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Title: Male circumcision: a cancer prevention strategy?
Source: Lancet Oncology. 2009 May;10(5):431.
Abstract: Given that less than 20% of males are circumcised in many developing countries, and that male circumcision is relatively simple and reduces viral infection, might this practice be more widely used as a preventive measure against cancer? In developing countries, male circumcision could have a vital role in specific segments of the population depending on the answers to specific scientific and infrasturcture related questions. Discussions around male circumcision strategies should be encouraged within the context of cancer prevention, and these should include local communities alongside assessments of current capacities, measurable targets, cost analyses and modelling, and the development of practicable guidelines, so as to place male circumcision within the possible options available for disease prevention.
Language: English
Keywords:
UGANDA | SUMMARY REPORT | PREVALENCE | MEN | MALE CIRCUMCISION | CANCER | PREVENTION AND CONTROL | HIV PREVENTION | STANDARDS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Measurement | Research Methodology | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Neoplasms | Diseases | HIV Infections | Viral Diseases
Document Number: 341199

Peer Reviewed

Title: Risk factors for virological failure and subtherapeutic antiretroviral drug concentrations in HIV-positive adults treated in rural northwestern Uganda.
Author: Ahoua L; Guenther G; Pinoges L; Anguzu P; Chaix ML; Le Tiec C; Balkan S; Olson D; Olaro C; Pujades-Rodriguez M
Source: BMC Infectious Diseases. 2009;9:81.
Abstract: BACKGROUND: Little is known about immunovirological treatment outcomes and adherence in HIV/AIDS patients on antiretroviral therapy (ART) treated using a simplified management approach in rural areas of developing countries, or about the main factors influencing those outcomes in clinical practice. METHODS: Cross-sectional immunovirological, pharmacological, and adherence outcomes were evaluated in all patients alive and on fixed-dose ART combinations for 24 months, and in a random sample of those treated for 12 months. Risk factors for virological failure (>1,000 copies/ml) and subtherapeutic antiretroviral (ARV) concentrations were investigated with multiple logistic regression. RESULTS: At 12 and 24 months of ART, 72% (n = 701) and 70% (n = 369) of patients, respectively, were alive and in care. About 8% and 38% of patients, respectively, were diagnosed with immunological failure; and 75% and 72% of patients, respectively, had undetectable HIV RNA (<400 copies/ml). Risk factors for virological failure (>1,000 copies/ml) were poor adherence, tuberculosis diagnosed after ART initiation, subtherapeutic NNRTI concentrations, general clinical symptoms, and lower weight than at baseline. About 14% of patients had low ARV plasma concentrations. Digestive symptoms and poor adherence to ART were risk factors for low ARV plasma concentrations. CONCLUSION: Efforts to improve both access to care and patient management to achieve better immunological and virological outcomes on ART are necessary to maximize the duration of first-line therapy.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | RURAL AREAS | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | TREATMENT | ADMINISTRATION AND DOSAGE | PROGRAM ACCESSIBILITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Program Evaluation
Document Number: 342064

Peer Reviewed

Title: Mortality and loss-to-follow-up during the pre-treatment period in an antiretroviral therapy programme under normal health service conditions in Uganda.
Author: Amuron B; Namara G; Birungi J; Nabiryo C; Levin J; Grosskurth H; Coutinho A; Jaffar S
Source: BMC Public Health. 2009 Aug 11;9(1):290.
Abstract: ABSTRACT: BACKGROUND: In many HIV programmes in Africa, patients are assessed clinically and prepared for antiretroviral treatment over a period of 4-12 weeks. Mortality rates following initiation of ART are very high largely because patients present late with advanced disease. The rates of mortality and retention during the pre-treatment period are not well understood. We conducted an observational study to determine these rates. METHODS: HIV-infected subjects presenting at The AIDS Support Clinic in Jinja, SE Uganda, were assessed for antiretroviral therapy (ART). Eligible subjects were given information and counselling in 3 visits done over 4-6 weeks in preparation for treatment. Those who did not complete screening were followed-up at home. Survival analysis was done using poisson regression. RESULTS: 4321 HIV-infected subjects were screened of whom 2483 were eligible for ART on clinical or immunological grounds. Of these, 637 (26%) did not complete screening and did not start ART. Male sex and low CD4 count were associated independently with not completing screening. At follow-up at a median 351 days, 181 (28%) had died, 189 (30%) reported that they were on ART with a different provider, 158 (25%) were alive but said they were not on ART and 109 (17%) were lost to follow-up. Death rates (95% CI) per 100 person-years were 34 (22, 55) (n.18) within one month and 37 (29, 48) (n.33) within 3 months. 70/158 (44%) subjects seen at follow-up said they had not started ART because they could not afford transport. CONCLUSIONS: About a quarter of subjects eligible for ART did not complete screening and pre-treatment mortality was very high even though patients in this setting were well informed. For many families, the high cost of transport is a major barrier preventing access to ART.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | CLIENTS | ANTIRETROVIRAL THERAPY | SCREENING | AIDS PREVENTION | DEATH RATE | PROGRAM ACCESSIBILITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | HIV | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | AIDS | Mortality | Population Dynamics | Demographic Factors | Population | Program Evaluation
Document Number: 342534

