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Komasawa M, Sato M, Ssekitoleko R, Waiswa P, Gitta S, Nabugoomu J, Honda S, Saito K, Aung MN. Study protocol for a type-II hybrid effectiveness-implementation trial to reach teenagers using mobile money shops to reduce unintended pregnancies in Uganda. BMJ Open 2024; 14:e084539. [PMID: 38582537 PMCID: PMC11002355 DOI: 10.1136/bmjopen-2024-084539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 03/22/2024] [Indexed: 04/08/2024] Open
Abstract
INTRODUCTION Unintended teenage pregnancies have become a global public health challenge, particularly in sub-Saharan Africa. There is a notably high prevalence of unintended pregnancies among unmarried teenagers in Uganda. This study will develop an intervention programme using mobile money shops (vendors) as a platform to deliver sexual and reproductive health and rights (SRHR) services to teenagers and assess its effectiveness and scalability in Uganda. METHODS AND ANALYSES This hybrid study comprises two integral components: an intervention study to assess the effectiveness of vendor-mediated intervention and implementation research to evaluate the implementation process. 30 vendors will be recruited for both intervention and control arms in 2 municipalities in Eastern Uganda, which have a high unintended pregnancy prevalence rate among unmarried teens aged 15-19 years. A preintervention and postintervention repeated survey involving 600 participants for each arm will be conducted over 4 months. The primary outcome is the rate of condom users among teenage vendor users. The secondary outcomes include the rate of preference for receiving SRHR services at vendors and knowledge regarding SRHR. A difference-in-differences analysis will be used to determine the effectiveness of the intervention. The Bowen model will be employed to evaluate the implementation design. ETHICS AND DISSEMINATION Ethical approval was obtained from the Ethics Review Committee of Uganda Christen University and JICA Ogata Sadako Research Institute for Peace and Development in Japan. The findings will be widely disseminated. This study was registered with the University Hospital Medical Information Network in Japan (UMIN000053332) on 12 January 2024. TRIAL REGISTRATION NUMBER UMIN000053332.
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Affiliation(s)
- Makiko Komasawa
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Shinjuku-ku, Japan
- Department of Global Health Research, Juntendo University, Bunkyo-ku, Japan
| | - Miho Sato
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | | | - Peter Waiswa
- School of Public Health, Makerere University, Kampala, Uganda
- Busoga Health Forum, Jinja, Uganda
| | - Sheba Gitta
- School of Public Health, Uganda and Busoga Health Forum, Jinja, Uganda
- Makerere University, Kampala, Uganda
| | | | - Sumihisa Honda
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kiyoko Saito
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Shinjuku-ku, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Juntendo University, Bunkyo-ku, Japan
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Ajumobi O, Sabitu K, Nguku P, Kwaga J, Ntadom G, Gitta S, Elizeus R, Oyibo W, Nsubuga P, Maire M, Poggensee G. Performance of an HRP-2 rapid diagnostic test in Nigerian children less than 5 years of age. Am J Trop Med Hyg 2015; 92:828-33. [PMID: 25711608 DOI: 10.4269/ajtmh.13-0558] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 01/05/2015] [Indexed: 11/07/2022] Open
Abstract
The diagnostic performance of histidine-rich protein 2 (HRP-2)-based malaria rapid diagnostic test (RDT) was evaluated in a mesoendemic area for malaria, Kaduna, Nigeria. We compared RDT results with expert microscopy results of blood samples from 295 febrile children under 5 years. Overall, 11.9% (35/295) tested positive with RDT compared with 10.5% (31/295) by microscopy: sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 100%, 98.5%, 88.6%, and 100%, respectively. The RDT sensitivity was not affected by transmission season, parasite density, and age. Specificity and positive PV decreased slightly during the high-transmission season (97.5% and 83.3%). The RDT test positivity rates in the low- and high-transmission seasons were 9.4% and 13.5%, respectively. Overall, the test performance of this RDT was satisfactory. The findings of a low proportion of RDT false positives, no invalid and no false-negative results should validate the performance of RDTs in this context.
