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BackgroundAn increase in mental health problems has been reported since the beginning of the COVID-19 pandemic. However, little is known about the prevalence of depressive and anxiety disorders, and how recent COVID-19 diagnosis may influence risk of these conditions especially in low-income settings. In this study, we assessed the association between recent COVID-19 diagnosis and depressive and anxiety symptoms among residents in an urban slum setting in Uganda.MethodsA cross-sectional study was conducted among 284 individuals in a slum settlement in Kampala, Uganda between April and May 2022. We assessed generalized anxiety and depression symptoms using two validated questionnaires. We collected data on sociodemographic characteristics, and self-reported recent COVID-19 diagnosis (in the previous 30 days). Using a modified Poisson regression, adjusted for age, sex, gender and household income, we separately provided prevalence ratios and 95% confidence intervals for the associations between recent COVID-19 diagnosis and depressive and anxiety symptoms.ResultsOverall, 33.8% and 13.4% of the participants met the depression and generalized anxiety screening criteria respectively. People with recent COVID-19 diagnosis were more likely to be depressed (53.1%) than those with no recent diagnosis (31.4%). Participants who were recently diagnosed with COVID-19 reported higher prevalence of anxiety (34.4%) compared to those with no recent diagnosis of COVID-19 (10.7%). After adjusting for confounding, recent diagnosis with COVID-19 was associated with depression (PR= 1.60, 95% CI 1.09 – 2.34) and anxiety (PR = 2.83, 95% CI 1.50 – 5.31).ConclusionThis study suggests an increased risk of depressive symptoms and GAD in adults following a COVID-19 diagnosis. We recommend additional mental health support for recently diagnosed persons. The long-term of COVID-19 on mental health effects also need to be investigated.

OBJECTIVE: Alcohol use continues to be a major public health problem in Uganda. This study sought to estimate the availability of sachet alcohol among retail food and beverage establishments in two Ugandan districts (Kampala and Jinja) before and after enactment of the national sachet alcohol ban. METHOD: Independent observations in 100 establishments were conducted by a pair of trained observers during the peak hours of 7 P.M. to 1 A.M. Using a standardized checklist, observers recorded indications of alcohol availability before and after enactment of the sachet alcohol ban. RESULTS: Availability of (a) alcohol and (b) sachet alcohol were significantly affected by the ban. Before the ban, 69% of all establishments sold alcohol; there was a significant reduction in alcohol availability after enactment of the ban to 43% of the establishments (p < .001). This reduction was observed in off-premise establishments (p < .001), but not in on-premise establishments (p = .710). Additionally, before the sachet alcohol ban, 52% of all establishments sold sachet alcohol; however, there was a significant reduction in sachet availability after enactment of the ban (1.4%, p < .001). CONCLUSIONS: Legislation banning the manufacture and sale of sachet alcohol has the potential to reduce sachet availability. Future studies should examine changes in alcohol consumption following the sachet alcohol ban.