Peer Reviewed

Title: Highly active antiretroviral therapy and increased use of contraceptives among HIV-positive women during expanding access to antiretroviral therapy in Mbarara, Uganda.
Author: Andia I; Kaida A; Maier M; Guzman D; Emenyonu N; Pepper L; Bangsberg DR; Hogg RS
Source: American Journal of Public Health. 2009 Feb;99(2):340-7.
Abstract: OBJECTIVES: We investigated whether the prevalence of contraceptive use among women who are HIV positive varied according to use of highly active antiretroviral therapy (HAART) in Mbarara, Uganda. METHODS: We used data from a cross-sectional survey of 484 women who were HIV positive (18-50 years) and were attending Mbarara University's HIV clinic, 45% of whom were receiving HAART. Multivariate logistic regression was used to investigate the association between HAART use and contraceptive use. Data were collected between November 2005 and June 2006. RESULTS: Overall, 45% of the women were sexually active in the previous 3 months. Of these, 85% reported using contraceptive methods, with 84% reporting use of barrier contraceptive methods. Women receiving HAART were more than twice as likely to use contraceptive methods (adjusted odds ratio [AOR] = 2.64; 95% confidence interval [CI] = 1.07, 6.49) and more than 3 times as likely to use barrier contraceptive methods (AOR = 3.62; 95% CI = 1.54, 8.55) than were women not receiving HAART. CONCLUSIONS: Our findings support the need for increased attention to better integration of reproductive health and HIV and AIDS services for women who are HIV positive.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | WOMEN | CONTRACEPTIVE USAGE | ANTIRETROVIRAL THERAPY | REPRODUCTIVE HEALTH | PROGRAM ACCESSIBILITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Demographic Factors | Population | Contraception | Family Planning | HIV | Health | Program Evaluation | Programs | Organization and Administration
Document Number: 329768

Title: PRISM tools for assessing, monitoring, and evaluating RHIS performance.
Author: Aqil A; Lippeveld T
Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center [CPC], MEASURE Evaluation, 2009 Mar. [32] p. (MS-09-34USAID Cooperative Agreement No. GPO-A-00-03-00003-00)
Abstract: PRISM Framework and its tools applications have expanded since 2004. Now it has been applied in Pakistan, Uganda, South Africa, Mexico, Paraguay, Honduras, Haiti, China and Cote d'Ivore for assessment and evaluation. It has been applied in diverse countries of Africa, Asia, Latin America and Carribean continents. While these applications showed the strengths and appropriateness of PRISM Framework and its tools in identifying strengths and weaknesses of the routine information systems, they brought some challenges to attention. First, to make a distinction between RHIS performance indicators -accuracy, timeliness and completeness, from their counterpart processes. Second, to keep minimum variables in various tools for triangulation of information to avoid respondent's burden of filling the details. Third, better measurement of use of information. Thus, there was a need to revise the PRISM tools. Uganda PRISM evaluation in 2007 for testing its reliability and validity also helped to make the revisions. PRISM tools version 3.0 meets old and new challenges in assessing, monitoring and evaluation of RHIS.
Language: English
Keywords:
PAKISTAN | MEXICO | HONDURAS | HAITI | CHINA | PARAGUAY | SOUTH AFRICA | UGANDA | SUMMARY REPORT | EVALUATION | INFORMATION PROCESSING | DATA COLLECTION | MANAGEMENT | PROGRAM ACTIVITIES | Developing Countries | Asia, Southern | Asia | North America | Americas | Central America | Latin America | Caribbean | Asia, Eastern | South America, Central | South America | Africa, Southern | Africa, Sub Saharan | Africa | Africa, Eastern | Information | Research Methodology | Organization and Administration | Programs
Document Number: 339994

10.

11.

Title: Seeking safety and empathy: adolescent health seeking behavior during pregnancy and early motherhood in central Uganda.
Author: Atuyambe L; Mirembe F; Annika J; Kirumira EK; Faxelid E
Source: Journal of Adolescence. 2009;32:781-796.
Abstract: Purpose: To explore adolescent health seeking behavior during pregnancy and early motherhood in order to contribute to health policy formulation and improved access to health care. This will in long-term have an impact on the reduction of morbidity and mortality among adolescent mothers and their newborns. Methods: This was a qualitative study that employed focus group discussions (FGDs) among adolescent girls (10-19 years) and key informant (KI) interviews with health workers. Age for FGD participants ranged from 16 to 19 years. The FGD participants were recruited while seeking antenatal care for their first pregnancy or immunization service for their first child, not being older than 6 months. Six health facilities were selected. Key informants were purposefully selected on the basis of being in-charge of maternity units. Thirteen FGDs comprising of a total of 92 adolescent girls were conducted. The FGDs were held with homogeneously constituted categories; married pregnant adolescents (5), unmarried pregnant adolescents (3) and married or not married adolescents with children (5). Semi structured interviews were held with six KIs who were in-charge of maternity units of health facilities. Latent content analysis technique was used for data analysis. Results: Two main themes emerged; ?feeling exposed and powerless?, and ?seeking safety and empathy?. The categories identified in the first theme were ?the dilemma of becoming an adolescent mother? and ?lack of decision power?. In the second theme the following categories were identified: ?cultural practices and beliefs about birth?, ?expectations and experiences?, ?transport, a key determinant to health seeking?, and ?dealing with constraints?. Adolescents felt exposed and powerless due to the dilemma of early motherhood and lack of decision making power. The adolescent mothers seemed to be in continuous quest for safety and empathy. In so doing they are part of cultural practices and beliefs about birth. They had expectations about the health care services but their experiences of the services were rather negative. Transport was a key determinant for health seeking and adolescents to some extent had learnt how to cope with constraints they face. Conclusion and implications: Pregnant adolescents seek health care in both modern and traditional health sectors in order to get safety and empathy. However, our findings indicate that they mostly utilize the traditional sector because it is most accessible in terms of distance, cost and cultural context. Adolescent mothers are disempowered in decision making because of their pregnancy state which often puts them in dilemma. We therefore suggest that policy makers need to improve health systems (including the traditional sector) especially maternal health services for adolescent girls. Improved infrastructure and attitudes of health worker as well as training in delivery of adolescent health services is critical.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | QUALITATIVE RESEARCH | ADOLESCENTS | YOUTH | PREGNANCY | SAFETY | SAFE MOTHERHOOD | MATERNAL HEALTH | HEALTH SERVICES | UTILIZATION OF HEALTH CARE | PROGRAM EVALUATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Public Health | Health | Delivery of Health Care | Programs | Organization and Administration
Document Number: 340225

12.

