Bruneian Suicidal behaviors among school attending adolescents: A nationwide cross sectional study

Background: It is aimed to determine the prevalence of suicidal behaviors regarding to epidemiological and psychosocial characteristics among Bruneian school-student adolescents.Methods: The cross-sectional study of 2599 (female: 49.9%; mean: 14.7 years old; SD: ±1.4) school-student adolescents aged between 13-17 years was based on the Global School-based Health Survey in Brunei. Data on suicidal behaviors, psychosocial and demographic characteristics were analyzed using multiple logistic regression model.Results: The prevalence of suicidal behaviors was 9.3%, 6.5% and 5.9% for suicidal ideation, suicidal plan and suicidal attempt respectively. Female adolescents reported more attempts (61.2%). It was found that some characteristics including suicide ideation (69%), anxiety (28%), loneliness (30%) were statistically different between the attempters of suicide and non-attempters among Bruneian school-student adolescents (p-valueConclusion: The revealed suicidal behaviors, including being lonely, anxious, bullied, attacked physically, alcohol use among school students should be considered by parents and school and counselling service staff in order to prevent selectively.Keywords: Suicide, Adolescents, Brunei Darussalam</p

An analysis of trends and distribution of the burden of road traffic injuries in Uganda, 2011 to 2015: a retrospective study

Introduction:&nbsp;gobally, 1.3 million people die from road traffic injuries every year. Over 90% of these deaths occur in low-and-middle-income countries. In Uganda, between 2012 and 2014, about 53,147 road traffic injuries were reported by the police, out of which 8,906 people died. Temporal and regional distribution of these injuries is not known, hence hindering targeted interventions. We described the trends and distribution of health facility reported road traffic injuries in Uganda from 2011 to 2015. Methods:&nbsp;we obtained monthly data on road traffic injuries, from 112 districts from the Ministry of Health Uganda. We analyzed the data retrospectively to generate descriptive statistics. Results:&nbsp;a total of 645,805 road traffic injuries were reported from January 2011 through December 2015 and 2,807 deaths reported from 2011 through 2014. Injuries increased from 37,219 in 2011 to 222,267 in 2014 and sharply dropped in December 2015 to 57,149. Kampala region had the highest number of injuries and deaths (18.3% (117,950/645,805) and 22.6% (634/2807)) respectively whereas Karamoja had the lowest injuries and deaths (1.7% (10,823/645,805) and 0.8% (21/2807)) respectively. Children aged 0-4 years accounted for 21.9% (615/2807) deaths; mostly females 81% (498/615) were affected. Conclusion:&nbsp;road traffic injuries increased during 2011-2014. Injuries and deaths were highest in Kampala and lowest in Karamoja region. It was noted that health facilities mostly received serious injuries. It is likely that the burden is higher but under reported. Concerted efforts are needed to increase road safety campaigns in Kampala and surrounding regions and to link pre-hospital deaths so as to understand the burden of road traffic crashes and recommend appropriate interventions

Knowledge, Perceptions, and Practices of Electronic Waste Management among Consumers in Kampala, Uganda

Background. Although proper management of electronic waste (e-waste) is key to preventing disease and protecting the environment, there is no clear mechanism for its management in Uganda. This study assessed knowledge, perceptions, and practices of e-waste management among consumers in Kampala city, Uganda. Methods. We conducted a cross-sectional study among people who used, repaired, or sold electronics (consumers). Both quantitative and qualitative methods of data collection using a sequential explanatory strategy were utilized. The quantitative survey involved 640 study participants, while qualitative interviews included 18 key informant interviews with stakeholders and six focus group discussions with 57 consumers. Modified Poisson regression was used to establish associations with corresponding 95% confidence intervals, and qualitative data analysed thematically. Results. Two-thirds (67.7%; 433/640) of electronics consumers had poor knowledge on the management of e-waste. More than three-quarters 79.1% (506) of the consumers had positive perceptions towards e-waste management. Consumers perceived e-waste as harmful to human health and the environment. Participants in informal employment were 0.96 times less likely to have positive perceptions towards e-waste management compared to those in formal employment (adjusted PR = 0.96, 95% CI: 0.93–0.99). Mobile phones and televisions were the most owned e-waste with only 7.96% (18/226) and 13.2% (7/53) disposed off, respectively. Selling e-waste to repair shops and donation were the common disposal options. Conclusion. Knowledge on proper e-waste management is poor among electronic consumers in Kampala, Uganda, though most have positive perceptions. There is need for increased awareness on e-waste management to prevent its effects on health and the environment. Special attention should be towards sensitisation on e-waste handling practices before disposal and final disposal options available