BackgroundIndoor air pollutants (IAP) such as particulate matter (PM) and carbon monoxide (CO) are a leading cause of acute respiratory symptoms, and long-term health impacts such as respiratory diseases, heart diseases and cancers. In Uganda, literature on the effects of IAP on respiratory outcomes in informal settlements is limited. This study investigated the association of selected IAPs and cooking fuels with respiratory symptoms among children and adults.MethodsThis study was conducted among 284 households in an informal settlement in Uganda from April to May 2022. Information on indoor air conditions, fuel type and adults reported the respiratory symptoms of their children as well as their respiratory symptoms within the previous 30 days. Same-day concentrations of PM less than 2.5 μm (PM2.5) and less than 10 μm(PM10) in diameter were monitored from 9 am to 2 pm using Temptop M2000c 2nd edition particle sensor while CO was measured using a carbon monoxide meter. Robust Poisson regression was used to model the associations between indoor air conditions, fuel type and respiratory health outcomes.ResultsApproximately 94.7% of the households were using biomass fuels. Cough (66.2%), shortness of breath (33.5%) and phlegm (17.6%) were common respiratory symptoms in adults while in children, morning cough (80.0%), day or night cough (34.4%) and shortness of breath (26.5%) were reported. The median PM2.5, PM10 and CO levels were 49.5(IQR= 31.1, 86.2) µg/m3, 73.6(IQR= 47.3,130.5) µg/m3 and 7.7(IQR= 4.1,12.5) ppm respectively. Increase in humidity was associated with higher levels of PM2.5 (ß = 2.74, p =0.004) and PM10 (ß= 4.14, p =0.002) however temperature increases were associated with lower levels of PM2.5 (ß = -11.72, p =0.009) and PM10 (ß= -16.36, p =0.008) but higher CO levels (ß=2.24, p = 0.032). Use of less polluting fuels such as electricity and gas were associated with low levels of PM2.5 (ß= -31.36, 95%CI =-60.7 – -2.02) while home dampness (ß = 3.39, 95%CI =0.07 – 6.72) was associated with higher indoor CO levels. Dampness was associated with acute phlegm in adults (PR= 2.78, 95%CI =1.57 – 4.90) and outdoor cooking was found to be associated with lower shortness of breath risk (PR = 0.60,95%CI =0.40 – 0.91).ConclusionThe prevalence of respiratory problems among adults and children was high. Poor indoor air conditions were associated with respiratory symptoms in adults and children. Efforts should be made to protect adults and children from the adverse effects of indoor air pollution.

Background Shop attendants are urban dwellers who may spend significant periods in sedentary lifestyles exposing them to non-communicable diseases. This study assessed the physical activity levels and sociodemographic factors associated with meeting the WHO recommended physical activity levels among shop attendants in Mbarara municipality, Uganda. Methods We conducted a cross-sectional study among 301 shop attendants. We used the global physical activity questionnaire to assess participants’ physical activity levels. Modified Poisson regression was used to assess the sociodemographic factors associated with meeting recommended physical activity levels. Results Of the 301 participants, 234 (77.7%) met the WHO physical activity recommendations, especially through work-related physical activity of moderate intensity 194 (64.5%). The median weekly duration of all moderate-intensity physical activity was 180 min (IQR=90 to 360). The median daily sedentary time was 300 min (IQR=300 to 360). Being male (adjusted prevalence ratio=1.33, 95% CI 1.17 to 1.51) was significantly associated with meeting recommended physical activity levels. Conclusion The physical activity levels among shop attendants were high and were mostly achieved through work-related activities of moderate intensity, with males being more likely to meet recommended physical activity levels. Findings suggest a need for gender-sensitive initiatives to increase physical activity levels, especially among female shop attendants.

Background Consistent use of insecticide-treated nets (ITNs) and intermittent preventive treatment in pregnancy (IPTp) have been recommended as cost-effective interventions for malaria prevention during pregnancy in endemic areas. However, the coverage and utilization of these interventions during pregnancy in sub-Saharan Africa is still suboptimal. This study aimed to determine the uptake of IPTp and ITNs and associated factors among women during their recent pregnancy in Eastern Uganda. Methods This was a cross-sectional study conducted among 2062 women who had delivered within the last 12 months prior to the start of the study in three districts of Eastern Uganda. The primary outcomes were consistent ITN use and optimal uptake (at least 3 doses) of IPTp. A modified Poisson regression was used to examine the association between consistent ITN use and the uptake of optimal doses of IPTp with independent variables. Data were analysed using Stata 14 software. Results The level of uptake of IPTp3 (at least three doses) was 14.7%, while IPTp2 (at least two doses) was 60.0%. The majority (86.4%) of mothers reported regularly sleeping under mosquito nets for the full duration of pregnancy. Uptake of IPTp3 was associated with engaging in farming (adjusted PR = 1.71, 95% CI [1.28–2.28]) or business (adjusted PR = 1.60, 95% CI [1.05–2.44]), and attending at least 4 antenatal care (ANC) visits (adjusted PR = 1.72, 95% CI [1.34–2.22]). On the other hand, consistent ITN use was associated with belonging to the fourth wealth quintile (adjusted PR = 1.08, 95% CI [1.02–1.14]) or fifth wealth quintile (adjusted PR = 1.08, 95% CI [1.02–1.15]), and attending at least 4 ANC visits (adjusted PR = 1.07, 95% CI [1.03–1.11]). Conclusion Uptake of IPTp3 and consistent ITN use during pregnancy were lower and higher than the current Ugandan national targets, respectively. Study findings highlight the need for more efforts to enhance utilization of ANC services, which is likely to increase the uptake of these two key malaria preventive measures during pregnancy.