Title: Adherence and treatment response among HIV-1 infected adults receiving antiretroviral therapy in a rural government hospital in southwestern Uganda.
Author: Bajunirwe F; Arts EJ; Tisch DJ; King CH; Debanne SM
Source: Journal of the International Association of Physicians in AIDS Care. 2009 Mar-Apr;8(2):139-147.
Abstract: Background. Large-scale, government-based antiretroviral therapy (ART) programs in rural areas of resource-poor countries remain largely unevaluated. Methods. We conducted a retrospective review of all patients receiving (n = 399) to assess survival and retention in care and a prospective evaluation of patients on ART for at least 6 months (n = 175). We used 3-day self-report to measure adherence. Results. The probability (95% confidence interval [CI]) of surviving and remaining in care was 0.76 (0.72, 0.81) at 1 year. Men and patients with advanced disease were more likely to die or be lost to follow-up. At baseline, 149 (85%) reported 100% adherence. Nonadherence was associated with lack of suppression of viral replication (odds ratio [OR] = 4.5; 95% CI: 1.8, 11.5). Missing a scheduled clinic visit and lack of disclosure of HIV status were associated with nonadherence. Conclusion. Viral suppression was high, but counseling to include HIV disclosure to family and keeping scheduled clinic appointments may improve long-term adherence and treatment outcomes.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | RETROSPECTIVE STUDIES | PROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | ADULTS | RURAL POPULATION | HIV INFECTIONS | USER COMPLIANCE | ANTIRETROVIRAL THERAPY | GOVERNMENT PROGRAMS | SEX FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Viral Diseases | Diseases | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | HIV | Programs | Organization and Administration
Document Number: 331336

13.

Peer Reviewed

Title: Quality of life and social support among patients receiving antiretroviral therapy in Western Uganda.
Author: Bajunirwe F; Tisch DJ; King CH; Arts EJ; Debanne SM; Sethi AK
Source: AIDS Care. 2009 Mar;21(3):271-9.
Abstract: Quality of life (QOL) among patients with HIV/AIDS has been shown to improve once treatment with antiretroviral therapy (ART) has been initiated. We conducted a cross-sectional study in Western Uganda to examine the factors associated with QOL among patients who had received ART for the duration of at least six months. We interviewed 330 patients attending the HIV/AIDS clinic at two government-supported hospitals in Western Uganda. We measured QOL using a culturally adapted version of the Medical Outcomes Study (MOS-HIV) tool and calculated the physical health summary (PHS) and mental health summary (MHS) scores. In addition, data were collected on sociodemographic factors, three-day self-reported adherence, social support, sexual behavior, CD4 count and viral load. Informational social support was significantly positively correlated with PHS (p=0.001) and MHS (p=0.002). Affectionate support was also significantly positively correlated to PHS (p=0.05) and MHS (p=0.03) but tangible support was not (PHS p value=0.85 and MHS p value=0.31). In the univariate analysis, older age, rural dwelling, alcohol use, CD4 count less than 200, and ART duration of less than one year were significantly associated with lower PHS scores. Lower PHS scores were also associated with sexual inactivity. In multivariate analysis, higher scores on informational social support and CD4> or =200 were associated with higher PHS score and past or recent alcohol consumption was associated with lower scores on MHS. Optimizing ART to restore CD4 count and provision of informational and affectionate social support but not tangible support, to HIV/AIDS patients may improve their QOL.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CLIENTS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | HIV INFECTIONS | QUALITY OF LIFE | CARE AND SUPPORT | SEX BEHAVIOR | HEALTH | MENTAL HEALTH | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | HIV | Viral Diseases | Diseases | Behavior | Social Welfare | Economic Factors | Health Services | Delivery of Health Care
Document Number: 341987

14.

Title: Demographic data for development in sub-Saharan Africa.
Author: Baldwin W; Diers J
Source: New York, New York, Population Council, 2009. 15 p. (Poverty, Gender, and Youth Working Paper No. 13)
Abstract: More demographic data are being collected throughout the developing world than ever before, but the effective use of that data to further development goals is often lacking. This paper summarizes case studies on the demand for data in four sub-Saharan African countries, namely Ethiopia, Ghana, Senegal, and Uganda. The project's objective was to create a detailed portrait of access and demand at the country level, and to determine whether policymakers are getting the data they need to develop sound policies. Common findings across the four countries include an increased external demand from international initiatives that has not necessarily translated into internal demand for data; a missing link between producers and users of data; and a need for data to be presented in user-friendly formats. One driver of internal demand for data is the decentralization and democratization process that is underway in all four countries; this demand highlighted the paucity of available data that can be disaggregated at the level to which policies were being devolved. Next steps are to support initiatives to establish data access as a right, encourage a culture of data-sharing among funders and producers of data, strengthen intermediaries between policymakers and data collectors, display data in accessible formats such as maps, and disaggregate available data to the most useful levels. (Author's abstract)
Language: English
Keywords:
ETHIOPIA | GHANA | SENEGAL | UGANDA | SUMMARY REPORT | DEMOGRAPHIC ANALYSIS | DATA COLLECTION | CASE STUDIES | DATA QUALITY | NEEDS | DECENTRALIZATION | DEMOCRACY | INFORMATION DISTRIBUTION | POVERTY | GENDER ISSUES | YOUTH | POLICY | PROGRAM ACCESSIBILITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Africa, Western | Research Methodology | Studies | Data Analysis | Economic Factors | Political Factors | Sociocultural Factors | Political Systems | Communication | Socioeconomic Factors | Age Factors | Population Characteristics | Demographic Factors | Population | Program Evaluation | Programs | Organization and Administration
Document Number: 331433

15.

