Assessing Uptake of COVID-19 Preventive Measures among Persons Aged 13-80 Years during Lockdown in Wakiso, Uganda: A Cross-Sectional Study

Background: The unprecedented spread of COVID-19 presents a serious public health concern. However, uptake of COVID-19-related preventive behaviors remains unknown. This study aimed to investigate current uptake of COVID-19 preventive measures and their associated factors in Wakiso, Uganda. Subjects and Method: A cross-sectional study was conducted in Wakiso, Uganda from April to September 2020. A total of 1,014 study subjects aged 13–80 years in the population health survey (PHS) who self-reported following any of the COVID-19 preventive behavioral strategies during lockdown was selected.  The dependent variable was COVID-19 preventive measures. Independent variables were gender, age, education, marital status, religion, occupation. The data were collected by questionnaire and analyzed using Modified Poisson regression test. Results: Female (aPR=1.48; 95% CI= 1.34 to 1.62; p<0.001), construction and mechanics workers (aPR=1.23; 95% CI= 1.10 to 1.38; p<0.001), housework (aPR= 0.72; 95% CI= 0.64 to 0.81; p <0.001), and students (aPR=0.58; 95% CI= 0.45 to 0.74; p<0.001) were associated with staying at home. Aged 45-54 years old (aPR=0.55; 95% CI= 0.50 to 0.61; p<0.001), more than 55 years (aPR=0.80, 95% CI= 0.66 to 0.97; p= 0.022), and housework (aPR=1.18; 95% CI= 1.03 to 1.35; p= 0.015) were associated with sanitize often. Conclusion: Female, construction and mechanic workers, housework, and student are associated with staying at home and it is statistically significant. Aged 45-54 and more than 55 years old, housework were associated with sanitize often and it is statistically significant. Keywords: preventive measures, COVID-19, Wakiso, Uganda Correspondence: Alex Daama. Africa Medical and Behavioral Sciences Organization (AMBSO). Plot 7441, Nansana, Hoima Road, Wakiso, Uganda P.O Box 25974. Email: [email protected]. Mobile: +256702347102 Journal of Health Promotion and Behavior (2021), 06(02): 153-162 DOI: https://doi.org/10.26911/thejhpb.2021.06.02.0

The Safety of Adult Male Circumcision in HIV-Infected and Uninfected Men in Rakai, Uganda

Ron Gray and colleagues report on complications of circumcision in HIV-infected and HIV-uninfected men from two related trials in Uganda, finding increased risk with intercourse before wound healing

The safety and acceptance of the PrePex device for non-surgical adult male circumcision in Rakai, Uganda. A non-randomized observational study.

To assess the safety and acceptance of the PrePex device for medical male circumcision (MMC) in rural Uganda.In an observational study, HIV-uninfected, uncircumcised men aged 18 and older who requested elective MMC were informed about the PrePex and dorsal slit methods and offered a free choice of their preferred procedure. 100 men received PrePex to assess preliminary safety (aim 1). An additional 329 men, 250 chose PrePex and 79 chose Dorsal slit, were enrolled following approval by the Safety Monitoring Committee (aim 2). Men were followed up at 7 days to assess adverse events (AEs) and to remove the PrePex device. Wound healing was assessed at 4 weeks, with subsequent weekly follow up until completed healing.The PrePex device was contraindicated in 5.7% of men due to a tight prepuce or phimosis/adhesions. Among 429 enrolled men 350 (82.0%) got the PrePex device and 79 (18.0%) the dorsal slit procedure. 250 of 329 men (76.0%) who were invited to choose between the 2 procedures chose Prepex. There were 9 AEs (2.6%) with the PrePex, of which 5 (1.4%) were severe complications, 4 due to patient self-removal of the device leading to edema and urinary obstruction requiring emergency surgical circumcision, and one due to wound dehiscence following device removal. 71.8% of men reported an unpleasant odor prior to PrePex removal. Cumulative rates of completed wound healing with the PrePex were 56.7% at week 4, 84.8% week 5, 97.6% week 6 and 98.6% week 7, compared to 98.7% at week 4 with dorsal slit (p<0.0001).The PrePex device was well accepted, but healing was slower than with dorsal slit surgery. Severe complications, primarily following PrePex self-removal, required rapid access to emergency surgical facilities. The need to return for removal and delayed healing may increase Program cost and client burden

Not Enough Money and Too Many Thoughts: Exploring Perceptions of Mental Health in Two Ugandan Districts Through the Mental Health Literacy Framework.

Mental health disorders account for a heavy disease burden in Uganda. In order to provide culturally appropriate mental health prevention and treatment approaches, it is necessary to understand how mental health is conceptualized in the population. Three focus group discussions (FGDs) and 31 in-depth interviews (IDIs) were conducted with men and women aged 14 to 62 years residing in rural, urban, and semi-urban low-income communities in central and western Uganda to explore perceptions and knowledge of mental health. Interpretive thematic analysis was undertaken; results were organized through the lens of the mental health literacy framework. Environmental and societal stressors were identified as primary underlying causes of poor mental health. While participants recognized symptoms of poor mental health, gaps in mental health literacy also emerged. Mental health resources are needed in this setting and additional qualitative work assessing knowledge and attitudes toward mental health care seeking behavior can inform the development of acceptable integrated services

Not Enough Money and Too Many Thoughts: Exploring Perceptions of Mental Health in Two Ugandan Districts Through the Mental Health Literacy Framework.

