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Background Despite the limited evidence, desludging operators remain at a heightened risk of work-related musculoskeletal disorders (WMSDs). This study established the prevalence and predictors of WMSDs among desludging operators in Uganda. Methods A digitalized structured questionnaire was used to collect cross-sectional data on musculoskeletal disorders and routine workplace activities from 303 desludging operators in Uganda. Data were analyzed using STATA version 15.0. Results The prevalence of WMSDs among desludging operators was 29.7%. The background characteristics associated with WMSDs included; attending safety training in the last 12 months (APR = 0.55, 95% CI: 0.31–0.98) and undertaking regular health check-ups (APR = 1.68, 95% CI: 1.16–2.44). The ergonomic factors associated with WMSDs were; working with a bent wrist (APR = 2.64, 95%CI: 1.54–4.52), working with hands above the head (APR = 0.40, 95% CI: 0.26–0.62), and pinching unsupported objects (APR = 0.87, 95% CI: 0.59–1.29). Psychosocial factors associated with WMSDs included; neither agreeing nor disagreeing about being able to influence the availability of equipment needed to do their work = 0.43, 95% CI: 0.20–0.94), having much influence over the amount of work done (APR = 1.75, 95% CI: 1.05–2.91), and sometimes feeling that everything done was an effort (APR = 1.71, 95% CI: 1.01–2.89). Conclusion The prevalence of WMSDs was high among desludging operators in Uganda. We recommend providing comprehensive training on occupational health and safety, with a specific focus on ergonomic hazards. In addition, personal protective equipment uses, regular exercise programs, and considerations for work pace, rest, and recovery opportunities should be prioritized to reduce the risk of WMSDs.

Background Cervical cancer remains a major public health challenge, accounting for substantial morbidity and mortality. Human Papilloma Virus (HPV) vaccination is the recommended primary intervention for HPV prevention. There’s however limited evidence on the level of knowledge, attitude, and practices of stakeholders on HPV vaccination in Kampala city, Uganda. This study assessed stakeholders’ knowledge, perceptions, and practices towards HPV vaccination program in Kampala, Uganda to guide programs aimed at improving uptake of the vaccine. Methods A cross-sectional study using mixed data collection methods was conducted in Kampala, Uganda. A structured questionnaire was administered to 524 adolescent girls. In addition, 6 Focus group discussions, and 13 key informant interviews (teacher and parents) were conducted. Multistage and purposive sampling were used for the quantitative and qualitative participants respectively. Quantitative data were entered using epidata, and cleaned and analyzed in Stata v14. Qualitative data were analyzed using thematic content analysis in atlas ti version 8. Results About 49.2% (258/524) of the girls had low knowledge of HPV. Qualitatively, knowledge was lacking among teachers and parents especially concerning the target age group, dosage, and vaccine interval. Girls residing in rural areas (aPR = 0.35, C. I = 0.14–0.85, P -value = 0.028) had lower knowledge levels compared to those in urban areas. About 51.9% (272/524) of girls had negative perceptions towards HPV vaccination. Parents expressed negative perceptions, beliefs, superstitions, and safety concerns of the vaccine. Only 8.6% (45/524) of the girls had completed the HPV vaccine schedule. Girls whose mothers were healthcare providers (aPR = 1.94, C. I = 1.10–3.41, P -value = 0.021), girls with high knowledge levels (aPR = 1.79, C. I = 1.21–2.63, P -value = 0.003) and positive perceptions (aPR = 2.87, C. I = 1.93–4.27, P -value = 0.000) had higher odds of vaccination. Conclusion All stakeholders generally had low levels of knowledge, negative perceptions, and poor uptake and practices toward HPV vaccination. We recommend sensitization campaigns in schools and communities to improve awareness, perceptions, and practices of stakeholders towards HPV vaccination.