Peer Reviewed

Title: Independent association between rate of clearance of infection and clinical outcome of HIV-associated cryptococcal meningitis: analysis of a combined cohort of 262 patients.
Author: Bicanic T; Muzoora C; Brouwer AE; Meintjes G; Longley N; Taseera K; Rebe K; Loyse A; Jarvis J; Bekker LG; Wood R; Limmathurotsakul D; Chierakul W; Stepniewska K; White NJ; Jaffar S; Harrison TS
Source: Clinical Infectious Diseases. 2009 Sep 1;49(5):702-9.
Abstract: BACKGROUND: Progress in therapy for cryptococcal meningitis has been slow because of the lack of a suitable marker of treatment response. Previously, we demonstrated the statistical power of a novel endpoint, the rate of clearance of infection, based on serial quantitative cultures of cerebrospinal fluid, to differentiate the fungicidal activity of alternative antifungal drug regimens. We hypothesized that the rate of clearance of infection should also be a clinically meaningful endpoint. METHODS: We combined data from cohorts of patients with human immunodeficiency virus-associated cryptococcal meningitis from Thailand, South Africa, and Uganda, for whom the rate of clearance of infection was determined, and clinical and laboratory data prospectively collected, and explored the association between the rate of clearance of infection and mortality by Cox survival analyses. RESULTS: The combined cohort comprised 262 subjects. Altered mental status at presentation, a high baseline organism load, and a slow rate of clearance of infection were independently associated with increased mortality at 2 and 10 weeks. Rate of clearance of infection was associated with antifungal drug regimen and baseline cerebrospinal fluid interferon-gamma levels. CONCLUSIONS: The results support the use of the rate of clearance of infection or early fungicidal activity as a means to explore antifungal drug dosages and combinations in phase II studies. An increased understanding of how the factors determining outcome interrelate may help clarify opportunities for intervention.
Language: English
Keywords:
SOUTH AFRICA | THAILAND | UGANDA | RESEARCH REPORT | CLIENTS | MENINGITIS | HIV INFECTIONS | DRUGS | INTERVENTIONS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Asia, Southeastern | Asia | Africa, Eastern | Program Activities | Programs | Organization and Administration | Central Nervous System Effects | Central Nervous System | Physiology | Biology | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342967

16.

Title: Role of parents in adolescent sexual activity and contraceptive use in four african countries.
Author: Biddlecom A; Awusabo-Asare K; Bankole A
Source: International Perspectives On Sexual and Reproductive Health. 2009 Jun;35(2):72-81.
Abstract: Data were collected in 2004 in nationally representative surveys of 12- to 19-year-olds in Burkina Faso, Ghana, Malawi, and Uganda. Bivariate analysis was used to compare gender differences for two outcomes among unmarried 15- to 19-year-olds having had sexual intercourse in the last 12 months and, among those who had had sex in this period, having used contraception at last sex. Unmarried adolescents reported moderate to high levels of parental monitoring and low levels of parent-child communication about sexual matters. In all countries, adolescent males who reported low monitoring were at elevated risk of having had sex in the last year, as were their female counterparts in three of the countries. Communication with parents was positively associated with sexual activity among Malawian males and Ugandan females. Parental monitoring was not associated with contraceptive use at last sex, whereas parent-child communication was associated with such use among Ghanaian females and among Ugandan adolescents of both genders. The authors conclude that programs to improve adolescent sexual and reproductive health should include dimensions of parental involvement.
Language: English
Keywords:
BURKINA FASO | GHANA | MALAWI | UGANDA | RESEARCH REPORT | SURVEYS | ADOLESCENTS | SEX BEHAVIOR | PARENTAL INVOLVEMENT | REPRODUCTIVE HEALTH | INTERPERSONAL COMMUNICATION | CONTRACEPTIVE USAGE | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Africa, Southern | Africa, Eastern | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Child Rearing | Health | Communication | Contraception | Family Planning
Document Number: 342142

17.

Peer Reviewed

Title: Is sexual risk taking behaviour changing in rural south-west Uganda? Behaviour trends in a rural population cohort 1993 2006.
Author: Biraro S; Shafer LA; Kleinschmidt I; Wolff B; Karabalinda A; Nalwoga A; Musinguzi J; Kirungi W; Opio A; Whitworth J; Grosskurth H
Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 1):i3-i11.
Abstract: Objective: To describe sexual behaviour trends in a rural Ugandan cohort in the context of an evolving HIV epidemic, 1993-2006. Methods: Sexual behaviour data were collected annually from a population cohort in which HIV serological surveys were also conducted. Behaviour trends were determined using survival analysis and logistic regression. Trends are reported based on the years in which the respective indicators were collected. Results: Between 1993 and 2006, median age at first sex increased from 16.7 years to 18.2 years among 17-20-year-old girls and from 18.5 years to 19.9 years among boys. Both sexes reported a dip in age at sexual debut between 1998 and 2001. One or more casual partners in the past 12 months among men rose from 11.6% in 1997 to 12.7% in 2004 and then declined to 10.2% in 2006. Among women it increased from 1.4% in 1997 to 3.7% in 2004 and then reduced to 1.4% in 2006. The rise in casual partners between 1997 and 2004 was driven mainly by older age groups. Trends in condom use with casual partners varied by age, increasing among those aged 35+ years, declining in the middle age groups and presenting a dip and then a rise in the youngest aged group (13-19 years). Conclusion: Among youth, risky behaviour declined but increased in the late 1990s/early 2000s. Among those aged 35+ years, condom use rose but casual partners also rose. Several indicators portrayed a temporary increase in risk taking behaviour from 1998 to 2002.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | KAP SURVEYS | COHORT ANALYSIS | LONGITUDINAL STUDIES | EPIDEMIOLOGIC METHODS | RURAL POPULATION | MULTIPLE PARTNERS | SEX BEHAVIOR | RISK BEHAVIOR | HIV INFECTIONS | SEX FACTORS | FIRST INTERCOURSE | AGE FACTORS | CONDOM USE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Sexual Partners | Behavior | Viral Diseases | Diseases | Risk Reduction Behavior
Document Number: 340101

18.

