Background. The coronavirus disease (COVID-19) morbidity is rising in Uganda. However, data are limited about people’s knowledge, attitudes, and practices. Objective. To determine knowledge about COVID-19, attitudes towards presidential directives and Ministry of Health (MoH) guidelines, and adherence to practicing public health preventive measures (KAP) in Uganda. Methods. This cross-sectional survey was conducted between April 28 and May 19, 2020. Data were collected using online social media platforms, websites, and popular media outlets. We descriptively summarized data and categorized KAP scores as knowledgeable about COVID-19, positive attitude towards presidential directives and MoH guidelines, and adherent to public health preventive measures, respectively. We tested sex differences in KAP using tests of significance and established independently associated factors using modified Poisson regression analysis, reported using adjusted prevalence risk ratio (aPR) with 95% confidence interval (CI). Results. We studied 362 participants with the following sociodemographic characteristics: 86 (23.8%) aged 25-29 years, 212 (58.6%) males, 270 (74.6%) with tertiary or university levels of education, and 268 (74.0%) urban residents. Of the 362 participants, 264 (93.9%) were knowledgeable about COVID-19 (94.1% males and 93.8% females), 51.3% had positive attitudes towards presidential directives and MoH guidelines (51.0% male and 51.8% female), and 175 (48.3%) were adherent to practicing public health preventive measures (42.9% males and 56.0% females). Compared to males, our data shows that females were more adherent to practicing public health preventive measures (aPR, 1.23; 95% CI, 1.01-1.53), knowledgeable about COVID-19 (aPR, 1.01; 95% CI, 0.95-1.07), and had positive attitudes towards directives and guidelines (aPR, 1.01; 95% CI, 0.82-1.25). Conclusions. This study shows that public health prevention efforts should be directed to closing the identified gaps in KAP among Ugandans in order to halt the spread of COVD-19 in Uganda as well as the East African region.
Background Childhood vaccination is an important public health intervention but there is limited information on coverage, trends, and determinants of vaccination completion in Uganda at the regional level. We examined trends in regional vaccination coverage and established the determinants of vaccination completion among children aged 12-23 months in Uganda. Methods We analyzed data from the women’s questionnaire for the 1995-2016 Uganda Demographic Health Survey (UDHS). Vaccine completion was defined as having received a dose of Bacillus-Calmette Guerin (BCG) vaccine; three doses of diphtheria, pertussis, and tetanus (DPT) vaccine; three doses of oral polio vaccine (OPV) (excluding OPV given at birth); and one dose of measles vaccine. We performed Chi-square tests to compare vaccination completion by socio-demographic factors stratified by 10 sub-regions: Eastern, East Central, Central 1, Central 2, Kampala, Karamoja, North, Western, West Nile, and Southwest. We performed logistic regression analysis for each of the regions to identify factors associated with vaccination completion at 5% level of statistical significance. Results Overall vaccination completion was 48.6% (95%CI, 47.2, 50.1) and ranged from 17.3% in Central 1 to 65.9% in Southwest. Vaccination completion rates declined significantly by 10.4% (95% confidence interval (CI), − 16.1, − 4.6) between 1995 and 2000, and increased significantly by 10.0% (95% CI, 4.6, 15.4) between 2000 and 2006, and by 5.4% (95% CI, 0.2, 10.6) between 2006 and 2011. Maternal education (secondary or higher level), receipt of tetanus toxoid (TT) during pregnancy, and possession of a child health card were associated with vaccination completion across all the sub-regions. Other factors like place of residence, religious affiliation, household wealth, maternal age, childbirth order, size of child at birth, and place of delivery were associated with vaccination completion but differed between the 10 sub-regions. Conclusion Besides considerable regional variations, the vaccination completion rate among children aged 12-23 months in Uganda remains suboptimal despite the availability of vaccines. Maternal education, receipt of TT, and possession of a child health card are associated with a higher likelihood of vaccination completion among children aged 12-23 months in all the regions of Uganda. Interventions to improve the utilization of vaccination services in Uganda should consider these factors.
Background There is inconsistent data about condom use at the last sexual intercourse (LSI) among university students in sub-Saharan Africa (SSA) and its association with sex, age, and condom negotiation efficacy. The primary objective of this study was to summarize the proportion of condom use at the LSI among university students in SSA. The secondary objective was to determine the association between condom use at the LSI with sex, age, and condom negotiation efficacy among university students in SSA. Methods In this systematic review and meta-analysis, two reviewers independently searched electronic databases and grey literature for eligible studies published until July 30, 2020, extracted data, and assessed the risk of bias in the included studies. We used the Dersimonian-Liard random-effects model to pool the proportion of condom use at the LSI and the association between condom use at the LSI with sex, age, and condom negotiation efficacy, reported using risk ratio (RR). We assessed publication bias using funnel plot and Egger’s test, and explored sources of heterogeneity using sub-group and meta-regression analyses. Results We meta-analyzed 44 studies with a combined sample size of 27,948 participants.Of 14,778 sexually active participants, 8,744 (pooled proportion, 52.9%; 95% CI, 45.0–60.7; 95% prediction interval, 2.8–98.9; I-squared = 99.0%, p< 0.0001) reported condom use at the LSI and the proportion of condom use at the LSI remained stagnant between 2000 and 2019 (p = 0.512). Condom use at the LSI was not associated with being a female compared to a male (pooled RR, 1.08; 95% CI, 0.68–1.71), being of a younger age (≤24 years old) compared to older age (25 years and more) (pooled RR, 1.16; 95% CI, 0-85-1.57), and having a higher condom negotiation efficacy compared to a lower condom negotiation efficacy (pooled RR, 1.54; 95% CI, 0-81-2.94). Conclusions We found a low and heterogenous use of a condom at the LSI among university students in SSA which was not associated with sex, age, or condom negotiation efficacy. Accordingly, context-relevant interventions are needed to improve condom use at the LSI among university students in SSA.
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