BackgroundAlthough pregnancy and child birth-related complications remain a global public health concern, little is known about their prevalence and associated factors. Our study assessed pregnancy-related complications and associated factors among women attending antenatal care at a specialized maternal and child health national referral hospital in Uganda.MethodologyA cross-sectional study was conducted among 285 pregnant women. Data were collected using the KoboCollect mobile application, and analysed using STATA 14. A modified poisson regression model was used for inferential statistics.FindingsOut of the 285 women, 27.4% (78/285) had pregnancy-related complications. The most reported complications were anaemia, 10.9% (31/285); eclampsia, 8.1% (23/285); and still births, 4.9% (14/285). Having a higher gravidity of 4-6 (APR= 0.32, 95% CI: 0.17-0.57) and of more than 7 (APR= 0.32, 95% CI: 0.14-0.73) was negatively associated with pregnancy-related complications. Factors positively associated with pregnancy-related complications included; late first ANC (APR=1.85, 95% CI: 1.17-2.92), parity of ≥ 3 (APR= 3.69, 95% CI: 1.50-9.08) and induced abortion prior to current pregnancy (APR= 1.64, 95% CI: (1.08-2.47).ConclusionThe prevalence of pregnancy-related complications was very high. Anaemia, eclampsia and still births were the most prevalent. A late first ANC, gravidity higher than 4, parity higher than 3, and history of an induced abortion prior to the current pregnancy were associated with having pregnancy-related complications. Interventions aimed at reducing maternal morbidity and mortality should aim at promoting early ANC attendance, and increasing access to safe abortion and family planning services.

BackgroundDe-sludging operators play a critical role in ensuring access to safe sanitation services. De-sludging activities, however, increase the operators’ risk of exposure to physical, chemical, ergonomic, psychological, and biological hazards, which eventually affect their health-related quality of life (HRQoL). Despite immense exposure to occupational hazards, only a few evidence-based interventions have been implemented to improve the occupational health and safety (OHS) of de-sludging operators.ObjectiveThe proposed study intends to utilise the sanitation safety planning (SSP) tool to improve the OHS of de-sludging operators in Uganda. The study aims to generate evidence of the prevalence of exposure to occupational hazards and the associated health outcomes, knowledge, attitude and uptake of OHS measures, as well as the HRQoL of de-sludging operators. The facilitators and barriers to the promotion of OHS shall also be explored.MethodsA mixed-methods study will be conducted among 356 desludging operators in the Greater Kampala Metropolitan Area. A structured questionnaire pre-loaded on the KoboCollect mobile data collection application will be used to obtain information on socio-demographic characteristics, history of work-related accidents and diseases, uptake of safety measures, and health-related quality of life. A total of 10 focus group discussions (FGDs) will be conducted among desludging operators, to understand how they cope with associated occupational hazards. In addition, 25 in-depth interviews (IDIs) will be conducted among purposively selected employers to understand the barriers and facilitators of provision and implementation of safety measures among desludging operators. Quantitative data will be analyzed using STATA version 15 while qualitative data will be transcribed verbatim and the analysis aided by the NVIVO software.Expected outcomesThe study will generate evidence of the occupational health and safety of desludging operators and the effectiveness of the SSP tool. These findings will be critical in informing the design and implementation of occupational health and safety programmes among desludging operators.

BackgroundPsychoactive 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 people aged 18-24 years.MethodsA cross-sectional study was conducted among 744 sexually active young psychoactive substance users living in informal settlements in Kampala, Uganda. Data were collected through face-to-face interviews using a digitalized structured questionnaire preloaded on Kobocollect. 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 factors associated with the outcome variable. Adjusted prevalence ratios at a p-value value ≤ 0.05 with a 95% confidence interval were considered.ResultsAbout 61.0% (454/744) of the respondents 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.ConclusionThis study revealed a high prevalence of sex under the influence of psychoactive substances among young people in informal settlements in Kampala, Uganda. The predictors of sex under the influence of psychoactive substances were being female, being 20-24 years of age, being married or divorced/separated, not living with biological parents or guardians, and using alcohol, marijuana and khat in the last 30 days. There is a need for sexual and reproductive health programs to incorporate risk reduction interventions that aim to reduce sex under the influence of psychoactive substances among the said categories in informal settlements.