Peer Reviewed

Title: Preventive service needs of young people perinatally infected with HIV in Uganda.
Author: Birungi H; Obare F; Mugisha JF; Evelia H; Nyombi J
Source: AIDS Care. 2009 Jun;21(6):725-731.
Abstract: This study examines the sexual expressions and experiences as well as the preventive practices of 732 adolescent boys and girls aged 15-19 years who were born with HIV. The data come from a project on the sexuality of young people perinatally infected with HIV conducted in 2007 in four districts of Uganda. The analysis involves both quantitative and qualitative approaches. The quantitative approach entails cross-tabulations with chi-square tests as well as significance tests of proportions. The qualitative approach involves an analysis of individual case stories, in-depth probes, and focus group discussions for content. The findings show disconnect between: (1) the information service providers give to young people and young people's actual needs and desires; (2) adolescents' fears and their actual preventive practices; and (3) the high level of reported condom use and the frequency of use. Programs need to recognize that young people perinatally infected with HIV are sexually active or anticipatebeing so in future.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | DATA ANALYSIS | YOUTH | PERSONS LIVING WITH HIV/AIDS | ADOLESCENT PREGNANCY | HIV INFECTIONS | AIDS | HIV PREVENTION | SEX BEHAVIOR | FEAR | CONDOM USE | PREGNANCY, UNWANTED | REPRODUCTIVE HEALTH | HEALTH SERVICES | NEEDS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Reproductive Behavior | Fertility | Population Dynamics | Behavior | Emotions | Psychological Factors | Risk Reduction Behavior | Health | Delivery of Health Care | Economic Factors
Document Number: 339860

19.

Peer Reviewed

Title: Sexual behavior and desires among adolescents perinatally infected with human immunodeficiency virus in Uganda: implications for programming.
Author: Birungi H; Mugisha JF; Obare F; Nyombi JK
Source: Journal of Adolescent Health. 2009 Feb;44(2):184-187.
Abstract: Counseling programs for adolescents living with HIV encourage abstinence from sex and relationships. This Uganda study, however, found that many of these adolescents are sexually active or desire to be in relationships but engage in poor preventive practices. Programs for HIV and AIDS programs need to strengthen preventive services to this group.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | ADOLESCENTS | HIV INFECTIONS | SEX BEHAVIOR | FETUS | NEEDS | PREVENTION AND CONTROL | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Behavior | Pregnancy | Reproduction | Economic Factors
Document Number: 330162

20.

Peer Reviewed

Title: Kaposi sarcoma-associated herpesvirus (KSHV) seroprevalence in population-based samples of African children: evidence for at least 2 patterns of KSHV transmission.
Author: Butler LM; Dorsey G; Hladik W; Rosenthal PJ; Brander C; Neilands TB; Mbisa G; Whitby D; Kiepiela P; Mosam A; Mzolo S; Dollard SC; Martin JN
Source: Journal of Infectious Diseases. 2009 Aug 1;200(3):430-8.
Abstract: BACKGROUND: Kaposi sarcoma-associated herpesvirus (KSHV) infection is endemic among adult populations in Africa. A prevailing view is that childhood transmission is primarily responsible for the high seroprevalence of KSHV among adults that is observed throughout the continent. However, few studies have directly examined children, particularly in locations where KS is not commonly endemic. METHODS: Participants were children aged 1.5-8.9 years, including 427 children from a population-based sample in South Africa, 422 from a population-based sample in Uganda, and 567 from a clinic-based sample in Uganda. All serum specimens were tested by the same laboratory for KSHV antibodies with use of 2 enzyme immunoassays (against K8.1 and ORF65) and 1 immunofluorescence assay. RESULTS: KSHV seroprevalence was 7.5%-9.0% among South African children and was not associated with age. In contrast, in the Ugandan population-based sample, KSHV seroprevalence increased from 10% among 2-year-old children to 30.6% among 8-year-old children ([Formula: see text]). In the Ugandan clinic-based sample, seroprevalence increased from 9.3% among 2-year-old children to 36.4% among 8-year-old children ([Formula: see text]). CONCLUSION: Two distinct relationships between age and KSHV infection among children imply that KSHV transmission among children is not uniform throughout Africa and is therefore not always responsible for the high seroprevalence observed in adults. There are at least 2 patterns of KSHV transmission in Africa.
Language: English
Keywords:
SOUTH AFRICA | UGANDA | RESEARCH REPORT | CHILDREN | HIV TESTING | LABORATORY PROCEDURES | HIV TRANSMISSION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Africa, Eastern | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases
Document Number: 342893

21.

Peer Reviewed

Title: Longitudinal antiretroviral adherence in HIV+ Ugandan parents and their children initiating HAART in the MTCT-plus family treatment model: role of depression in declining adherence over time.
Author: Byakika-Tusiime J; Crane J; Oyugi JH; Ragland K; Kawuma A; Musoke P; Bangsberg DR
Source: AIDS and Behavior. 2009 Jun;13(Suppl 1):S82-S91.
Abstract: The authors conducted a study to assess the effect of family-based treatment on adherence amongst HIV-infected parents and their HIV-infected children attending the Mother-To-Child-Transmission Plus program in Kampala, Uganda. Adherence was assessed using home-based pill counts and self-report. Mean adherence was over 94%. Depression was associated with incomplete adherence on multivariable analysis. Adherence declined over time. Qualitative interviews revealed lack of transportation money, stigma, clinical response to therapy, drug packaging, and cost of therapy may impact adherence. Our results indicate that providing ART to all eligible HIV-infected members in a household is associated with excellent adherence in both parents and children. Adherence to ART among new parents declines over time, even when patients receive treatment at no cost. Depression should be addressed as a potential barrier to adherence. Further study is necessary to assess the long-term impact of this family treatment model on adherence to ART in resource-limited settings.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | FOCUS GROUPS | PARENTS | CHILDREN | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | QUESTIONNAIRES | DEPRESSION | PACKAGING | STIGMA | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | HIV | Behavior | Mental Disorders | Marketing | Economic Factors | Social Problems
Document Number: 341904

22.

