Iganga, Uganda
Iganga, Uganda

Busoga University , is a private university in Uganda, affiliated with Busoga Diocese of the Church of Uganda. Wikipedia.


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Muhamadi L.,District Health Office | Nsabagasani X.,Northern Uganda Transition Initiative | Tumwesigye M.N.,Makerere University | Ekstrom A.-M.,Makerere University | And 2 more authors.
Health Policy | Year: 2010

Objective: This study explores reasons for late ART initiation among known HIV positive persons in care from a client/caretaker perspective in eastern Ugandan where ART awareness is presumably high yet AIDS related mortality is a common function of late initiation of ARVs. Methods: In Iganga, Uganda we conducted in-depth interviews with clients who started ART at 50-200 CD4 cells/μL and those initiated very late at CD4<50 cells/μL. Focus-group discussions were also conducted with caretakers of clients on ART. Content analysis was performed to identify recurrent themes. Results: ARV stock-outs, inadequate pre-antiretroviral care and lack of staff confidentiality were system barriers to timely ART initiation. Weak social support and prevailing stigma and misconceptions about ARVs as drugs designed to kill, cause cancer, infertility or impotence were other important factors. Conclusion: If the new WHO recommendations (start ART at CD4 350 cells/μL) should be feasible, PLHIV/communities need sensitization about the importance of regular pre-ARV care through the local media and authorities. The ARV supply chain and staff attitudes towards client confidentiality must also be improved in order to encourage timely ART initiation. PLHIV/communities should be sensitization about drug package labeling and the use and importance of ARVs. Stronger social support structures must be created through public messages that fight stigma, enhance acceptance of PLHIV and encourage timely ART initiation. © 2010 Elsevier Ireland Ltd.


PubMed | National Institute of Allergy and Infectious Diseases, Rakai Health science Program, Busoga University and Johns Hopkins University
Type: Journal Article | Journal: PloS one | Year: 2015

In Kasensero fishing community, home of the first recorded case of HIV in Uganda, HIV transmission is still very high with an incidence of 4.3 and 3.1 per 100 person-years in women and men, respectively, and an HIV prevalence of 44%, reaching up to 74% among female sex workers. We explored drivers for the high HIV transmission at Kasensero from the perspective of fishermen and other community members to inform future policy and preventive interventions.20 in-depth interviews including both HIV positive and HIV negative respondents, and 12 focus-group discussions involving a total of 92 respondents from the Kasensero fishing community were conducted during April-September 2014. Content analysis was performed to identify recurrent themes.The socio-economic risk factors for high HIV transmission in Kasensero fishing community cited were multiple and cross-cutting and categorized into the following themes: power of money, risk denial, environmental triggers and a predisposing lifestyle and alcoholism and drug abuse. Others were: peer pressure, poor housing and the search for financial support for both the men and women which made them vulnerable to HIV exposure and or risk behavior.There is a need for context specific combination prevention interventions in Kasensero that includes the fisher folk and other influential community leaders. Such groups could be empowered with the knowledge and social mobilization skills to fight the negative and risky behaviors, perceptions, beliefs, misconceptions and submission attitudes to fate that exposes the community to high HIV transmission. There is also need for government/partners to ensure effective policy implementation, life jackets for all fishermen, improve the poor housing at the community so as to reduce overcrowding and other housing related predispositions to high HIV rates at the community. Work place AIDS-competence teams have been successfully used to address high HIV transmission in similar settings.