Introduction: The association between extra-spousal partnerships and HIV in married or cohabiting individuals remains controversial. We established the association between extra-spousal partnerships and HIV prevalence among married or cohabiting individuals in Rakai, Uganda.Methods: This secondary analysis uses data from a large cross-sectional study conducted among 2,135 married or cohabiting individuals aged 15-49 years in Rakai, Uganda, between November 2013 and February 2014. Data were collected on socio-demographic and behavioral characteristics, including extra-spousal partnerships. We used a modified Poisson regression model to assess the association between extra-spousal partnerships and HIV prevalence among married or cohabiting individuals living in three study communities with differing HIV prevalence. Stata version 14.0 was used for data analysis. Results: Of 2,103 respondents included in the analysis, 13.4% (282/2103) reported extra-spousal partnerships; 4.5% (n=49) among females and 22.9% (n=233) among males. Of those reporting extra-spousal partnerships, 48.6% (n=137) were in their second or higher order marriage while 74.1% (n=209) reported a marital duration of six or more years. HIV prevalence was higher among those reporting extra-spousal partnerships (14.6%, 36/247) than in those who did not (7.6%, 120/1575; P<0.0001). In multivariable analyses, we found that engaging in extra-spousal relationships increased the risk of HIV infection by 67% (adjusted Prevalence Ratio [adj. PR] = 1.67; 95%CI: 1.16, 2.39), after adjusting for potential and suspected confounders. Conclusion: We found that engaging in extra-spousal partnerships increased the risk of HIV infection by more than two-thirds. These findings suggest a need for targeted HIV prevention interventions for married or cohabiting individuals who report extra-spousal partnerships.

BackgroundThe 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 applied the Systems Theoretical Framework (STF) of career development to establish the employment status of AFROHUN-Uganda alumni, and the facilitators and barriers for application of the OH approach in their organisations.MethodsWe conducted a cross-sectional study using mixed methods to collect and analyse data from a random sample of 182 OH alumni of the 2013-2018 cohorts. For quantitative data, descriptive statistics were computed using Stata 14.0 statistical software. A total of 12 in-depth interviews were conducted, and NVivo 12 Pro was used to organise data during thematic analysis.ResultsWhile the majority, 87.4% were or got employed after participating in the AFROHUN Uganda capacity building programme, 68.1% were employed at the time of the survey, 57.7% have worked with their current employer for at least a year, and 39% hold managerial positions. The facilitators of applying the OH approach into employing organisations included being knowledgeable about OH, the presence of a multidisciplinary workforce, the nature of activities implemented, and existing partnerships and collaborations between organisations. The barriers to the application of the OH approach included limited funding, a negative attitude towards working with people from other disciplines, and limited knowledge of the One Health approach.ConclusionNotably, more than two-thirds of the OH alumni are employed, and more than a third hold managerial position. While these findings portray a fairly good absorption rate of the OH alumni into the workforce, they also highlight the facilitators of application of the OH approach that need to be promoted as well as the barriers that need to be addressed if the application of the OH approach is to be improved within the workforce.