Peer Reviewed

Title: Improvement of the patient flow in a large urban clinic with high HIV seroprevalence in Kampala, Uganda.
Author: Castelnuovo B; Babigumira J; Lamorde M; Muwanga A; Kambugu A; Colebunders R
Source: International Journal of STD and AIDS. 2009 Feb;20(2):123-4.
Abstract: Antiretroviral treatment roll-out programmes in Africa often have difficulties to cope with the increasing number of clients. Based on the findings of a survey carried out in 2005 that showed long waiting times, innovative organizational changes (nurse visits and pharmacy-only refill visits) were introduced in our clinic. In August 2007, the survey was repeated to evaluate the impact of these changes. During both surveys we used the same standardized questionnaire. In 2007, 400 patients visited the clinic on the study day compared to 250 in 2005. The median time spent at the clinic decreased from 157 minutes in 2005 (range 22-426) to 124 minutes (15-314). All the waiting times for different services decreased except the time between the visit to the triage nurse and the doctors' visit. A similar methodology could be used by other health services to evaluate and compare different models of care.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | CLINICAL RESEARCH | SURVEYS | URBAN POPULATION | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | CLINIC VISITS | ANTIRETROVIRAL THERAPY | AIDS PREVENTION | CAPACITY BUILDING | TIME FACTORS | ORGANIZATION AND ADMINISTRATION | WAITING AREAS AND QUEUES | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Sampling Studies | Studies | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Service Statistics | Program Activities | Programs | HIV | AIDS | Program Sustainability | Population Dynamics | Workplace | Employment | Macroeconomic Factors | Economic Factors
Document Number: 331091

23.

Title: Three-year outcome data of second-line antiretroviral therapy in Ugandan adults: good virological response but high rate of toxicity.
Author: Castelnuovo B; John L; Lutwama F; Ronald A; Spacek LA
Source: Journal of the International Association of Physicians in AIDS Care. 2009 Jan-Feb;8(1):52-59.
Abstract: Objective: To evaluate the safety and virological response to lopinavir/ritonavir containing second-line therapy after failing a first line nonnucleoside reverse transcriptase inhibitor NNRTI) based regimen. Design. Prospective 36 months cohort study of patients switched to zidovudine/stavudine plusdidanosine plus lopinavir/ritonavir capsules as second-line regimen. Methodology. Structured interview, medical examination and laboratory assessment performed every 6 months. Results. We enrolled 40 patients; 1 died and 3 were lost to follow-up. Median CD4+count at baseline was 108cell/microL, median log viral load was 4.8 copies/mL. Sixteen (40%) patients had baseline genotypic resistant test, 14 (87%) had lamivudine resistance mutations, and all had NNRTIs resistance mutations. At month 36, 82% of the patients achieved viral suppression (<400copies/mL) and the median increase in CD4+count was 214 cell/microL, (interquartile range: 128-295). Twenty-five patients (62%) experienced at least one adverse event. Conclusions. Our study confirms lopinavir/ritonavir-based second-line regimen but with a high rate of toxicities.
Language: English
Keywords:
AFRICA | UGANDA | RESEARCH REPORT | ADULTS | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL DRUGS | ANTIRETROVIRAL THERAPY | TOXICITY | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Age Factors | Population Characteristics | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Physiology | Biology
Document Number: 331330

24.

Peer Reviewed

Title: Two-year virologic outcomes of an alternative AIDS care model: evaluation of a peer health worker and nurse-staffed community-based program in Uganda.
Author: Chang LW; Alamo S; Guma S; Christopher J; Suntoke T; Omasete R; Montis JP; Quinn TC; Juncker M; Reynolds SJ
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Mar 1;50(3):276-82.
Abstract: BACKGROUND: There is growing concern about the human resources needed to care for increasing numbers of patients receiving antiretroviral therapy in resource-limited settings. We evaluated an alternative model, community-based, comprehensive antiretroviral program staffed primarily by peer health workers and nurses. METHODS: We conducted a retrospective cohort study of patients receiving antiretroviral therapy during the first 10 months of program enrollment beginning in late 2003. Virologic, immunologic, clinical, and adherence data were collected. RESULTS: Of 360 patients started on treatment, 258 (72%) were active and on therapy approximately 2 years later. Viral load testing demonstrated that 86% of active patients (211/246 tested) had a viral load <400 copies per milliliter. The median CD4 increase for active patients was 197 cells per cubic millimeter (interquartile range, 108-346). Patients with either a history of antiretroviral use or lack of CD4 response were more likely to experience virologic failure. Survival was 84% at 1 year and 82% at 2 years. World Health Organization stage 4 was predictive of both not sustaining therapy and increased mortality. CONCLUSIONS: A community-based antiretroviral treatment program in a resource-limited setting can provide excellent AIDS care over at least a 2-year period. A comprehensive program based upon peer health workers and nurses provides an effective alternative model for AIDS care.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | COHORT ANALYSIS | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HEALTH PERSONNEL | ANTIRETROVIRAL THERAPY | AIDS | HEALTH SERVICES | USER COMPLIANCE | TREATMENT | PROGRAM EVALUATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Delivery of Health Care | Health | HIV | Behavior | Medical Procedures | Medicine
Document Number: 330892

25.

