Depression, anxiety, and stress among Ugandan university students during the COVID-19 lockdown: an online survey

Background: COVID19 pandemic forced most countries to lockdown, leading to the prolonged closure of many learning institutions. This dramatic shift led to increase of mental illness symptoms among university students. Objective: To determine the prevalence and factors associated with symptoms of depression, anxiety, and stress among Uganda’s university students during the COVID-19 lockdown. Methods: We conducted a one-month online survey using the Depression Anxiety and Stress Scale (DASS-21). Results: Participants n=321 were enrolled with mean age, 24.8(SD=5.1) years and 198(61.7%) were males. The prevalence of mental health symptoms among participants was 80.7%, 98.4%, and 77.9% for depression, high levels of anxiety,and stress, respectively. Statistically significant association between mental health symptoms on multi-logistic regression was found with Males (depression=2.97[1.61–5.48] and stress=1.90[1.07–3.35]), engagement in leisure activity (depression= 1.87[1.01–3.49] and stress=1.98[1.10–3.56]), and being finalist (stress=0.55[0.31– 0.97]). Use of addictive substances seem to potentially alleviate symptoms of depression, anxiety and stress in the short term.  Conclusions: The findings of this study suggest a high prevalence of symptoms of depression, anxiety and stress among university students during the COVID-19 lockdown. Students’ mental health should be monitored by all stakeholders, especially as the pandemic progresses. Keywords: COVID-19 lockdown; University students; Mental health

Uganda’s post-COVID recovery strategy & NDC implementation

This paper analyses the climate friendliness of Uganda’s post-COVID-19 recovery strategy and, specifically, its alignment with the country’s targets in its Nationally Determined Contributions (NDCs). The recovery strategy has the potential to provide effective climate change response and meet the NDCs. However, there are several gaps related to the marginalisation of climate action in the economic recovery resource-allocation process, the ability of macroeconomic recovery strategies to advance a genuinely green and resilient economy, and limited fiscal space to invest in a climate-sensitive recovery. The paper concludes with policy recommendations on encouraging a robust economic recovery through actions that champion Uganda’s NDC commitments

Beyond water service coverage for slum dwellers: multiple water uses for livelihood enhancement

National Water and Sewerage Corporation and Loughborough University implemented a research project ‘Livelihoods from Enhanced Water Access for the Poor in Slums’ (LEAPS), funded under the DFID’s Water Security for the Poor (REACH) Program. The overall aim of LEAPS was to improve water security for development growth for the urban poor and was implemented in Kampala slums in Uganda. Data was collected through community meetings, observations, focus group discussions, key informant and household interviews. This aided development of a slum-specific MUS framework. Key findings were (i) piped water was predominantly used for productive uses; (ii) access to water services was still perceived a challenge for some residents; (iii) community groups and households interested in MUS activities require start-up funding; and (iv) stakeholder organisations were willing to work with NWSC to implement the MUS framework. The developed framework could be adapted by utilities in other cities to enhance livelihoods for slum-dwellers

Enhancing livelihoods of the urban poor through productive uses of utility-supplied water services – Evidence from Kampala, Uganda

Slums, one of the main faces of urban poverty, are escalating in Sub-Saharan countries and other developing countries. Achievement of the overly ambitious Sustainable Development Goals will require cross-sectoral interventions. A good example is the Multiple Use water Services (MUS) framework, a livelihood-centred approach that is implemented in rural areas of over twenty countries, where water supply primarily designed for domestic purposes is also used for productive uses (e.g. animal husbandry) to improve householders’ livelihoods. This paper reports on a study conducted in 2017/18 in Kampala (Uganda) which adapted the existing ruralbased MUS framework into a slum-specific framework. The study found that using utility-supplied water for productive uses was predominant in the slums, albeit unrecognised by the water utility. Implementation of the slum-specific MUS framework will be effective only with the water utility’s recognition/support, probably as part of its philanthropic portfolio. Livelihoods-based NGOs could provide further ‘software’ support

Population-based monitoring of HIV drug resistance early warning indicators in Uganda: A nationally representative survey following revised WHO recommendations: S1 Data

With the scale-up of antiretroviral therapy (ART) there is a need to monitor programme performance to maximize ART efficacy and to prevent emergence of HIV drug resistance (HIVDR). In keeping with the elements of the World Health Organisation (WHO) guidance we carried out a nationally representative assessment of early warning indicators (EWI) at 304 randomly selected ART service outlets in Uganda

Prevalence of protective tetanus antibodies and immunological response following tetanus toxoid vaccination among men seeking medical circumcision services in Uganda.