PubMed | Rakai Health science Program, Busoga University and Johns Hopkins University
Type: | Journal: BMC public health | Year: 2015

In Kasensero fishing community, home of the first recorded case of HIV in Uganda, HIV transmission remains high with an incidence of 4.3 and 3.1 per 100 person-years in women and men, respectively, and an HIV prevalence of 44 %, reaching up to 74 % among female sex workers. We explored the social contextual factors for the high HIV transmission at Kasensero to inform future policy and preventive interventions.We conducted 20 in-depth interviews, including both HIV positive and HIV negative respondents, and 12 focus-group discussions involving a total of 92 respondents from the Kasensero fishing community from April-September 2014. Content analysis was performed to identify recurrent themes.Our findings suggest that the high HIV transmission in Kasensero is a complex function of eight themes including; positive/negative attitudes about HIV and combination HIV prevention such as the demand for services versus ART/circumcision disinhibition; HIV depository; Multiple partners; Frequent unprotected sex; Clothing; Parental behaviors; Pressure within the sex industry; and Cross generational sex.The current combination HIV prevention services by the RHSP need to be enhanced with more government involvement including ensuring sustainable supply of ART and circumcision services since they are reportedly highly demanded. Community involvement through the engagement of popular peers could also help in the campaign to change the HIV predisposing culture, misconceptions and risky social norms of the population. Social Context HIV Transmission Fishing Community.


Muhamadi L.,District Health Office | Muhamadi L.,Makerere University | Muhamadi L.,Karolinska Institutet | Muhamadi L.,Busoga University | And 9 more authors.
Trials | Year: 2011

Background: Many newly screened people living with HIV (PLHIV) in Sub-Saharan Africa do not understand the importance of regular pre-antiretroviral (ARV) care because most of them have been counseled by staff who lack basic counseling skills. This results in low uptake of pre-ARV care and late treatment initiation in resource-poor settings. The effect of providing post-test counseling by staff equipped with basic counseling skills, combined with home visits by community support agents on uptake of pre-ARV care for newly diagnosed PLHIV was evaluated through a randomized intervention trial in Uganda.Methods: An intervention trial was performed consisting of post-test counseling by trained counselors, combined with monthly home visits by community support agents for continued counseling to newly screened PLHIV in Iganga district, Uganda between July 2009 and June 2010, Participants (N = 400) from three public recruitment centres were randomized to receive either the intervention, or the standard care (the existing post-test counseling by ARV clinic staff who lack basic training in counseling skills), the control arm. The outcome measure was the proportion of newly screened and counseled PLHIV in either arm who had been to their nearest health center for clinical check-up in the subsequent three months +2 months. Treatment was randomly assigned using computer-generated random numbers. The statistical significance of differences between the two study arms was assessed using chi-square and t-tests for categorical and quantitative data respectively. Risk ratios and 95% confidence intervals were used to assess the effect of the intervention.Results: Participants in the intervention arm were 80% more likely to accept (take up) pre-ARV care compared to those in the control arm (RR 1.8, 95% CI 1.4-2.1). No adverse events were reported.Conclusions: Provision of post-test counseling by staff trained in basic counseling skills, combined with home visits by community support agents had a significant effect on uptake of pre-ARV care and appears to be a cost-effective way to increase the prerequisites for timely ARV initiation.Trial registration: The trial was registered by Current Controlled Trials Ltd C/OBioMed Central Ltd as ISRCTN94133652 and received financial support from Sida and logistical support from the European Commission. © 2011 Muhamadi et al; licensee BioMed Central Ltd.


Lubega M.,District Health Office | Lubega M.,Makerere University | Lubega M.,Busoga University | Lubega M.,National Institute of Allergy and Infectious Diseases | And 11 more authors.
Journal of Acquired Immune Deficiency Syndromes | Year: 2015