Peer Reviewed

Title: Comparison of laboratory methods for analysis of non-nucleoside reverse transcriptase inhibitor resistance in Ugandan infants.
Author: Church JD; Huang W; Parkin N; Marlowe N; Guay LA; Omer SB; Musoke P; Jackson JB; Eshleman SH
Source: AIDS Research and Human Retroviruses. 2009 Jul;25(7):657-63.
Abstract: Detailed comparisons of HIV drug resistance assays are needed to identify the most useful assays for research studies, and to facilitate comparison of results from studies that use different methods. We analyzed nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance in 40 HIV-infected Ugandan infants who had received nevirapine (NVP)-based prophylaxis using the following assays: an FDA-cleared HIV genotyping assay (the ViroSeq HIV-1 Genotyping System v2.0), a commercially available HIV genotyping assay (GeneSeq HIV), a commercially available HIV phenotyping assay (PhenoSense HIV), and a sensitive point mutation assay (LigAmp). ViroSeq and GeneSeq HIV results (NVP resistance yes/no) were similar for 38 (95%) of 40 samples. In 6 (15%) of 40 samples, GeneSeq HIV detected mutations in minor subpopulations that were not detected by ViroSeq, which identified two additional infants with NVP resistance. LigAmp detected low-level mutations in 12 samples that were not detected by ViroSeq; however, LigAmp testing identified only one additional infant with NVP resistance. GeneSeq HIV and PhenoSense HIV determinations of susceptibility differed for specific NNRTIs in 12 (31%) of the 39 samples containing mixtures at relevant mutation positions. PhenoSense HIV did not detect any infants with NVP resistance who were not identified with GeneSeq HIV testing. In this setting, population sequencing-based methods (ViroSeq and GeneSeq HIV) were the most informative and had concordant results for 95% of the samples. LigAmp was useful for the detection and quantification of minority variants. PhenoSense HIV provided a direct and quantitative measure of NNRTI susceptibility.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | DATA ANALYSIS | COMPARATIVE STUDIES | RESEARCH METHODOLOGY | INFANT | PERSONS LIVING WITH HIV/AIDS | HIV | POPULATION GENETICS | LABORATORY PROCEDURES | HIV TESTING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Genetics | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342880

26.

Peer Reviewed

Title: In utero HIV infection is associated with an increased risk of nevirapine resistance in ugandan infants who were exposed to perinatal single dose nevirapine.
Author: Church JD; Mwatha A; Bagenda D; Omer SB; Donnell D; Musoke P; Nakabiito C; Eure C; Bakaki P; Matovu F; Thigpen MC; Guay LA; McConnell M; Fowler MG; Jackson JB; Eshleman SH
Source: AIDS Research and Human Retroviruses. 2009 Jul;25(7):673-7.
Abstract: Use of single dose nevirapine (sdNVP) to prevent HIV mother-to-child transmission is associated with the emergence of NVP resistance in many infants who are HIV infected despite prophylaxis. We combined results from four clinical trials to analyze predictors of NVP resistance in sdNVP-exposed Ugandan infants. Samples were tested with the ViroSeq HIV Genotyping System and a sensitive point mutation assay (LigAmp, for detection of K103N, Y181C, and G190A). NVP resistance was detected at 6-8 weeks in 36 (45.0%) of 80 infants using ViroSeq and 33 (45.8%) of 72 infants using LigAmp. NVP resistance was more frequent among infants who were infected in utero than among infants who were diagnosed with HIV infection after birth by 6-8 weeks of age. Detection of NVP resistance at 6-8 weeks was not associated with HIV subtype (A vs. D), pre-NVP maternal viral load or CD4 cell count, infant viral load at 6-8 weeks, or infant sex. NVP resistance was still detected in some infants 6-12 months after sdNVP exposure. In this study, in utero HIV infection was the only factor associated with detection of NVP resistance in infants 6-8 weeks after sdNVP exposure.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | CLINICAL TRIALS | INFANT | TREATMENT | HIV PREVENTION | ANTIRETROVIRAL DRUGS | DRUG RESISTANCE | PERSONS LIVING WITH HIV/AIDS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Clinical Research | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases
Document Number: 342890

27.

Title: Combating cross-generational sex in Uganda.
Author: Clifton D
Source: Washington, D.C., Population Reference Bureau [PRB], 2009 Feb. [3] p.
Abstract: Cross-generational sex -- or Sugar Daddy syndrome -- is a pattern of sexual behavior between young women and much older men that brings increased health risks and consequences for young women. In most cases of cross-generational sex, the women are ages 15 to 19 and unmarried; their male partners are at least 10 years older. Although most cross-generational sex is based on the exchange of favors or material goods, it is different from commercial sex or prostitution. Sadly, few large-scale interventions have been undertaken to combat this risky behavior and even fewer have been evaluated to show how well they actually work. However, in Uganda, an important collaboration between the government, local organizations, and USAID may be leading the way. The association of cross-generational sex with unsafe behaviors and HIV risk makes the practice a priority for attention in Africa. While there is much work to be done, this program has successfully involved the community in its efforts. In one year, audiences sent in more than 900 letters with questions and comments about the radio dramas and related materials. Y.E.A.H. has obviously struck a resonant chord in Uganda -- one that could possibly be replicated in other countries in sub-Saharan Africa. (Excerpts)
Language: English
Keywords:
UGANDA | SUMMARY REPORT | YOUTH | WOMEN | SUGAR DADDIES | TRANSACTIONAL SEX | RISK BEHAVIOR | SEX BEHAVIOR | INTERVENTIONS | PROGRAM EVALUATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Programs | Organization and Administration
Document Number: 331482

28.