IntroductionTetanus infection associated with men who had male circumcision has been reported in East Africa, suggesting a need for tetanus toxoid-containing vaccines (TTCV).ObjectiveTo determine the prevalence of tetanus toxoid antibodies following vaccination among men seeking circumcision.MethodsWe enrolled 620 consenting men who completed a questionnaire and received TTCV at enrollment (day 0) prior to circumcision on day 28. Blood samples were obtained at day 0 from all enrollees and on days 14, 28 and 42 from a random sample of 237 participants. Tetanus toxoid (TT) IgG antibody levels were assayed using EUROIMMUN. Analyses included prevalence of TT antibodies at enrollment and used a mixed effects model to determine the immunological response.ResultsMean age was 21.4 years, 65.2% had knowledge of tetanus, 56.6% knew how tetanus was contracted, 22.8% reported ever receipt of TTCV, and 16.8% had current/recently healed wounds. Insufficient tetanus immunity was 57.1% at enrollment, 7.2% at day 14, 3.8% at day 28, and 0% at day 42. Antibody concentration was 0.44IU/ml (CI 0.35-0.53) on day 0, 3.86IU/ml (CI 3.60-4.11) on day 14, 4.05IU/ml (CI 3.81-4.29) on day 28, and 4.48IU/ml (CI 4.28-4.68) on day 42. TT antibodies increased by 0.24IU/ml (CI 0.23, 0.26) between days 0 and 14 and by 0.023IU/ml (CI 0.015, 0.031) between days 14 and 42 days. Immunological response was poorer in HIV-infected clients and men aged 35+ years.ConclusionInsufficient immunity was common prior to TTCV, and a protective immunological response was achieved by day 14. Circumcision may safely be provided 14 days after vaccination in HIV-uninfected men aged less than 35 years

First results of the randomised UK FAST Trial of radiotherapy hypofractionation for treatment of early breast cancer (CRUKE/04/015)

Background and purpose: Randomised trials testing 15- or 16-fraction regimens of adjuvant radiotherapy in women with early breast cancer have reported favourable outcomes compared with standard fractionation. To evaluate hypofractionation further, two 5-fraction schedules delivering 1 fraction per week have been tested against a 25-fraction regimen. Materials and methods: Women aged P50 years with node negative early breast cancer were randomly assigned after microscopic complete tumour resection to 50 Gy in 25 fractions versus 28.5 or 30 Gy in 5 once-weekly fractions of 5.7 or 6.0 Gy, respectively, to the whole breast. The primary endpoint was 2-year change in photographic breast appearance. Results: Nine hundred and fifteen women were recruited from 2004 to 2007. Seven hundred and twentynine patients had 2-year photographic assessments. Risk ratios for mild/marked change were 1.70 (95% CI 1.26–2.29, p < 0.001) for 30 Gy and 1.15 (0.82–1.60, p = 0.489) for 28.5 Gy versus 50 Gy. Three-year rates of physician-assessed moderate/marked adverse effects in the breast were 17.3% (13.3–22.3%, p < 0.001) for 30 Gy and 11.1% (7.9–15.6%, p = 0.18) for 28.5 Gy compared with 9.5% (6.5–13.7%) after 50 Gy. With a median follow-up in survivors of 37.3 months, 2 local tumour relapses and 23 deaths have occurred. Conclusion: At 3 years median follow-up, 28.5 Gy in 5 fractions is comparable to 50 Gy in 25 fractions, and significantly milder than 30 Gy in 5 fractions, in terms of adverse effects in the breast. � 2011 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 100 (2011) 93–10