Background: Over 50% of people living with HIV (PLHIV) in sub-Saharan Africa are lost to follow-up between diagnosis and initiation of antiretroviral treatment during pre-antiretroviral (pre- ARV) care. The effect of providing home counseling visits by community support agents on 2-year retention in pre-ARV care was evaluated through a randomized controlled trial in eastern Uganda. Methods: Four hundred newly screened HIV-positive patients were randomly assigned to receive posttest counseling alone (routine arm) or posttest counseling and monthly home counseling visits by community support agents to encourage them go back for routine pre-ARV care (intervention arm). The outcome measure was the proportion of new PLHIV in either arm who attended their scheduled pre-ARV care visits for at least 6 of the anticipated 8 visits in the first 24 months after HIV diagnosis. The difference between the 2 study arms was assessed using the x2 and T tests. Mantel-Haenszel Risk Ratios and multivariate logistic models were used to assess the adjusted effect of the intervention on the outcome. Results: In all models generated, participants receiving monthly home counseling visits were 2.5 times more likely to be retained in pre-ARV compared with those in standard care over a period of 24 months (adjusted risk ratio, 2.5; 95% confidence interval: 2.0 to 3.0). Conclusion: Monthly follow-up home visits by community workers more than doubled the retention of PLHIV in pre-ARV care in rural Uganda and can be applicable in similar resourcepoor settings. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Muhamadi L.,District Health Office | Muhamadi L.,Karolinska Institutet | Muhamadi L.,Makerere University | Muhamadi L.,Busoga University | And 4 more authors.
Pan African Medical Journal | Year: 2013

Although voluntary medical male circumcision (VMMC) in Iganga district was launched in 2010 as part of the Uganda national strategy to prevent new HIV infections with a target of having 129,896 eligible males circumcised by 2012, only 35,000 (27%) of the anticipated target had been circumcised by mid 2012. There was paucity of information on why uptake of VMMC was low in this setting where HIV awareness is presumably high. This study sought to understand motivators for uptake of VMMC from the perspective of the clients themselves in order to advocate for feasible approaches to expanding uptake of VMMC in Iganga district and similar settings. Methods: In Iganga district, we conducted seven key informant interviews with staff who work in the VMMC clinics and twenty in-depth interviews with clients who had accepted and undergone VMMC. Ten focus-group discussions including a total of 112 participants were also conducted with clients who had undergone VMMC. Results: Motivators for uptake of VMMC in the perspective of the circumcised clients and the health care staff included: perceived medical benefit to those circumcised such as protection against acquiring HIV and other sexually transmitted diseases, peer/partner influence, sexual satisfaction and safety and cost to access the service. Conclusion: Since perceived medical benefit was a motivator for seeking VMMC, it can be used to strengthen campaigns for increasing uptake of VMMC. Peer influence could also be used in advocacy campaigns for VMMC expansion, especially using peers who have already undergone VMMC. There is need to ensure that safety and cost to access the service is affordable especially to rural poor as it was mentioned as a motivator for seeking VMMC. © Lubega Muhamadi et al.


Nancy Mungai W.,Egerton University | Njue A.M.,Egerton University | Abaya S.G.,Community Livelihood Development Forum | Said A.H.V.,The University of Dodoma | Ibembe J.D.,Busoga University
African Journal of Agricultural Research | Year: 2011

Frequent periodic flooding and land use changes taking place in the Lake Victoria basin (LVB) in east Africa may cause soil deterioration and further exacerbating food insecurity. Surface (0 to 20 cm) soil samples were collected at three locations along Sondu Miriu (Kenya) and Simiyu-Duma (Tanzania) rivers. Samples were collected from fields that were periodically flooded (1-28 d) and those that never flood, either under grass or crops. Samples were analysed for soil texture, organic carbon (OC), total nitrogen (TN), pH, extractable phosphorus (P), exchangeable potassium (K) and β-glucosidase activities. β-glucosidase activities, clay and P contents were higher in some of the soils that flood, while OC, exchangeable K and sand contents were lower at P< 0.05 in flooded soils. Observed differences account for 11% of comparisons in the two river basins. Soils under grass had higher β-glucosidase activities and silt content but lower sand content than cultivated soils in 6% of samples in the two basins. However, conversion of natural ecosystems to grassland or cropped lands resulted in a 17 to 113% reduction in OC, TN, and exchangeable K in Sondu, and a 129% decline in TN in Simiyu. Soil properties exhibited clear but different patterns from upstream to downstream in the two basins. OC, TN, clay and β-glucosidase activities were higher in Sondu upstream, while OC, TN, extractable P and exchangeable K were lower in Simiyu upstream. Observed difference across each basin underscore the importance of inherent soil characteristics in influencing soil properties compared to short-term flooding or short duration changes in land use. © 2011 Academic Journals.


