Research Articles

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Browsing Research Articles by Author "Aleni, Mary"

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    High prevalence of malaria in pregnancy among women attending antenatal care at a large referral hospital in northwestern Uganda:
    (PLOS One, 2023-04-05) Mangusho, Caleb; Mwebesa, Edson; Izudi, Jonathan; Aleni, Mary; Dricile, Ratib; Mangwi, Richard Ayiasi; Legason, Ismail Draguma
    Background Malaria in pregnancy contributes to substantial morbidity and mortality among women in Uganda. However, there is limited information on the prevalence and factors associated with malaria in pregnancy among women in Arua district, northwestern Uganda. We, therefore, assessed the prevalence and factors associated with malaria in pregnancy among women attending routine antenatal care (ANC) clinics at Arua regional referral hospital in north-western Uganda. Methods We conducted an analytic cross-sectional study between October and December 2021. We used a paper-based structured questionnaire to collect data on maternal socio-demographic and obstetric factors and malaria preventive measures. Malaria in pregnancy was defined as a positive rapid malarial antigen test during ANC visits. We performed a modified Poisson regression analysis with robust standard errors to determine factors independently associated with malaria in pregnancy, reported as adjusted prevalence ratios (aPR) and 95% confidence intervals (CI). Results We studied 238 pregnant women with a mean age of 25.32±5.79 years that attended the ANC clinic, all without symptomatic malaria. Of the participants, 173 (72.7%) were in their second or third trimester, 117 (49.2%) were first or second-time pregnant women, and 212 (89.1%) reported sleeping under insecticide-treated bednets (ITNs) every day. The prevalence of malaria in pregnancy was 26.1% (62/238) by rapid diagnostic testing (RDT), with the independently associated factors being daily use of insecticide-treated bednets (aPR 0.41, 95% CI 0.28, 0.62), first ANC visit after 12 weeks of gestation (aPR1.78, 95% CI 1.05, 3.03), and being in the second or third trimester (aPR 0.45, 95% CI 0.26, 0.76). Conclusion The prevalence of malaria in pregnancy among women attending ANC in this setting is high. We recommend the provision of insecticide-treated bednets to all pregnant women and early ANC attendance to enable access to malaria preventive therapy and related interventions.
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    “I don’t support It for my children”: perceptions of parents and guardians regarding the use of modern contraceptives by adolescents in Arua City, Uganda
    (Hindawi, 2023-04-03) Vuamaiku, Godfrey Jalinga; Epuitai, Joshua; Andru, Monicah; Aleni, Mary
    Despite the high rates of adolescent pregnancies, the utilization of modern contraceptives is still low among adolescents in Uganda which highlights a missed opportunity for the prevention of unwanted pregnancies among adolescents. We explored the perception of parents and guardians regarding the use of modern contraceptives by adolescents and the roles parents and guardians play in the use of modern contraceptives by the adolescents. A descriptive qualitative study was conducted in one of the suburbs of Arua city in the West Nile subregion in Uganda. Fifteen (15) in-depth interviews were conducted with parents and or guardians to explore their perceptions and roles regarding the use of modern contraceptives by adolescents. Thematic analysis was used in qualitative data analysis. Parents did not support adolescents’ use of modern contraceptives. Lack of parental support was related to perceptions that modern contraceptives promote sexual promiscuity, fear that it causes infertility and that it is incompatible with cultural, religious, and moral norms. Parents and guardians opted to emphasize the importance of abstinence, conformity with cultural and religious norms, and the need to focus on completing school instead of encouraging the use of modern contraceptives. Few parents and guardians supported the use of modern contraceptives, specifically condoms, to prevent unwanted pregnancy by the adolescents and parents/guardians, sexually transmitted infections, and early school dropouts. Parents and guardians expressed feelings of inadequacy related to discussions on contraception use with their adolescent children and therefore avoided talking about it. Our study reveals a lack of parental support regarding the use of modern contraceptives among adolescents. Public health interventions which promote intergenerational, socioculturally, and religiously appropriate communication should be instituted in the communities in order to promote sustainable adoption of modern contraceptive use among adolescents.