Retention of HIV infected pregnant and breastfeeding women on option B+ in Gomba District, Uganda: a retrospective cohort study

Abstract Background Lifelong antiretroviral therapy for HIV infected pregnant and lactating women (Option B+) has been rapidly scaled up but there are concerns about poor retention of women initiating treatment. However, facility-based data could underestimate retention in the absence of measures to account for self-transfers to other facilities. We assessed retention-in-care among women on Option B+ in Uganda, using facility data and follow-up to ascertain transfers to other facilities. Methods In a 25-month retrospective cohort analysis of routine program data, women who initiated Option B+ between March 2013 and March 2015 were tracked and interviewed quantitatively and qualitatively (in-depth interviews). Kaplan Meier survival analysis was used to estimate time to loss-to-follow-up (LTFU) while multivariable Cox proportional hazards regression was applied to estimate the adjusted predictors of LTFU, based on facility data. Thematic analysis was done for qualitative data, using MAXQDA 12. Quantitative data were analyzed with STATA® 13. Results A total of 518 records were reviewed. The mean (SD) age was 26.4 (5.5) years, 289 women (55.6%) attended primary school, and 53% (276/518) had not disclosed their HIV status to their partners. At 25 months post-ART initiation, 278 (53.7%) were LTFU based on routine facility data, with mean time to LTFU of 15.6 months. Retention was 60.2 per 1000 months of observation (pmo) (95% CI: 55.9–64.3) at 12, and 46.3/1000pmo (95% CI: 42.0–50.5) at 25 months. Overall, 237 (55%) women were successfully tracked and interviewed and 43/118 (36.4%) of those who were classified as LTFU at facility level had self-transferred to another facility. The true 25 months post-ART initiation retention after tracking was 71.3% (169/237). Women < 25 years, aHR = 1.71 (95% CI: 1.28–2.30); those with no education, aHR = 5.55 (95% CI: 3.11–9.92), and those who had not disclosed their status to their partners, aHR = 1.59 (95% CI: 1.16–2.19) were more likely to be LTFU. Facilitators for Option B+ retention based on qualitative findings were adequate counselling, disclosure, and the desire to stay alive and raise HIV-free children. Drug side effects, inadequate counselling, stigma, and unsupportive spouses, were barriers to retention in care. Conclusions Retention under Option B+ is suboptimal and is under-estimated at health facility level. There is need to institute mechanisms for tracking of women across facilities. Retention could be enhanced through strategies to enhance disclosure to partners, targeting the uneducated, and those < 25 years

Peer-led training improves lifejacket wear among occupational boaters: Evidence from a cluster randomized controlled trial on Lake Albert, Uganda.

BackgroundThe burden of drowning among occupational boaters in low and middle-income countries is highest globally. In Uganda, over 95% of people who drowned from boating-related activities were not wearing lifejackets at the time of the incident. We implemented and evaluated a peer-led training program to improve lifejacket wear among occupational boaters on Lake Albert, Uganda.MethodsWe conducted a two-arm cluster randomized controlled trial in which fourteen landing sites were randomized to the intervention and non-intervention arm with a 1:1 allocation ratio. In the intervention arm, a six-month peer-to-peer training program on lifejacket wear was implemented while the non-intervention arm continued to receive the routine Marine Police sensitizations on drowning prevention through its community policing program. The effect of the intervention was assessed on self-reported and observed lifejacket wear using a test of differences in proportions of wear following the intention to treat principle. The effect of contamination was assessed using mixed effect modified Poisson regression following the As Treated analysis principle at 95% CI. Results are reported according to the CONSORT statement-extension for cluster randomized trials.ResultsSelf-reported lifejacket wear increased markedly from 30.8% to 65.1% in the intervention arm compared to the non-intervention arm which rose from 29.9% to 43.2%. Observed wear increased from 1.0% to 26.8% in the intervention arm and from 0.6% to 8.8% in the non-intervention arm. The test of differences in proportions of self-reported lifejacket wear (65.1%- 43.2% = 21.9%, p-value ConclusionThis study demonstrated that peer-led training significantly improves lifejacket wear among occupational boaters. The government of Uganda through the relevant ministries, and the Landing Site Management Committees should embrace and scale up peer-led training programs on lifejacket wear to reduce drowning deaths