Mental health disorders account for a heavy disease burden in Uganda. In order to provide culturally appropriate mental health prevention and treatment approaches, it is necessary to understand how mental health is conceptualized in the population. Three focus group discussions (FGDs) and 31 in-depth interviews (IDIs) were conducted with men and women aged 14 to 62 years residing in rural, urban, and semi-urban low-income communities in central and western Uganda to explore perceptions and knowledge of mental health. Interpretive thematic analysis was undertaken; results were organized through the lens of the mental health literacy framework. Environmental and societal stressors were identified as primary underlying causes of poor mental health. While participants recognized symptoms of poor mental health, gaps in mental health literacy also emerged. Mental health resources are needed in this setting and additional qualitative work assessing knowledge and attitudes toward mental health care seeking behavior can inform the development of acceptable integrated services

Household food insecurity and its association with self-reported male perpetration of intimate partner violence: a survey of two districts in central and western Uganda

Objectives This study aimed to determine the lifetime prevalence of male-perpetrated intimate partner violence (IPV), and to assess the association with food insecurity, sociodemographic factors and health risk behaviours in Uganda in the year preceding COVID-19-associated lockdowns.Design Population-based, cross-sectional household survey.Setting Urban, semiurban and rural communities of the Wakiso and Hoima districts in Uganda.Participants A total of N=2014 males aged 13–80 years participated in the survey. The current study included males who reported having ever been in a sexual union and responded to the IPV questions (N=1314).Measures Data were collected face-to-face from May 2018 to July 2019 using an interviewer-mediated questionnaire. Lifetime IPV perpetration was measured as ‘no physical and/or sexual IPV’, ‘physical’ versus ‘sexual violence only’, and ‘physical and sexual violence’. Past-year food insecurity was measured through the Food Insecurity Experience Scale and categorised into ‘none’, ‘low’ and ‘high’. Multinomial logistic regression was used to determine the crude and adjusted relative risk ratios (aRRRs) of IPV perpetration in relation to self-reported food insecurity, adjusting for sociodemographic and health risk behaviours.Results The prevalence of self-reported lifetime IPV perpetration was 14.6% for physical and 6.5% for sexual violence, while 5.3% reported to have perpetrated both physical and sexual IPV. Most (75.7%) males reported no food insecurity, followed by low (20.7%) and high (3.6%) food insecurity. In adjusted models, food insecurity was associated with increased risk of having perpetrated both physical and sexual violence (aRRR=2.57, 95% CI 1.52 to 4.32). IPV perpetration was also independently associated with having had more than one lifetime sexual partner and drinking alcohol, but not with education level or religion.Conclusion This study suggests that food insecurity is associated with male IPV perpetration, and more efforts are needed to prevent and mitigate the expected worsening of this situation as a result of the COVID-19 pandemic

Details of adverse events with the PrePex device during the study.

<p>Details of adverse events with the PrePex device during the study.</p

Effects of medical male circumcision (MC) on plasma HIV viral load in HIV+ HAART naïve men; Rakai, Uganda.

BACKGROUND: Medical male circumcision (MC) of HIV-infected men may increase plasma HIV viral load and place female partners at risk of infection. We assessed the effect of MC on plasma HIV viral load in HIV-infected men in Rakai, Uganda. METHODS: 195 consenting HIV-positive, HAART naïve men aged 12 and above provided blood for plasma HIV viral load testing before surgery and weekly for six weeks and at 2 and 3 months post surgery. Data were also collected on baseline social demographic characteristics and CD4 counts. Change in log10 plasma viral load between baseline and follow-up visits was estimated using paired t tests and multivariate generalized estimating equation (GEE). RESULTS: Of the 195 men, 129 had a CD4 count ≧ 350 and 66 had CD4 <350 cells/mm3. Men with CD4 counts <350 had higher baseline mean log10 plasma viral load than those with CD4 counts ≧ 350 cells/mm3 (4.715 vs 4.217 cps/mL, respectively, p = 0.0005). Compared to baseline, there was no statistically significant increase in post-MC HIV plasma viral loads irrespective of CD4. Multivariate analysis showed that higher baseline log10 plasma viral load was significantly associated with reduction in mean log10 plasma viral load following MC (coef.  = -0.134, p<0.001). CONCLUSION: We observed no increase in plasma HIV viral load following MC in HIV-infected, HAART naïve men

Number of adverse events with PrePex circumcision.

<p>Number of adverse events with PrePex circumcision.</p

Figure 1 shows the study flow chart.

<p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0100008#pone-0100008-g001" target="_blank">Figure 1</a> shows the study flow chart.</p