Browsing by Author "Ssenyonga, Ronald"

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    Adverse drug reaction reporting with the Med Safety app inUganda: a cluster-randomised, controlled trial
    (Elsevier, 2025-10) Kiguba, Ronald; Ndagije, Helen B.; Mwebaza, Norah; Ssenyonga, Ronald; Giibwa, Lilian; Isabirye, Gerald; Owiny, Jonathan; Nambasa, Victoria; Ntale, Ismail; Atuhaire, Joanitah; Mwesigwa, Douglas; Mayengo, Julius; Walusimbi, David; Mugisa, Ian; Katureebe, Cordelia; Harrison, Kendal; Karamagi, Charles; Pirmohamed, Munir
    Background: The massive roll-out of new and repurposed medicines in low-income and middle-income countries (LMICs) highlights the need for more efficient pharmacovigilance systems, including use of digital technologies. We assessed the effectiveness of the Med Safety app in improving suspected adverse drug reaction (ADR) reporting by health-care workers to Uganda's National Pharmacovigilance Centre. Methods: This was a pragmatic, multicentre, open-label, cluster-randomised, controlled trial undertaken at health facilities (clusters), providing dolutegravir-based combination antiretroviral therapy in Uganda. Clusters were randomly assigned (1:1) to the intervention group or control group using a computer-generated simple randomisation sequence. In the intervention group, pharmacists with expertise in pharmacovigilance delivered 2 h of face-to-face training to health-care workers in clusters, regardless of their smartphone ownership, in Med Safety and traditional ADR reporting methods. The control group received the same training as the intervention group except for Med Safety training. The primary outcome was the cluster-level ADR reporting rate at the end of follow-up and was analysed in all sites that received the allocated intervention. The trial is registered with the Pan African Clinical Trials Registry (PACTR202009822379650) and is completed. Findings: Between Aug 11, 2020 and Nov 1, 2022, 382 clusters were randomly assigned and 367 received the allocated intervention and were included in the primary outcome analysis (184 in the intervention group and 183 in the control group), with 2464 health-care workers (1211 in the intervention group and 1253 in the control group). The follow-up time for the included clusters was variable and was median 37·8 months (IQR 34·2–39·8). In the primary analysis, the intervention group had a higher mean overall ADR reporting rate of 10·6 (SD 17·4) reports per 100 000 person-months versus 5·9 (17·9) in the control group (incidence rate ratio 1·73 [95% CI 1·26–2·37]; p=0·001). Interpretation: Med Safety increased ADR reporting rates among health-care workers in Uganda. Integrating digital technologies into pharmacovigilance systems could strengthen drug-safety monitoring in Uganda and other LMICs.
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    Association between childhood sexual violence and low educational attainment among young people aged 18-24: Evidence from the 2018 Uganda violence against children survey
    (Child Protection and Practice, 2025-02-18) Ndibalekera, Maria; Bangirana, Clare Ahabwe; Amollo, Mathew; Olido, Kenneth; Kafuko, Agatha; Opobo, Timothy; Ssenyonga, Ronald
    Background: Researchers have identified various factors that contribute to low levels of educational attainment. However, studies examining the association between childhood sexual violence victimization and educational attainment remain scarce. Understanding this relationship is vital since experiencing violence during childhood is associated with poor educational outcomes and a higher likelihood of financial difficulties and employment issues later in life. Objective: This study sought to understand the association between childhood sexual violence victimization and low educational attainment for male and female young adults. Participants and setting: The study uses data from the Uganda Violence Against Children Survey (2018), focusing on participants aged 18-24. Methods: Secondary analysis was done using STATA 14 among participants aged 18-24 years from whom responses on childhood sexual violence (CSV) victimization were solicited. CSV was measured in its different forms i.e., unwanted sexual touches, attempted forced sex, physically forced sex, pressured sex and sexual exploitation, while low educational attainment was defined as being out of school and having primary or less as the highest level of education. Bivariable analysis and multivariable logistic regressions were conducted. Results: The majority (67.2%) of the sample of 2312 young adults had low educational attainment. Basing on the different forms of childhood sexual violence victimization (sexual exploitation, unwanted sexual touches, attempted forced sex, physically forced sex and pressured sex), low education attainment ranged between 59.2% and 72.3% for males and 50.9% and 72.4% for females. The different forms of CSV were not significantly associated with low educational attainment except attempted forced sex among females (P=0.011) in the bivariate analysis and child marriage in the multivariate model (P=0.022). Conclusion: Low levels of educational attainment in Uganda are prevalent and could be influenced by various factors that warrant further investigation. There is a need for additional research to clarify the association between childhood sexual violence victimization and low educational attainment. Considering the well -established advantages of education for individuals and communities, it is essential to strengthen initiatives aimed at increasing both access to and the quality of educational services.