Peer Reviewed

Title: High retention and appropriate use of insecticide-treated nets distributed to HIV-affected households in Rakai, Uganda: results from interviews and home visits.
Author: Cohee L; Mills LA; Kagaayi J; Jacobs I; Galiwango R; Ludigo J; Ssekasanvu J; Reynolds SJ
Source: Malaria Journal. 2009;8:76.
Abstract: BACKGROUND: Distribution of insecticide-treated nets (ITNs) has recently been incorporated into comprehensive care strategies for HIV-positive people in malaria-endemic areas. WHO now recommends free or low-cost distribution of ITNs to all persons in malaria-endemic areas, regardless of age, pregnancy and HIV status. Knowledge about and appropriate use of ITNs among HIV-positive ITN recipients and their household members has not been well characterized. METHODS: 142 randomly selected adults were interviewed in July-August 2006 to assess knowledge, retention, and appropriate use of ITNs they had received through a PEPFAR-funded comprehensive HIV care programme in rural Uganda. RESULTS: Among all participants, 102 (72%, CI: 65%-79%) reported they had no ITNs except those provided by the programme. Of 131 participants who stated they were given >or= 1 ITN, 128 (98%, CI: 96%-100%) stated they still possessed at least one programme-provided ITN. Reported programme-ITN (pITN) use by participants was high: 119 participants (91%, CI: 86%-96%) reported having slept under pITN the night prior to the survey and 115 (88%, CI: 82%-94%) reported sleeping under pITN seven days per week. Being away from home and heat were the most common reasons given for not sleeping under an ITN. A sub-study of thirteen random home visits demonstrated concordance between participants' survey reports and actual use of ITNs in homes. CONCLUSION: There was excellent self-reported retention and appropriate use of ITNs distributed as a part of a community-based outpatient HIV care programme. Participants perceived ITNs as useful and were unlikely to have received ITNs from other sources.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | KAP SURVEYS | PERSONS LIVING WITH HIV/AIDS | HOUSEHOLDS | RURAL POPULATION | PESTICIDES | BED NETS | HOME VISITS | HIV INFECTIONS | MALARIA PREVENTION | KNOWLEDGE | PARTICIPATION | PROGRAM EVALUATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Viral Diseases | Diseases | Family and Household | Sociocultural Factors | Population Characteristics | Demographic Factors | Population | Ingredients and Chemicals | Parasite Control | Public Health | Health | Communication | Malaria | Parasitic Diseases | Social Behavior | Behavior | Programs | Organization and Administration
Document Number: 341152

29.
Title: [Czech model for decrease of maternal mortality in Uganda] Cesky model pro snizeni materske umrtnosti v Ugande.
Author: Donat J
Source: Casopis Lekaru Ceskych. 2009;148(7):338-41.
Abstract: High maternal and perinatal mortality is the leading problem of the health care in developing countries of Sub-Saharan Africa, including Uganda. The main condition for decrease of maternal mortality is availability of an emergency obstetrical care in hospital accompanied by skilled team of specialists (gynaecologist, anaesthesiologist, paediatrician), which are able to treat all obstetrical complications and provide an intensive care to risk newborns. The Czech Hospital and School for midwives in Uganda was founded and build with the aim to accomplish a grant project for the decrease of maternal, perinatal and child mortality. Our project to connect emergency obstetrical care in hospital to villages and traditional delivery attendants by mobile phones shows a simple and original model, which can help to decrease maternal mortality in Uganda and in the other countries of Sub-Saharan Africa as well. The Czech-Uganda Hospital started its work on 19th February 2007 with a team of Slovak doctors; however, till now, after 2 years of work, it doesn't fulfil its role of a specialised obstetrical department, which would be able to join its partners in villages and start the grant project for decrease of maternal and perinatal mortality.
Language: Czech
Keywords:
UGANDA | AFRICA, SUB SAHARAN | RESEARCH REPORT | MATERNAL MORTALITY | PERINATAL MORTALITY | EMERGENCY SERVICES | PREGNANCY COMPLICATIONS | MIDWIVES AND MIDWIFERY | PREVENTION AND CONTROL | Africa, Eastern | Africa | Developing Countries | Mortality | Population Dynamics | Demographic Factors | Population | Health Services | Delivery of Health Care | Health | Diseases | Health Personnel
Document Number: 342652

30.

Peer Reviewed

Title: Infant feeding among HIV-positive mothers and the general population mothers: comparison of two cross-sectional surveys in Eastern Uganda.
Author: Fadnes LT; Engebretsen IM; Wamani H; Semiyaga NB; Tylleskar T; Tumwine JK
Source: BMC Public Health. 2009;9:124.
Abstract: BACKGROUND: Infant feeding recommendations for HIV-positive mothers differ from recommendations to mothers of unknown HIV-status. The aim of this study was to compare feeding practices, including breastfeeding, between infants and young children of HIV-positive mothers and infants of mothers in the general population of Uganda. METHODS: This study compares two cross-sectional surveys conducted in the end of 2003 and the beginning of 2005 in Eastern Uganda using analogous questionnaires. The first survey consisted of 727 randomly selected general-population mother-infant pairs with unknown HIV status. The second included 235 HIV-positive mothers affiliated to The Aids Support Organisation, TASO. In this article we compare early feeding practices, breastfeeding duration, feeding patterns with dietary information and socio-economic differences in the two groups of mothers. RESULTS: Pre-lacteal feeding was given to 150 (64%) infants of the HIV-positive mothers and 414 (57%) infants of general-population mothers. Exclusive breastfeeding of infants under the age of 6 months was more common in the general population than among the HIV-positive mothers (186 [45%] vs. 9 [24%] respectively according to 24-hour recall). Mixed feeding was the most common practice in both groups of mothers. Solid foods were introduced to more than half of the infants under 6 months old among the HIV-positive mothers and a quarter of the infants in the general population. Among the HIV-positive mothers with infants below 12 months of age, 24 of 90 (27%) had stopped breastfeeding, in contrast to 9 of 727 (1%) in the general population. The HIV-positive mothers were poorer and had less education than the general-population mothers. CONCLUSION: In many respects, HIV-positive mothers fed their infants less favourably than mothers in the general population, with potentially detrimental effects on both the child's nutrition and the risk of HIV transmission. Mixed feeding and pre-lacteal feeding were widespread. Breastfeeding duration was shorter among HIV-positive mothers. Higher educational level and being socio-economically better off were associated with more beneficial infant feeding practices.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | COMPARATIVE STUDIES | MOTHERS | PERSONS LIVING WITH HIV/AIDS | INFANT NUTRITION | BREASTFEEDING | SOCIOECONOMIC STATUS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Nutrition | Health | Socioeconomic Factors | Economic Factors | Disease Transmission Control | Prevention and Control
Document Number: 341408


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