganda
| | | | - Joanne A McGriff
- The Centre for Global Safe Water, Sanitation and Hygiene at Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
| | - Yuke Wang
- The Centre for Global Safe Water, Sanitation and Hygiene at Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
| | - Tonny Ssekamatte
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
| | - Habib Yakubu
- The Centre for Global Safe Water, Sanitation and Hygiene at Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
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Multiple sexual partnerships and associated factors among young psychoactive-substance-users in informal settlements in Kampala, Uganda. PLoS One 2020; 15:e0239323. [PMID: 33021998 PMCID: PMC7537871 DOI: 10.1371/journal.pone.0239323] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/04/2020] [Indexed: 01/15/2023] Open
Abstract
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 multiple sexual partnerships and associated factors among young psychoactive-substance-users in informal settlements in Kampala, Uganda. METHODS This was a cross-sectional study involving 744 young (aged 18-24 years), sexually active, psychoactive substance-users selected from 12 of the 57 informal settlements of Kampala City. The prevalence of multiple sexual partnerships and their differential distribution by socio-demographic strata was established. Modified Poisson regression models were run in Stata 14 software to generate prevalence rate ratios for the factors associated with multiple sexual partnerships. RESULTS About 40.6% (37.9% of males and 50.0% of females) had engaged in multiple sexual partnerships in the last 30 days. Engaging in multiple sexual partnerships in the last 30 days was positively associated with being female (PR 1.29, 95% CI: 1.03-1.63); staying in the informal settlement for 6-10 years (PR 1.34, 95% CI: 1.02-1.75) and chewing khat in the last 30 days (PR 1.93, 95% CI: 1.10-3.40). CONCLUSION Multiple sexual partnerships are highly prevalent among young psychoactive-substance-users, irrespective of the socio-demographic strata. Being female, having lived in the informal settlement for 6-10 years, and chewing khat were significantly associated with having multiple sexual partners in the last 30 days. In tackling this high-risk sexual behaviour, it is recommended that risk-reduction interventions are considered for the different socio-demographic strata identified in this study, i.e. females, those who have lived in the informal settlement for about 6-10 years, and those who chew khat.
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