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Affiliation(s)
- Olufemi Ajumobi
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria; Ahmadu Bello University, Zaria, Nigeria; National Malaria Control Programme, Federal Ministry of Health, Abuja, Nigeria; African Field Epidemiology Network, Kampala, Uganda; Makerere University, Kampala, Uganda; College of Medicine, University of Lagos, Nigeria; Global Public Health Solutions, Atlanta, Georgia; Division of Global Health Protection and Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kabir Sabitu
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria; Ahmadu Bello University, Zaria, Nigeria; National Malaria Control Programme, Federal Ministry of Health, Abuja, Nigeria; African Field Epidemiology Network, Kampala, Uganda; Makerere University, Kampala, Uganda; College of Medicine, University of Lagos, Nigeria; Global Public Health Solutions, Atlanta, Georgia; Division of Global Health Protection and Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Patrick Nguku
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria; Ahmadu Bello University, Zaria, Nigeria; National Malaria Control Programme, Federal Ministry of Health, Abuja, Nigeria; African Field Epidemiology Network, Kampala, Uganda; Makerere University, Kampala, Uganda; College of Medicine, University of Lagos, Nigeria; Global Public Health Solutions, Atlanta, Georgia; Division of Global Health Protection and Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jacob Kwaga
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria; Ahmadu Bello University, Zaria, Nigeria; National Malaria Control Programme, Federal Ministry of Health, Abuja, Nigeria; African Field Epidemiology Network, Kampala, Uganda; Makerere University, Kampala, Uganda; College of Medicine, University of Lagos, Nigeria; Global Public Health Solutions, Atlanta, Georgia; Division of Global Health Protection and Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Godwin Ntadom
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria; Ahmadu Bello University, Zaria, Nigeria; National Malaria Control Programme, Federal Ministry of Health, Abuja, Nigeria; African Field Epidemiology Network, Kampala, Uganda; Makerere University, Kampala, Uganda; College of Medicine, University of Lagos, Nigeria; Global Public Health Solutions, Atlanta, Georgia; Division of Global Health Protection and Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sheba Gitta
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria; Ahmadu Bello University, Zaria, Nigeria; National Malaria Control Programme, Federal Ministry of Health, Abuja, Nigeria; African Field Epidemiology Network, Kampala, Uganda; Makerere University, Kampala, Uganda; College of Medicine, University of Lagos, Nigeria; Global Public Health Solutions, Atlanta, Georgia; Division of Global Health Protection and Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rutebemberwa Elizeus
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria; Ahmadu Bello University, Zaria, Nigeria; National Malaria Control Programme, Federal Ministry of Health, Abuja, Nigeria; African Field Epidemiology Network, Kampala, Uganda; Makerere University, Kampala, Uganda; College of Medicine, University of Lagos, Nigeria; Global Public Health Solutions, Atlanta, Georgia; Division of Global Health Protection and Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Wellington Oyibo
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria; Ahmadu Bello University, Zaria, Nigeria; National Malaria Control Programme, Federal Ministry of Health, Abuja, Nigeria; African Field Epidemiology Network, Kampala, Uganda; Makerere University, Kampala, Uganda; College of Medicine, University of Lagos, Nigeria; Global Public Health Solutions, Atlanta, Georgia; Division of Global Health Protection and Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Peter Nsubuga
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria; Ahmadu Bello University, Zaria, Nigeria; National Malaria Control Programme, Federal Ministry of Health, Abuja, Nigeria; African Field Epidemiology Network, Kampala, Uganda; Makerere University, Kampala, Uganda; College of Medicine, University of Lagos, Nigeria; Global Public Health Solutions, Atlanta, Georgia; Division of Global Health Protection and Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mark Maire
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria; Ahmadu Bello University, Zaria, Nigeria; National Malaria Control Programme, Federal Ministry of Health, Abuja, Nigeria; African Field Epidemiology Network, Kampala, Uganda; Makerere University, Kampala, Uganda; College of Medicine, University of Lagos, Nigeria; Global Public Health Solutions, Atlanta, Georgia; Division of Global Health Protection and Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gabriele Poggensee
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria; Ahmadu Bello University, Zaria, Nigeria; National Malaria Control Programme, Federal Ministry of Health, Abuja, Nigeria; African Field Epidemiology Network, Kampala, Uganda; Makerere University, Kampala, Uganda; College of Medicine, University of Lagos, Nigeria; Global Public Health Solutions, Atlanta, Georgia; Division of Global Health Protection and Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Pires GM, Folgosa E, Nquobile N, Gitta S, Cadir N. Mycobacterium tuberculosis resistance to antituberculosis drugs in Mozambique. J Bras Pneumol 2014; 40:142-7. [PMID: 24831398 PMCID: PMC4083649 DOI: 10.1590/s1806-37132014000200007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 01/20/2014] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE: To determine the drug resistance profile of Mycobacterium
tuberculosis in Mozambique. METHODS: We analyzed secondary data from the National Tuberculosis Referral Laboratory, in
the city of Maputo, Mozambique, and from the Beira Regional Tuberculosis Referral
Laboratory, in the city of Beira, Mozambique. The data were based on
culture-positive samples submitted to first-line drug susceptibility testing (DST)
between January and December of 2011. We attempted to determine whether the
frequency of DST positivity was associated with patient type or provenance. RESULTS: During the study period, 641 strains were isolated in culture and submitted to
DST. We found that 374 (58.3%) were resistant to at least one antituberculosis
drug and 280 (43.7%) were resistant to multiple antituberculosis drugs. Of the 280
multidrug-resistant tuberculosis cases, 184 (65.7%) were in previously treated
patients, most of whom were from southern Mozambique. Two (0.71%) of the cases of
multidrug-resistant tuberculosis were confirmed to be cases of extensively
drug-resistant tuberculosis. Multidrug-resistant tuberculosis was most common in
males, particularly those in the 21-40 year age bracket. CONCLUSIONS: M. tuberculosis resistance to antituberculosis
drugs is high in Mozambique, especially in previously treated patients. The
frequency of M. tuberculosis strains that were
resistant to isoniazid, rifampin, and streptomycin in combination was found to be
high, particularly in samples from previously treated patients.