Otieno A.C.,Busoga University | Buyinza M.,Makerere University
Research Journal of Applied Sciences | Year: 2010

The idea of Collaborative Forest Management (CFM) is ostensibly a conservation panacea in conflict prone forest resource management in developing countries. Most of these economies have about 40% of their population poor and eking life from natural resources in their neighbourhood, a point of conflict with government agents meant to conserve the resources, West Bugwe Forest Reserve (WBFR) epitomized this situation in Uganda. The study aimed at assessing the potentialities of CFM, with a goal of sustainable forest resource management of WBFR. The findings from 233 respondents revealed that illegal human activities viz. charcoal burning, fuel wood collection and farming were responsible for the deforestation of WBFR; the forest officials were both actively involved and by proxy engaged in the given illegal activities; main push factors to the forest reserve were poverty, domestic needs, inadequate land, landlessness and ignorance of the policy and CFM was found to be a significant tool in reducing deforestation of WBFR. It was felt that government enhance the resources in the forest department, motivate the forest officials and encourage CFM to resolve the disparities between the local communities and foresters, making both parties accountable and benefit from the forest resources at their proximity. © Medwell Journals, 2010.


Although voluntary medical male circumcision (VMMC) in Iganga district was launched in 2010 as part of the Uganda national strategy to prevent new HIV infections with a target of having 129,896 eligible males circumcised by 2012, only 35,000 (27%) of the anticipated target had been circumcised by mid 2012. There was paucity of information on why uptake of VMMC was low in this setting where HIV awareness is presumably high. This study sought to understand motivators for uptake of VMMC from the perspective of the clients themselves in order to advocate for feasible approaches to expanding uptake of VMMC in Iganga district and similar settings.In Iganga district, we conducted seven key informant interviews with staff who work in the VMMC clinics and twenty in-depth interviews with clients who had accepted and undergone VMMC. Ten focus-group discussions including a total of 112 participants were also conducted with clients who had undergone VMMC.Motivators for uptake of VMMC in the perspective of the circumcised clients and the health care staff included: perceived medical benefit to those circumcised such as protection against acquiring HIV and other sexually transmitted diseases, peer/partner influence, sexual satisfaction and safety and cost to access the service.Since perceived medical benefit was a motivator for seeking VMMC, it can be used to strengthen campaigns for increasing uptake of VMMC. Peer influence could also be used in advocacy campaigns for VMMC expansion, especially using peers who have already undergone VMMC. There is need to ensure that safety and cost to access the service is affordable especially to rural poor as it was mentioned as a motivator for seeking VMMC.


In Iganga, Uganda, 45% of women who tested HIV-positive during antenatal care between 2007 and 2010 were lost to follow-up (LTFU). We explored reasons for LTFU during prevention of mother-to-child transmission (PMTCT) from a client perspective in eastern Uganda, where antiretroviral therapy (ART) awareness is presumably high.Seven key informant interviews and 20 in-depth interviews, including both clients who had been retained under PMTCT care and those LTFU during PMTCT were held. Ten focus-group discussions involving a total of 112 participants were also conducted with caretakers/ relatives of the PMTCT clients. Content analysis was performed to identify recurrent themes.Our findings indicate that LTFU during PMTCT in eastern Uganda was due to sex inequality, high transport costs to access the services, inadequate posttest counseling, lack of HIV status disclosure, and the isolated/exposed location of the ART clinic, which robs the clients of their privacy.There is a need for approaches that empower women with social capital, knowledge, and skills to influence health-seeking practices. There is also a need to train low-ranking staff and take PMTCT services closer to the clients at the lower-level units to make them affordable and accessible to rural clients. Posttest counseling should be improved to enable PMTCT clients to appreciate the importance of PMTCT services through increasing the number of staff in antenatal care to match the client numbers for improved quality. The counseling should emphasize HIV status disclosure to partners and encourage partner escort for antenatal care visits for further counseling. The exposed and isolated ART clinic should be integrated with the other regular outpatient services to reduce the labeling stigma.

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