Trends of Injuries due to Gender Based Violence, Uganda, 2012 – 2016, a retrospective descriptive analysis

Introduction: Gender-based violence (GBV) in Uganda is widespread. The 2012 Uganda Bureau of Statistics report indicated that 60% of Ugandan women experienced GBV, which is approximately twice the global rate. There is paucity of information on epidemiology of injuries due to GBV in Uganda. We studied trends and distribution of injuries due to GBV in Uganda. Methods: We conducted a retrospective descriptive analysis using routinely-collected surveillance data from the Uganda Health Management Information System over five years (2012–2016). We calculated prevalence and annual injury rates due to GBV per 10,000 population and compared them across different population segments and time periods. We used logistic regression to determine trends. Results: In 2016, GBV resulted in 49,842 hospital visits in Uganda. Injury rates due to GBV were 13.5 per 10,000 population for the year 2012, and 13.6 per 10,000 population for 2016. Injury rates declined slightly from 2012 to 2016 (OR: 0.995, 95% CI: 0.991–0.997). In 2016, the odds of injuries due to GBV were 1.36 times in females compared to males (OR: 1.36, 95% CI: 1.33–1.38). Northern and Eastern regions (17.4 and 16.9 per 10,000, respectively) had higher GBV-associated injury burden than Central and Western regions (11.0 and 10.1 per 10,000 population, respectively). Conclusion: The incidence of injuries due to GBV in Uganda has not changed meaningfully from 2012 to 2016. We recommend development of interventions for GBV prevention targeting both males and females. There is a need for targeted efforts in the Eastern and Northern region

Trends of injuries due to gender based violence, Uganda, 2012 – 2016, a retrospective descriptive analysis

Introduction: Gender-based violence (GBV) in Uganda is widespread. The 2012 Uganda Bureau of Statistics report indicated that 60% of Ugandan women experienced GBV, which is approximately twice the global rate. There is paucity of information on epidemiology of injuries due to GBV in Uganda. We studied trends and distribution of injuries due to GBV in Uganda. Methods: We conducted a retrospective descriptive analysis using routinely-collected surveillance data from the Uganda Health Management Information System over five years (2012–2016). We calculated prevalence and annual injury rates due to GBV per 10,000 population and compared them across different population segments and time periods. We used logistic regression to determine trends. Results: In 2016, GBV resulted in 49,842 hospital visits in Uganda. Injury rates due to GBV were 13.5 per 10,000 population for the year 2012, and 13.6 per 10,000 population for 2016. Injury rates declined slightly from 2012 to 2016 (OR: 0.995, 95% CI: 0.991–0.997). In 2016, the odds of injuries due to GBV were 1.36 times in females compared to males (OR: 1.36, 95% CI: 1.33–1.38). Northern and Eastern regions (17.4 and 16.9 per 10,000, respectively) had higher GBV-associated injury burden than Central and Western regions (11.0 and 10.1 per 10,000 population, respectively). Conclusion: The incidence of injuries due to GBV in Uganda has not changed meaningfully from 2012 to 2016. We recommend development of interventions for GBV prevention targeting both males and females. There is a need for targeted efforts in the Eastern and Northern region

Effects and factors associated with indoor residual spraying with Actellic 300 CS on malaria morbidity in Lira District, Northern Uganda