Background: Exposure to green spaces is associated with improved mental health and may reduce risk of suicide. Here, we investigate the association between long-term exposure to residential surrounding greenness and sui-cide mortality. Methods: We used data from the 2001 Belgian census linked to mortality register data (2001-2011). We included all registered individuals aged 18 years or older at baseline (2001) residing in the five largest urban areas in Belgium (n = 3,549,514). Suicide mortality was defined using the tenth revision of the World Health Organi-sation International Classification of Diseases (ICD-10) codes X60-X84, Y10-Y34, and Y870. Surrounding greenness was measured using the Normalized Difference Vegetation Index (NDVI) within a 300 m and 1,000 m buffer around the residential address at baseline. To assess the association between residential surrounding greenness and suicide mortality, we applied Cox proportional hazards models with age as the underlying time scale. Models were adjusted for age, sex, living arrangement, migrant background, educational attainment, neighbourhood socio-economic position. We additionally explored potential mediation by residential outdoor nitrogen dioxide (NO2) concentrations. Finally, we assessed potential effect modification by various socio-demographic characteristics of the population (sex, age, educational attainment, migrant background, and neighbourhood socio-economic position). Associations are expressed as hazard ratios and their 95% confidence intervals (CI) for an interquartile range (IQR) increase in residential surrounding greenness. Results: We observed a 7% (95%CI 0.89-0.97) and 6% (95%CI 0.90-0.98) risk reduction of suicide mortality for an IQR increase in residential surrounding greenness for buffers of 300 m and 1,000 m, respectively. Further-more, this association was independent of exposure to NO2. After stratification, the inverse association was only apparent among women, and residents of Belgian origin, and that it was stronger among residents aged 36 or older, those with high level of education, and residents of most deprived neighbourhoods. Conclusion: Our results suggest that urban green spaces may protect against suicide mortality, but this beneficial effect may not be equally distributed across all strata of the population.

Background. Hand hygiene in refugee camp settlements remains an important measure against diarrhoeal infections. Refugee settings are characterised by overcrowding and inadequate access to water and hygiene facilities which favour proliferation of faecal-oral diseases. Handwashing with soap and water is therefore an effective way of preventing such diseases. Despite this knowledge, there is limited information about access to functional handwashing facilities in these settings and associated factors in Uganda. Methods. Quantitative data were collected from 312 refugee households in Rhino Camp Settlement, Northwestern Uganda, using a semistructured interviewer-administered questionnaire. A modified Poisson regression was used to obtain prevalence ratios (PRs) and 95% confidence intervals (CIs) for the determinants of access to a functional handwashing facility among refugee households. All analyses were performed using STATA 14.0 statistical software. Results. Of the 312 households, 123 (39.4%) had access to a handwashing facility, but only 72 (23.1%) of households had handwashing facilities that were functional. Duration of stay in the camp exceeding 3 years (adjusted PR = 2.63; 95% CI (1.73–4.00)) and history of receiving home-based education on hand hygiene (adjusted PR = 9.44; 95% CI (1.40–63.86)) were independent predictors of access to a functional handwashing facility. Conclusion. Access to functional handwashing facilities among the refugee households was low. Our findings highlight the need for more and continued handwashing promotional programs, most especially among newly arrived refugees in the camp.