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    Missed diagnosis of gestational diabetes mellitus due to selective screening: Evidence from a cross-sectional study in the West Nile Sub-Region, Uganda
    (Taylor & Francis, 2024-03-13) Abindu, Vincent; Hope, Derick; Aleni, Mary; Andru, Monicah; Mangwi, Richard Ayiasi; Afayo, Victor; Oyet, Caesar; Kiconco, Ritah
    Purpose: To ascertain the prevalence and risk factors of gestational diabetes mellitus (GDM) in pregnant women receiving antenatal care (ANC) services within the West Nile subregion of Uganda. An analytical cross-sectional study was conducted on 233 pregnant women who are within 24–28 weeks of gestation and are receiving ANC services in selected hospitals. GDM was diagnosed according to the World Health Organization (WHO) criteria (2013). A questionnaire and anthropometric measurements were used to obtain relevant data. The chi-square test and logistic regression were used to determine the association between GDM and the study variables, including participants’ sociodemographic and medical characteristics. The prevalence of hyperglycemia first detected in pregnancy among the participants tested was 8%. Overall, 7.45% had GDM and 0.53% had diabetes mellitus in pregnancy. The fasting plasma glucose test alone was positive in 86.7% of the GDM cases. The factors that were significantly associated with GDM included age ≥25 years (p = 0.017, AOR = 3.51) and body mass index (BMI) ≥25 kg/m2 (p = 0.024, AOR = 2.67). Out of the participants diagnosed with GDM, 28.6% did not have a known risk factor. Of the pregnant women with GDM, 57% would have been missed if the selective screening in the national clinical guidelines had been followed. Urinary tract infection (UTI) and Candida were detected in 36.36% and 13.85% of the participants, respectively. Conclusion: The study provides new data on the prevalence of GDM in rural settings in the West Nile subregion of Uganda. Of the participants, 7.5% were diagnosed with GDM, of which 57% would have been missed based on the selective screening of the national clinical guidelines. The study findings support the universal screening of GDM in pregnant women.
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    The state of patient-centered care and associated factors at a large referral hospital in Northwestern Uganda: Perceptions of patients
    (Elsevier, 2024-11-07) Aleni, Mary; Mwebesa, Edson; Twesigye, Deus; Andru, Monicah; Assusi, Mildred Edna; Atuhairwe, Irene; Nsubuga, Allan G.; Ewing, Helen; Roepke, Abbey
    Background: A Patient-Centered Care (PCC) approach to health service delivery is considered one of the essential domains of healthcare quality. This has been shown to improve patient satisfaction with health services and patient outcomes, but it has not been fully embraced in many low and middle income countries. Purpose: To evaluate patients’ perceptions of PCC and identify the factors influencing perceived PCC at a large referral hospital in Northwestern Uganda. Materials and Methods: We conducted a descriptive cross-sectional correlational study. Four hundred and eighty (480) patients or their attendants participated in the study. Data was collected using an interviewer administered questionnaire. Statistical analysis was applied at univariate, bivariate and multivariate levels using Stata V.14 to assess the state of PCC, patient perceptions and factors associated with perceived PCC. Results: Sixty five percent (64.8 %) of the participants perceived they received PCC. Most of the dimensions of PCC were rated high on a 5-point Likert scale, with respect for patient’s values and preferences ranked highest; mean score of 3.9 (SD = 0.9) and coordination of care ranked lowest, mean score of 3.5 (SD = 0.9). Being outpatient, single or never in union had a reduced perception score of PCC. Patients who had heard of PCC had a higher perception of PCC. Conclusion: Patient-Centered Care was rated optimally at ARRH. All the PCC dimensions were rated highly except coordination of care and information, education and communication which could be improved by building the capacity of health workers in effective communication and coordination of health care services.
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    Unsatisfactory COVID-19-related knowledge, attitudes and practices among undergraduate university students in Uganda: an online cross-sectional survey
    (Scientific Research Publishing, 2021-06) Nyeko, Richard; Amanya, Sharon B.; Aleni, Mary; Akello, Franceska
    This study examined the COVID-19-related knowledge, attitude and practices among undergraduate students in Uganda. An online cross-sectional survey was conducted from 12th-19th June 2020 among undergraduate students using a standard questionnaire designed using Google Forms sent via WhatsApp Messenger. The data were analyzed using SPSS. Pearson’s Chi-square test was used to test the differences and odds ratios with their 95% confidence intervals were used for quantifying the association between independent and dependent variables. p < 0.05 was considered significant. A cut-off score of ≥80% was used to denote sufficient knowledge, positive attitude, and good practices. Of the 161 respondents, 102 (63.4%) were males with a mean age of 24.2 (5.0) years. The majority 121 (75.2%) were pursuing health-related programs and overall, 110 (68.3%) had sufficient knowledge while 76 (47.2%) had a positive attitude and good practice each. Knowledge and attitude were significantly associated with health-related programs (AOR 4.78, 95% CI 2.06 - 11.07; p < 0.001) and (AOR 3.18, 95% CI 1.33 - 7.62; p = 0.010) respectively. The practice was associated with the male gender (AOR 2.37, 95% CI 1.19 - 4.73; p = 0.014). The most commonly cited sources of COVID-19 information were news media 147 (91.3%), Ministry of Health 134 (83.2%), and social media 125 (77.6%). The ministry of health was considered the most trustworthy source 139 (86.3%) and social media the least 21 (13.0%). COVID-19-related knowledge, attitude and practices among undergraduates in Uganda were low overall. Therefore, concerted efforts to provide tailored health education and behaviour change communication are needed.