Abstract Background Indoor residual spraying (IRS) with Actellic 300 CS was conducted in Lira District between July and August 2016. No formal assessment has been conducted to estimate the effect of spraying with Actellic 300 CS on malaria morbidity in the Ugandan settings. This study assessed malaria morbidity trends before and after IRS with Actellic 300 CS in Lira District in Northern Uganda. Methods The study employed a mixed methods design. Malaria morbidity records from four health facilities were reviewed, focusing on 6 months before and after the IRS intervention. The outcome of interest was malaria morbidity defined as; proportion of outpatient attendance due to total malaria, proportion of outpatient attendance due to confirmed malaria and proportion of malaria case numbers confirmed by microscopy or rapid diagnostic test. Since malaria morbidity was based on count data, an ordinary Poisson regression model was used to obtain percentage point change (pp) in monthly malaria cases before and after IRS. A household survey was also conducted in 159 households to determine IRS coverage and factors associated with spraying. A modified Poisson regression model was fitted to determine factors associated with household spray status. Results The proportion of outpatient attendance due to malaria dropped from 18.7% before spraying to 15.1% after IRS. The proportion of outpatient attendance due to confirmed malaria also dropped from 5.1% before spraying to 4.0% after the IRS intervention. There was a decreasing trend in malaria test positivity rate (TPR) for every unit increase in month after spraying. The decreasing trend in TPR was more prominent 5–6 months after the IRS intervention (Adj. pp = − 0.60, P-value = 0.015; Adj. pp = − 1.19, P-value < 0.001). The IRS coverage was estimated at 89.3%. Households of respondents who were formally employed or owned any form of business were more likely to be unsprayed; (APR = 5.81, CI 2.72–12.68); (APR = 3.84, CI 1.20–12.31), respectively. Conclusion Coverage of IRS with Actellic 300 CS was high and was associated with a significant decline in malaria related morbidity 6 months after spraying

A randomized trial to assess retention rates using mobile phone reminders versus physical contact tracing in a potential HIV vaccine efficacy population of fishing communities around Lake Victoria, Uganda

Abstract Background High retention (follow-up) rates improve the validity and statistical power of outcomes in longitudinal studies and the effectiveness of programs with prolonged administration of interventions. We assessed participant retention in a potential HIV vaccine trials population of fishing communities along Lake Victoria, Uganda. Methods In a community-based individual randomized trial, 662 participants aged 15–49 years were randomized to either mobile phone or physical contact tracing reminders and followed up at months 1, 2, 3, 6, 12 and 18 post-enrolment. The visit schedules aimed at mimicking a vaccine efficacy trial representing an early interval (months 1–6) where most vaccinations would be administered and a later period of post-vaccination follow-up. The primary outcome was retention measured as the proportion of post-baseline follow up visits completed by a participant. Retention was estimated in early and later follow-up intervals, and overall for all the six follow-up visits. Adjusted differences in retention between the study arms were determined by multivariable logistic regression using Stata® 14. One participant was later dropped from the analysis because of age ineligibility discovered after enrolment. Results Of the expected total follow up visits of 3966 among 661 participants, 84.1% (3334) were attained; 82.1% (1626/1980) in the phone arm and 86% (1708/1986) in the physical tracing arm (p = 0.001). No statistically significant differences in retention were observed between the study arms in the first 6 months but thereafter, retention was significantly higher for physical contact reminders than mobile phones; 91.5% versus 82.1% (p < 0.0001) at month 12 and 82.8% versus 75.4%, (p = 0.021) at month 18. Controlling for sex, age, education, occupation, community location, length of stay and marital status, the odds of good retention (completing 5 out of 6 follow-up visits) were 1.56 (95% CI;1.08–2.26, p = 0.018) for physical contact tracing compared to mobile phone tracing. Other statistically significant predictors of good retention were residing on islands and having stayed in the fishing communities for 5 or more years. Conclusions Among fishing communities of Lake Victoria, Uganda, 84% of follow-up visits can be attained and participant retention is higher using physical contact reminders than mobile phones. Trial registration number PACTR201311000696101 (http://www.pactr.org/). retrospectively registered on 05 November, 2013