IntroductionWater should comply with standard/regulatory physio-chemical and biological parameters to ensure that it is safe for domestic use. We therefore sought to assess the physico-chemical and biological quality of groundwater sources in Kadama subcounty, Kibuku district, Eastern Uganda. MethodsA cross-sectional quantitative study was conducted. We collected water samples from twenty-three functional water sources. We assessed the turbidity, pH and presence of Escherichia coli (E. coli) using the turbidity meter, pH meter and membrane filtration technique, respectively. Furthermore, physical sanitary inspection of the water sources was done using a standard pretested observational checklist to assess existing risk factors.ResultsThe majority, 69.5% of the water sources included in the study were boreholes, with about 43.5% of them from Nandere parish. Majority of the water sources 86.9% (20/23) had clogged/blocked drainage channels, about a third of water sources 60.9% (14/23) did not have fences/protection around them and majority of the water sources, 82.6% (19/23) had stagnated apron. Some water sources 8.7% (2/23) had open defecation around them. The water samples had a mean pH of 6.87 (SD 0.920) with 4.4% acidic, 86.9% normal/acceptable pH level and 8.6% in alkaline state. About two-thirds (65.3%) of these water sources had turbidity levels less than 5 NTUs. In addition, boreholes had a better turbidity score of 81.2% (13/16) compared to the water wells 71.4% (5/7). About half, 43.5% of the water sources were above the WHO recommended range of zero coliforms. ConclusionsSome ground water sources had sanitary risk factors and significant levels of E. coli which makes them unfit for human consumption, though they can be used for other domestic purposes including washing clothes. This calls for urgent need to keep surrounding water sources clean and continuously disinfect drinking water from groundwater sources before human consumption.

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 applied the Systems Theoretical Framework (STF) of career development to establish the employment status of AFROHUN-Uganda alumni, and the facilitators and barriers to application of the OH approach in their organisations. Methods We conducted an embedded mixed-methods study among a random sample of 182 AFROHUN-Uganda alumni of the 2013–2018 cohorts. For quantitative data, descriptive statistics were computed using Stata 14.0 statistical software. A total of 12 in-depth interviews were conducted, and NVivo 12 Pro was used to organise data during thematic analysis. Results While the majority, 87.4% were or got employed after participating in the AFROHUN Uganda capacity building programme, 68.1% were employed at the time of the survey, 57.7% had worked with their current employer for at least a year, and 39% held managerial positions. The facilitators of applying the OH approach into employing organisations included being knowledgeable about OH, the presence of a multidisciplinary workforce, the nature of activities implemented, and existing partnerships and collaborations between organisations. The barriers to the application of the OH approach included limited funding, a negative attitude towards working with people from other disciplines, and limited knowledge of the One Health approach. Conclusion Notably, more than two-thirds of the OH alumni were employed, and more than a third held managerial position. While these findings portray a fairly good absorption rate of the OH alumni into the workforce, they also highlight the facilitators of application of the OH approach that need to be promoted as well as the barriers that need to be addressed if the application of the OH approach is to be improved within the workforce.

BackgroundThe 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 build OH competencies among participants with the ultimate goal of promoting a multidisciplinary approach to solving global health challenges. Despite these trainings, there is limited documentation of the extent of acquisition and application of the One Health competencies at workplaces. This tracer study established the extent of acquisition and application of the One Health competencies by the AFROHUN-Uganda alumni.MethodsA cross-sectional study was conducted among a random sample of 182 AFROHUN-Uganda alumni of 2013-2017. A blended approach of interviewer and self-administered was used during data collection. Virtual interviews using zoom and skype, and phone interviews with alumni were conducted when face-to-face interviews were not possible. Data were collected electronically, with the aid of the KoboCollect mobile application, pre-installed on android enabled devices. Data were analysed using STATA14.0.ResultsThe majority of respondents, 78.6% (143/182) had jobs that required application of One Health knowledge and skills, 95.6% (174/182) had learned employable skills from OH activities and 89.6% (163/182) had applied such skills when searching for employment. About 21.7% (34/180) to a very high extent required One Health field-specific theoretical knowledge at their workplaces, 27.4% (43/80) to a very high extent required One Health field-specific practical knowledge/skills, 42.7% (67/180) to a high extent required a change in attitude and perceptions towards working with people from different disciplines, 49.0% (77/180) required collaboration and networking skills, and more than half, 51.0% (80/180) required team building skills.ConclusionThe majority of One Health alumni to a very high extent acquired and applied One Health competences such as teamwork, effective communication, community entry and engagement, report writing and problem-solving skills. This study revealed the significant contribution of the AFROHUN Uganda OH activities towards supportive work environments, and highlights areas of improvement such as supporting the trainees to acquire people-management skills, innovation, and an entrepreneurial mind set.