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    Association between childhood sexual violence and low educational attainment among young people aged 18–24: Evidence from the 2018 Uganda violence against children survey
    (Elsevier, 2025-02-21) Ndibalekera, Maria; Bangirana, Clare Ahabwe; Amollo, Mathew; Olido, Kenneth; Kafuko, Agatha; Opobo, Timothy; Ssenyonga, Ronald
    Background Researchers have identified various factors that contribute to low levels of educational attainment. However, studies examining the association between childhood sexual violence victimization and educational attainment remain scarce. Understanding this relationship is vital since experiencing violence during childhood is associated with poor educational outcomes and a higher likelihood of financial difficulties and employment issues later in life. Objective This study sought to understand the association between childhood sexual violence victimization and low educational attainment for male and female young adults. Participants and setting. The study uses data from the Uganda Violence Against Children Survey (2018), focusing on participants aged 18–24. Methods Secondary analysis was done using STATA 14 among participants aged 18–24 years from whom responses on childhood sexual violence (CSV) victimization were solicited. CSV was measured in its different forms i.e., unwanted sexual touches, attempted forced sex, physically forced sex, pressured sex and sexual exploitation, while low educational attainment was defined as being out of school and having primary or less as the highest level of education. Bivariable analysis and multivariable logistic regressions were conducted. Results The majority (67.2%) of the sample of 2312 young adults had low educational attainment. Basing on the different forms of childhood sexual violence victimization (sexual exploitation, unwanted sexual touches, attempted forced sex, physically forced sex and pressured sex), low education attainment ranged between 59.2% and 72.3% for males and 50.9% and 72.4% for females. The different forms of CSV were not significantly associated with low educational attainment except attempted forced sex among females (P = 0.011) in the bivariate analysis and child marriage in the multivariate model (P = 0.022). Conclusion Low levels of educational attainment in Uganda are prevalent and could be influenced by various factors that warrant further investigation. There is a need for additional research to clarify the association between childhood sexual violence victimization and low educational attainment. Considering the well established advantages of education for individuals and communities, it is essential to strengthen initiatives aimed at increasing both access to and the quality of educational services.
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    How have unintended pregnancies and contraceptive use among adolescent girls and young women changed in Uganda? Evidence from the 2014 and 2019 PMA national surveys
    (Public Library of Science (PLOS), 2025-04-29) Kibira, Simon P.S.; Nakafeero, Mary; Amollo, Mathew; Ssenyonga, Ronald; Ndejjo, Rawlance; Anglewicz, Phil; Kukundakwe, Melody; Luzze, Mabel; Kagongwe, Samuel; Guma, Victor; Zalwango, Vivian; Makumbi, Fredrick Edward
    Unintended pregnancies among adolescent girls and young women (AGYW), and any pregnancy among adolescent girls are still a challenge, especially in Sub-Saharan Africa and Uganda. We assess prevalence of unintended pregnancy in Uganda, associated factors and contraceptive use following unintended pregnancy among adolescent girls and young women in 2014 and 2019 in Uganda. Data are from the 2014 and 2019 performance monitoring for action (PMA) surveys. There were 1,479 AGYW reporting ever/ or current pregnancy in the two surveys, 780 in 2014 and 699 in 2019. Data included socio-demographics and pregnancy intendedness. Descriptive analyses were conducted stratified by adolescent girls and young women and compared between surveys. The percent of unintended pregnancies was determined as the number of AGYW reporting unintended pregnancy divided by eligible participants. A weighted comparison of the prevalence of unintended pregnancies was made between the surveys, and statistical significance determined at a 5% type-1 error rate. All analyses were conducted with Stata version15 using svy surveyset methodology accounting for complex survey design. Relative to 2014, the 2019 survey showed a significant reduction in percent of AGYW reporting ever pregnant or given birth, 60% to 49%, p = 0.007; a decline in unintended pregnancy among adolescent girls, 52% to 42%, p = 0.049, and among young women with secondary education, 36% to 13%, p = 0.001. Conversely, the 2019 survey showed significant increase in contraception among those ever pregnant, 26% to 40%, p < 0.001; higher in young women (30% to 47%, p = 0.001) compared to adolescent girls (16% to 25%, p = 0.005). The commonest contraceptive methods were short-acting at both surveys, while the long-acting methods significantly increased among young women (20% to 35%, p = 0.003). The decline in unintended pregnancies was consistent with increased use of contraceptive methods. Although we observed a significant decline in unintended pregnancy among adolescent girls, the proportion reporting unintended pregnancy remains high.