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Affiliation(s)
| | - Elena Folgosa
- National Institute of Health, Ministry of Health, Maputo, Mozambique
| | - Ndlovu Nquobile
- National Institute of Health, Ministry of Health, Maputo, Mozambique
| | - Sheba Gitta
- National Institute of Health, Ministry of Health, Maputo, Mozambique
| | - Nureisha Cadir
- National Institute of Health, Ministry of Health, Maputo, Mozambique
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Nguku P, Oyemakinde A, Sabitu K, Olayinka A, Ajayi I, Fawole O, Babirye R, Gitta S, Mukanga D, Waziri N, Gidado S, Biya O, Gana C, Ajumobi O, Abubakar A, Sani-Gwarzo N, Ngobua S, Oleribe O, Poggensee G, Nsubuga P, Nyager J, Nasidi A. Training and service in public health, Nigeria Field Epidemiology and Laboratory Training, 2008 - 2014. Pan Afr Med J 2014; 18 Suppl 1:2. [PMID: 25328621 PMCID: PMC4199351 DOI: 10.11694/pamj.supp.2014.18.1.4930] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 07/09/2014] [Indexed: 11/06/2022] Open
Abstract
The health workforce is one of the key building blocks for strengthening health systems. There is an alarming shortage of curative and preventive health care workers in developing countries many of which are in Africa. Africa resultantly records appalling health indices as a consequence of endemic and emerging health issues that are exacerbated by a lack of a public health workforce. In low-income countries, efforts to build public health surveillance and response systems have stalled, due in part, to the lack of epidemiologists and well-trained laboratorians. To strengthen public health systems in Africa, especially for disease surveillance and response, a number of countries have adopted a competency-based approach of training - Field Epidemiology and Laboratory Training Program (FELTP). The Nigeria FELTP was established in October 2008 as an inservice training program in field epidemiology, veterinary epidemiology and public health laboratory epidemiology and management. The first cohort of NFELTP residents began their training on 20th October 2008 and completed their training in December 2010. The program was scaled up in 2011 and it admitted 39 residents in its third cohort. The program has admitted residents in six annual cohorts since its inception admitting a total of 207 residents as of 2014 covering all the States. In addition the program has trained 595 health care workers in short courses. Since its inception, the program has responded to 133 suspected outbreaks ranging from environmental related outbreaks, vaccine preventable diseases, water and food borne, zoonoses, (including suspected viral hemorrhagic fevers) as well as neglected tropical diseases. With its emphasis on one health approach of solving public health issues the program has recruited physicians, veterinarians and laboratorians to work jointly on human, animal and environmental health issues. Residents have worked to identify risk factors of disease at the human animal interface for influenza, brucellosis, tick-borne relapsing fever, rabies, leptospirosis and zoonotic helminthic infections. The program has been involved in polio eradication efforts through its National Stop Transmission of Polio (NSTOP). The commencement of NFELTP was a novel approach to building sustainable epidemiological capacity to strengthen public health systems especially surveillance and response systems in Nigeria. Training and capacity building efforts should be tied to specific system strengthening and not viewed as an end to them. The approach of linking training and service provision may be an innovative approach towards addressing the numerous health challenges.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Joseph Nyager