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. These trainings aim to build competencies that, enhance a multidisciplinary approach to solving global health challenges. Despite the investment in OH trainings, there is limited documentation of the extent of acquisition and application of the OH competencies at workplaces. This tracer study explored the extent of acquisition and application of the OH competencies by the AFROHUN-Uganda alumni. Methods A cross-sectional study was conducted among a random sample of 182 AFROHUN-Uganda alumni of 2013–2018 cohorts. A blended approach of interviewer-administered and self-administered questionnaires was used. Virtual platforms such as Zoom, Microsoft teams, and Skype, and phone interviews were used to collect data when face-to-face interactions with alumni were not possible. Data were collected electronically, either through a link or with the aid of the KoboCollect mobile application, pre-installed on android enabled devices, and analysed using STATA14.0. Results The majority of respondents, 78.6% (143/182) had jobs that required application of OH knowledge and skills, 95.6% (174/182) had learned employable skills from OH activities and 89.6% (163/182) had applied such skills when searching for employment. About 21.7% (34/180) to a very high extent required OH field-specific theoretical knowledge at their workplaces, 27.4% (43/80) to a very high extent required OH field-specific practical knowledge/skills, 42.7% (67/180) to a high extent required a change in attitude and perceptions towards working with people from different disciplines, 49.0% (77/180) required collaboration and networking skills, and more than half, 51.0% (80/180) required team building skills. Conclusions The majority of OH alumni to a very high extent acquired and applied OH competences such as teamwork, effective communication, community entry and engagement, report writing and problem-solving skills. This study revealed the significant contribution of the AFROHUN Uganda OH activities towards supportive work environments, and highlights areas of improvement such as supporting the trainees to acquire people-management skills, innovation, and an entrepreneurial mind set.

BackgroundThe Corona Virus Disease of 2019 (COVID-19) has gravely affected several aspects of national and global society, including education. Given the risk it poses, the Government of Uganda (GOU) adopted and recommended face mask use as one of the preventive measures to limit its transmission in communities. However, there is limited data on the levels of face mask usage and associated factors among students in schools in Uganda. This study aimed at assessing the face mask usage and associated factors among students in schools in rural Eastern Uganda amidst the COVID-19 pandemic.MethodsA cross sectional quantitative descriptive study was conducted among 423 students in schools in rural Eastern Uganda. Multi-stage sampling method was employed in the selection of study participants. The data was collected by trained data collectors using structured questionnaires pre-installed on ODK enabled smart phones. The data entered was cleaned using Excel 2016 and exported to Stata14.0 statistical software (Statacorp, College station, Texas, USA) for analysis. Bivariate and multivariable logistic regression analyses were employed using 95% CI (confidence interval). Variables with p-value < 0.20 and those with literature backup evidence were included in the multivariable model. Variables with p-value < 0.05 were considered to be statistically significant. This study revealed that less than three quarters (62.3%) wore face masks correctly.ResultsAlmost all, 98.9% of the participants mentioned that they wore face masks due to fear of missing classes and 49.0% disagreed that they were vulnerable to COVID-19. Students in boarding schools (AOR = 1.61, 95%CI: 1.05-2.47), those who believed that they were vulnerable to COVID-19 (AOR = 1.70, 95%CI: 1.11-2.10), and those who disagreed that masks are uncomfortable (AOR = 1.62, 95%CI: 1.06-2.46) were more likely to wear facemasks correctly.ConclusionThis study revealed that more than a third of the students did not wear face masks correctly. Correct wearing of face masks was associated with being in a boarding school, belief that they were susceptible to COVID-19, and disagreeing that masks were uncomfortable. This therefore highlights the need for sensitization programmes in academic institutions in order to improve students’ perceptions toward COVID-19 and face masks, and consequently increase correct face mask usage in schools.