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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.

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.

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.

Sustaining Water, Sanitation, and Hygiene (WASH), and Infection Prevention and Control (IPC) services in healthcare facilities (HCFs) remain a challenge in the developing world. This is largely attributable to ineffective management systems such as leadership, training, monitoring, financing and accountability, and operation and maintenance (O&M) for WASH and IPC. This study analysed management systems for the sustainability of WASH and IPC in HCFs in the Greater Kampala Metropolitan Area (GKMA), Uganda. A descriptive cross-sectional study was conducted in 59 HCFs. Data were obtained from HCF in-charges using the WASHCon tool. Indicators of sustainability across HCF level and ownership were compared using Chi-square tests, performed in Stata 14 statistical software. A p-value of less than 0.05 was considered significant. Less than half, 42.4% (25/59) of the HCFs had trained their staff on WASH issues, and 44.1% (26/59) had WASH and IPC guidelines. Nearly all, 91.2% (31/34) of the HCFs that needed new sinks, taps, or pipes could not afford them due to insufficient funds. The perceptions of in-charges that it was their responsibility: to ensure that staff receive training on WASH and IPC (p = 0.014); to oversee the O&M of WASH and IPC infrastructure (p = 0.005); and to sustain WASH and IPC infrastructure and behaviours (p = 0.014) varied by ownership of the HCF. Availability of written guidelines on WASH and IPC varied by level and ownership (p = 0.010). In this study, sub-optimal management systems for WASH and IPC were noted, and leadership, training and monitoring, financing, and accountability varied across level and ownership of the HCFs. Nonetheless, simple acts such as recognising the best performing staff in WASH and IPC can boost the morale of the staff. Also, there is a need for budget increments and functionalisation of the WASH and IPC committees in order to sustain recommended practices.

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.

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 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 are 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.

Background: Improved Water, Sanitation and Hygiene (WASH) services in Health Care Facilities (HCFs) is of significant public health importance. It is associated with a reduction in the transmission of hospital acquired infections (HAIs), increased trust and uptake of healthcare services, cost saving from infections averted, increased efficiency and improved staff morale. Despite these benefits, there is limited evidence on the status of WASH in HCFs in the Greater Kampala Metropolitan Area (GKMA). This study assessed the status of WASH within HCFs in the GKMA in order to inform policy and WASH programming.Methods: A cross-sectional study was conducted in 60 HCFs. The status of WASH in the study facilities 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. The relationships between WASH status and HCF characteristics were assessed using Fishers’ exact tests.Results: Overall, 84.5% (49/58) and 12.1% (7/58) of HCFs had limited and basic WASH status respectively. About 48.3% (28/58) had a limited water supply status, 84.5% (49/58) had limited sanitation status, 50.0% (29/58) had limited environmental cleanliness status, 56.9% (33/58) had limited hand hygiene status and 51.7% (30/58) had limited waste management status. Overall, there were significant differences in water supply status by ownership of the HCF and level of HCF. There was a significant statistical difference in WASH status between public and private not for profit facilities (p = 0.021). A significant difference was also observed in WASH status between hospitals and lower levels HCFs (p = 0.004). Conclusion: Majority of the HCFs in the GKMA had limited access to all WASH service domains i.e. water supply, sanitation, hand hygiene, environmental cleanliness and healthcare waste management. We recommend deliberate increased investments in WASH for healthcare services, especially for sanitation and hand hygiene provisions which were in the poorest state. Improvements in WASH conditions will not only minimize the risk of transmission of HAIs but also associated costs.