- Federal Ministry of Agriculture and Rural Development, Nigeria
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Oyemakinde A, Nguku P, Babirye R, Gitta S, Nsubuga P, Nyager J, Nasidi A. Building a public health workforce in Nigeria through experiential training. Pan Afr Med J 2014; 18 Suppl 1:1. [PMID: 25328620 PMCID: PMC4199347 DOI: 10.11694/pamj.supp.2014.18.1.4920] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 07/20/2014] [Indexed: 11/24/2022] Open
Affiliation(s)
- Akin Oyemakinde
- Nigeria Centre for Disease Control (NCDC), Federal Ministry of Health, Abuja, Nigeria
| | - Patrick Nguku
- African Field Epidemiology Network (AFENET), Abuja, Nigeria
| | | | - Sheba Gitta
- African Field Epidemiology Network (AFENET), Abuja, Nigeria
| | - Peter Nsubuga
- Global Public Health Solutions, Atlanta, Georgia, USA
| | - Joseph Nyager
- Federal Ministry of Agriculture and Rural Development, Abuja Nigeria
| | - Abdulsalami Nasidi
- Nigeria Centre for Disease Control (NCDC), Federal Ministry of Health, Abuja, Nigeria
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Ajumobi OO, Tsofo A, Yango M, Aworh MK, Anagbogu IN, Mohammed A, Umar-Tsafe N, Mohammed S, Abdullahi M, Davis L, Idris S, Poggensee G, Nguku P, Gitta S, Nsubuga P. High concentration of blood lead levels among young children in Bagega community, Zamfara - Nigeria and the potential risk factor. Pan Afr Med J 2014; 18 Suppl 1:14. [PMID: 25328633 PMCID: PMC4199350 DOI: 10.11694/pamj.supp.2014.18.1.4264] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 04/23/2014] [Indexed: 11/06/2022] Open
Abstract
Introduction In May 2010, lead poisoning (LP) was confirmed among children <5years (U5) in two communities in Zamfara state, northwest Nigeria. Following reports of increased childhood deaths in Bagega, another community in Zamfara, we conducted a survey to investigate the outbreak and recommend appropriate control measures. Methods We conducted a cross-sectional survey in Bagega community from 23rd August to 6th September, 2010. We administered structured questionnaires to parents of U5 to collect information on household participation in ore processing activities. We collected and analysed venous blood samples from 185 U5 with LeadCare II machine. Soil samples were analysed with X-ray fluorescence spectrometer for lead contamination. We defined blood lead levels (BLL) of >10ug/dL as elevated BLL, and BLL ≥45ug/dL as the criterion for chelation therapy. We defined soil lead levels (SLL) of ≥400 parts per million (ppm) as elevated SLL. Results The median age of U5 was 36 months (Inter-quartile range: 17-48 months). The median BLL was 71µg/dL (range: 8-332µg/dL). Of the 185 U5, 184 (99.5%) had elevated BLL, 169 (91.4%) met criterion for CT. The median SLL in tested households (n = 37) of U5 was 1,237ppm (range: 53-45,270ppm). Households breaking ore rocks within the compound were associated with convulsion related-children's death (OR: 5.80, 95% CI: 1.08 - 27.85). Conclusion There was an LP outbreak in U5 in Bagega community possibly due to heavy contamination of the environment as a result of increased ore processing activities. Community-driven remediation activities are ongoing. We recommended support for sustained environmental remediation, health education, intensified surveillance, and case management.
