Browsing by Author "Dricile, Ratib"

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    Factors associated with continuity of care in hypertension and type 2 diabetes among forcibly displaced persons in the Bidibidi refugee settlement in Uganda: Protocol for a cross-sectional, mixed-methods study
    (Elsevier, 2023-03-02) Gyawali, Bishal; Dricile, Ratib; Dræbel, Tania Aase; Kyaddondo, David; Nakanjako, Rita; Nanfuka, Esther; Bygbjerg, Christian; Meyrowitsch, Dan Wolf; Skovdal, Morten
    Background: Non-communicable diseases in humanitarian settings are generally under-researched, particularly in Africa and have been called a neglected crisis. Little is known about factors affecting access to and (dis)continuity of care for chronic conditions, such as hypertension (HTN) and type 2 diabetes among forcibly displaced persons (FDPs) in Uganda. Aim:To investigate factors affecting access to and (dis)continuity of HTN and/or type 2 diabetes care among FDPs in the Bidibidi refugee settlement, Uganda. Methods: A sequential explanatory mixed-methods design incorporating methodological and investigator triangulation will be conducted. The study aims to employ a community-based participatory research approach to equitably engage community members, researchers, and other stakeholders in the research process, recognising and maximising their diverse contributions. In phase 1, the quantitative arm of the study, 960 FDPs with HTN and/or type 2 diabetes will be interviewed about their sociodemographic characteristics, health status, migration experiences, social capital, and awareness, treatment, and control of these diseases. Participants will be purposively recruited from phase 1 as well as village health teams, healthcare providers, and policymakers to participate in phase 2, the qualitative study, in order to gain more insight into how mobility and social factors affect (dis)continuity of care among FDPs with HTN and/or type 2 diabetes. Discussion: The findings from phase 1 and phase 2 of the study will be integrated through a triangulation process to provide a more holistic and comprehensive insight into the factors affecting access to and (dis)continuity for HTN and/or type 2 diabetes care among FDPs. Understanding these factors is expected to pave the way for conceptualizing health-enabling environments and strengthening health systems for FDPs with chronic conditions. It is anticipated that the study will generate baseline evidence that might be beneficial in developing and implementing HTN and diabetes care models for FDPs in the region.
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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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    Impact of mass media campaigns on knowledge of malaria prevention measures among pregnant mothers in Uganda: a propensity score‑matched analysis
    (Springer Nature, 2024-08-24) Mwebesa, Edson; Awor, Susan; Natuhamya, Charles; Dricile, Ratib; Legason, Ismail D.; Okimait, David; Mangwi, Richard Ayiasi; Tumwesigye, Nazarius M.
    Background: Uganda grapples with a considerable malaria burden, reporting prevalence rates of over 33% in some regions. To address this, the Uganda Ministry of Health employs audiovisual platforms for disseminating malaria prevention messages. However, the impact of these messages on pregnant women’s knowledge of malaria prevention remains insufficiently explored. This paper therefore emphasizes the influence of audiovisual messages on the knowledge of malaria prevention measures among pregnant women in Uganda. Methods: Secondary data obtained from the Uganda Malaria Indicator Survey (MIS) 2018–2019 was used for this analysis. Women aged 15–49 were included in the study. A total of 8868 women were selected using a two-stage sample design. The two stages of selection included clusters and households. Women who were currently pregnant were included in the study, resulting in a weighted sample of 721 women. Propensity score-matched analysis was used to evaluate the impact of access to malaria messages on knowledge of prevention measures. Results: The study revealed that 39% [95% CI 34.0–44.2] of pregnant women were exposed to malaria messages before the survey. Those exposed had a 17.2% higher knowledge [ATT = 0.172; 95% CI 0.035–0.310] of using mosquito nets for prevention compared to those unexposed. Among women exposed, radios accounted for most form of access to mass media campaigns [64.8, 95% CI 57.0–71.8] followed by interpersonal communication [45.0, 95% CI 37.6–52.6], community health workers [38.8, 95% CI 29.6–48.8], community events [21.4, 95% CI 15.8–28.3], and social mobilization [18.3, 95% CI 12.7–25.8]. Conclusion: Results highlight the importance of radios in spreading important malaria prevention messages to pregnant women. Being exposed to these messages is linked to increased awareness and knowledge about the proper use of insecticide-treated bed nets (ITNs) for preventing malaria. This finding underscores the importance of evaluating different channels for mass media campaigns to ensure the effective delivery of information about malaria prevention to the intended audiences.
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    Persistent malnutrition among children under five in pastoral communities of Aweil centre, South Sudan
    (International Journal of Scientific Research and Management (IJSRM), 2023-03) Dricile, Ratib; Chakrabartty, Arupkumar; Kabakyenga, Jerome Kahuma
    Malnutrition is one of the leading causes of morbidity and mortality among children globally, and has been linked to 60% of the 10.9M deaths annually of under-fives. High prevalence of infectious diseases contributes to malnutrition and vice versa making the situation even worse. In WHO’s African region, the median stunting prevalence is 31.3%. The worst scenarios are seen in the war tone countries; for example Aweil Center of South Sudan has consistently high malnutrition rates despite running nutrition projects by UN agencies, government and other partners with relative stability. Results from Survey carried out in 2013 indicated poverty levels at 76%, severe acute malnutrition (SAM) prevalence rate of 6.3% (95% CI, 4.5-8.9), Global acute malnutrition (GAM) rate of 22.4% (95% CI, 17.8-27.7) with under five mortality rate of 152 deaths/ 1,000 live births. A cross-sectional study with two-stage cluster sampling method done to determine the associated factors of malnutrition among children 6-59 months in Aweil Center County. The results showed high burden of infectious diseases like fever, diarrhea, eye, skin and respiratory tract infections at 94.5% with p-value 0.00022 (95%C.I, 0.1667-0.291). Very low household dietary diversity score of only 24 % (125out of 513 families). There was low coverage of primary health care interventions; e.g. Vitamin A, LLITN and measles vaccinations at 53%, 52.8% and 55% respectively. Accessibility to CBDs for iCCM associated with better nutrition status of children p-value 0.032 and OR 0.62 (95% CI 0.41-0.94). Poor feeding methods, family planning practices; and poor access roads to markets impact on nutrition status of children. Multifaceted approach is needed to root out the persistent malnutrition from Aweil Center: Shift from food aid to support of food production, scale up of primary health care and iCCM interventions to include IPT for malnourished children and community awareness on feeding practices and family planning.