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Affiliation(s)
| | - Ahmed Tsofo
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Matthias Yango
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Mabel Kamweli Aworh
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | | | - Abdulazeez Mohammed
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | | | | | | | - Lora Davis
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Suleiman Idris
- Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Gabriele Poggensee
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Patrick Nguku
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Sheba Gitta
- African Field Epidemiology Network, Kampala, Uganda
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Ajumobi OO, Tsofo A, Yango M, Aworh MK, Anagbogu IN, Mohammed A, Umar-Tsafe N, Mohammed S, Abdullahi M, Davis L, Idris S, Poggensee G, Nguku P, Gitta S, Nsubuga P. High concentration of blood lead levels among young children in Bagega community, Zamfara – Nigeria and the potential risk factor. Pan Afr Med J 2014. [DOI: 10.11604/pamj.supp.2014.18.1.4264] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Nguku P, Oyemakinde A, Sabitu K, Olayinka A, Ajayi I, Fawole O, Babirye R, Gitta S, Mukanga D, Waziri N, Gidado S, Biya O, Gana C, Ajumobi O, Abubakar A, Sani-Gwarzo N, Ngobua S, Oleribe O, Poggensee G, Nsubuga P, Nyager J, Nasidi A. Training and service in Public Health, Nigeria Field Epidemiology and Laboratory Training, 2008-2014. Pan Afr Med J 2014. [DOI: 10.11604/pamj.supp.2014.18.1.4930] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Oyemakinde A, Nguku P, Babirye R, Gitta S, Nsubuga P, Nyager J, Nasidi A. Building a public health workforce in Nigeria through experiential training. Pan Afr Med J 2014. [DOI: 10.11604/pamj.supp.2014.18.1.4920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Bwire G, Malimbo M, Makumbi I, Kagirita A, Wamala JF, Kalyebi P, Bingi A, Gitta S, Mukanga D, Mengel M, Dahlke M. Cholera surveillance in Uganda: an analysis of notifications for the years 2007-2011. J Infect Dis 2013; 208 Suppl 1:S78-85. [PMID: 24101649 DOI: 10.1093/infdis/jit203] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Cholera outbreaks have occurred periodically in Uganda since 1971. The country has experienced intervals of sporadic cases and localized outbreaks, occasionally resulting in prolonged widespread epidemics. METHODS Cholera surveillance data reported to the Uganda Ministry of Health from 2007 through 2011 were reviewed to determine trends in annual incidence and case fatality rate. Demographic characteristics of cholera cases were analyzed from the national line list for 2011. Cases were analyzed by district and month of report to understand the geographic distribution and identify any seasonal patterns of disease occurrence. RESULTS From 2007 through 2011, Uganda registered a total of 7615 cholera cases with 181 deaths (case fatality rate = 2.4%). The absolute number of cases and incidence per 100 000 varied from year to year with the highest incidence occurring in 2008 following heavy rainfall and flooding in eastern Uganda. For 2011, cholera cases occurred in 1.6 times more males than females. The geographical areas affected by the outbreaks shifted each year, with the exception of a few endemic districts. No clear seasonal trends in cholera occurrence were identified for this time period. CONCLUSIONS We observed an overall decline in cases reported during the 5 years under review. During this period, concerted efforts were made by the Ugandan government and development partners to educate communities on proper sanitation and hygiene and provide safe water and timely treatment. Mechanisms to ensure timely and complete cholera surveillance data are reported to the national level should continue to be strengthened.
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Affiliation(s)
- Godfrey Bwire
- Ministry of Health Uganda, Control of Diarrheal Diseases Unit
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Roka ZG, Akech M, Wanzala P, Omolo J, Gitta S, Waiswa P. Factors associated with obstetric fistulae occurrence among patients attending selected hospitals in Kenya, 2010: a case control study. BMC Pregnancy Childbirth 2013; 13:56. [PMID: 23448615 PMCID: PMC3599423 DOI: 10.1186/1471-2393-13-56] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 02/26/2013] [Indexed: 11/28/2022] Open
Abstract
Background In Kenya, about 3000 fistula cases are estimated to occur every year with an incidence of 1/1000 women. This study sought to identify risk factors associated with developing obstetrics fistula in order to guide implementation of appropriate interventions. Methods An unmatched case control study was conducted in three major hospitals in Kenya between October and December 2010. Cases were patients who had fistula following delivery within the previous five years. Controls were systematically selected from women who attended obstetrics and gynecology clinics at these hospitals, and did not have present or past history of fistula. Odds ratio was used as measure of association with their corresponding 95% confidence interval. Factors with p value of <0.1 were included into forward additive logistic regression model to generate adjusted odds ratios. Results Seventy cases and 140 controls were included in the study. Independent risk factors associated with obstetrics fistula included duration of labour of >24 hours (OR = 4.7, 95% CI = 2.4 -9.2), seeking delivery services after 6 hours of labour onset (OR = 6.9, 95% CI = 2.2-21.3), taking more than 2 hours to reach a health facility (OR = 5.7, 95% CI = 2.9 -11.5), having none or primary education (OR = 9.6, 95% CI = 3.3 –27.9) and being referred to another facility for emergency obstetrics services (OR = 8.6, 95% CI = 2.7 –27). Conclusions Risk factors for developing obstetrics fistula were delays in care seeking including delay in making decision to seek delivery servers after six hours of labour onset, taking more than two hours to reach a health facility, labour duration of more than 24 hours and having no formal or primary education. Efforts geared at strengthening all levels of the health system to reduce delays in access to emergency obstetric care are needed.
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Affiliation(s)
- Zeinab Gura Roka
- Kenya Field epidemiology and laboratory program Ministry of Public Health and Sanitation Kenya, P.O. BOX 21691-00100, Nairobi, Kenya.
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Nabbanja J, Gitta S, Peterson S, Rwenyonyi CM. Orofacial manifestations in HIV positive children attending Mildmay Clinic in Uganda. Odontology 2012; 101:116-20. [DOI: 10.1007/s10266-012-0060-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Accepted: 01/30/2012] [Indexed: 10/28/2022]
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Mukanga D, Tshimanga M, Wurapa F, Binka F, Serwada D, Bazeyo W, Pariyo G, Wabwire-Mangen F, Gitta S, Chungong S, Trostle M, Nsubuga P. The genesis and evolution of the African Field Epidemiology Network. Pan Afr Med J 2011; 10 Supp 1:2. [PMID: 22359690 PMCID: PMC3266681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 12/07/2011] [Indexed: 11/06/2022] Open
Abstract
In an effort to contain the frequently devastating epidemics in sub-Saharan Africa, the World Health Organization (WHO) Regional Office for Africa launched the Integrated Disease Surveillance and Response (IDSR) strategy in an effort to strengthen surveillance and response. However, 36 sub-Saharan African countries have been described as experiencing a human resource crisis by the WHO. Given this human resource situation, the challenge remains for these countries to achieve, among others, the health-related Millennium Development Goals (MDGs). This paper describes the process through which the African Field Epidemiology Network (AFENET) was developed, as well as how AFENET has contributed to addressing the public health workforce crisis, and the development of human resource capacity to implement IDSR in Africa. AFENET was established between 2005 and 2006 as a network of Field Epidemiology Training Programs (FETPs) and Field Epidemiology and Laboratory Training Programs (FELTPs) in Africa. This resulted from an expressed need to develop a network that would advocate for the unique needs of African FETPs and FELTPs, provide service to its membership, and through which programs could develop joint projects to address the public health needs of their countries. A total of eight new programs have been developed in sub-Saharan Africa since 2006. Programs established after 2006 represent over 70% of current FETP and FELTP enrolment in Africa. In addition to growth in membership and programs, AFENET has recorded significant growth in external partnerships. Beginning with USAID, CDC and WHO in 2004-2006, a total of at least 26 partners have been added by 2011. Drawing from lessons learnt, AFENET is now a resource that can be relied upon to expand public health capacity in Africa in an efficient and practical manner. National, regional and global health actors can leverage it to meet health-related targets at all levels. The AFENET story is one that continues to be driven by a clearly recognized need within Africa to develop a network that would serve public health systems development, looking beyond the founders, and using the existing capacity of the founders and partners to help other countries build capacity for IDSR and the International Health Regulations (IHR, 2005).
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Abstract
PURPOSE The Ponseti method has been demonstrated to be an effective, low-technology method of correcting congenital clubfoot. The purpose of this paper is to identify barriers to adherence to the Ponseti method of clubfoot treatment in Uganda. Understanding of barriers underlies successful and culturally appropriate approaches to program implementation. METHOD A qualitative study (rapid ethnographic study), using semi-structured interviews, focus groups and observation, was conducted. Interviews were conducted with parents of children with clubfoot (42), adults with clubfoot (2), community leaders (40), traditional healers (39) and practitioners treating clubfoot (38). Some 48 focus groups (24 male, 24 female) were conducted with general community members to ascertain their opinions on the potential barriers. The data was collected by a team of researchers in 8 districts of Uganda over the period of one month. It was then coded manually by the researchers and sorted into themes. RESULTS The barriers to adherence were classified into 6 themes: (i) problems with programmatic resource availability and regional differences, (ii) distance to treatment site, (iii) poverty, (iv) lack of paternal support, (v) caregiver's other responsibilities, and (vi) challenges of the treatment process. A number of factors that were helpful for encouraging adherence were also identified: (i) outreach and follow-up services, (ii) counselling/caregiver-practitioner partnership, (iii) family harmony and solidarity, and (iv) receiving quality care. CONCLUSIONS Our study highlights the barriers to adherence in the treatment of clubfoot, as well as factors that could be helpful for overcoming these barriers. This information provides health planners with knowledge to assist them in meeting the needs of the population and implementing effective and appropriate awareness and treatment programs for clubfoot in Uganda.
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Affiliation(s)
- T McElroy
- Health Care and Epidemiology, University of British Columbia, Canada.
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