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    One-year follow-up effects of the informed health choices secondary school intervention on students’ ability to think critically about health in Uganda: a cluster randomized trial
    (Springer Nature, 2025-02-26) Ssenyonga, Ronald; Oxman, Andrew D.; Nakyejwe, Esther; Chesire, Faith; Mugisha, Michael; Nsangi, Allen; Oxman, Matt; Rose, Christopher James; Rosenbaum, Sarah E.; Moberg, Jenny; Kaseje, Margaret; Nyirazinyoye, Laetitia; Dahlgren, Astrid; Lewin, Simon; Sewankambo, Nelson K.
    Introduction We assessed the effects of the Informed Health Choices (IHC) secondary school intervention on students’ ability to think critically about choices 1 year after the intervention. Methods We randomized eighty secondary schools to the intervention or control (usual curriculum). The schools were randomly selected from the central region of Uganda and included rural and urban, government, and privately-owned schools. One randomly selected class of year-2 students (ages 14–17) from each school participated in the trial. The intervention included a 2-day teacher training workshop, 10 lessons accessed online by teachers and delivered in classrooms during one school term (May–August 2022). The lessons addressed nine prioritized IHC concepts. We used two multiple-choice questions for each concept to evaluate the students’ ability to think critically about choices at both the end of the school term and again after 1 year. The primary outcome was the proportion of students with a passing score (≥ 9 of 18 questions answered correctly) on the “Critical Thinking about Health” (CTH) test. Results After 1-year, 71% (1749/2477) of the students in the intervention schools and 71% (1684/2376) of the students in the control schools completed the CTH test. In the intervention schools, 53% (934/1749) of students who completed the test had a passing score compared to 33% (557/1684) of students in the control schools (adjusted difference 22%, 95% CI 16–28). Conclusions The effect of the IHC secondary school intervention on students’ ability to assess health-related claims was largely sustained for at least 1 year. Trial registration Pan African Clinical Trial Registry PACTR202204861458660. Registered on 4 April 2022.
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    One‑year follow‑up effects of the informed health choices secondary school intervention on students’ ability to think critically about health in Uganda: a cluster randomized trial
    (Springer Nature, 2025-02-26) Ssenyonga, Ronald; Oxman, Andrew D.; Nakyejwe, Esther; Chesire, Faith; Mugisha, Michael; Nsangi, Allen; Oxman, Matt; Rose, Christopher James; Rosenbaum, Sarah E.; Moberg, Jenny; Kaseje, Margaret; Nyirazinyoye, Laetitia; Dahlgren, Astrid; Lewin, Simon; Sewankambo, Nelson K.
    Introduction: We assessed the effects of the Informed Health Choices (IHC) secondary school intervention on students’ ability to think critically about choices 1 year after the intervention. Methods: We randomized eighty secondary schools to the intervention or control (usual curriculum). The schools were randomly selected from the central region of Uganda and included rural and urban, government, and privately-owned schools. One randomly selected class of year-2 students (ages 14–17) from each school participated in the trial. The intervention included a 2-day teacher training workshop, 10 lessons accessed online by teachers and delivered in classrooms during one school term (May–August 2022). The lessons addressed nine prioritized IHC concepts. We used two multiple-choice questions for each concept to evaluate the students’ ability to think critically about choices at both the end of the school term and again after 1 year. The primary outcome was the proportion of students with a passing score (≥ 9 of 18 questions answered correctly) on the “Critical Thinking about Health” (CTH) test. Results: After 1-year, 71% (1749/2477) of the students in the intervention schools and 71% (1684/2376) of the students in the control schools completed the CTH test. In the intervention schools, 53% (934/1749) of students who completed the test had a passing score compared to 33% (557/1684) of students in the control schools (adjusted difference 22%, 95% CI 16–28). Conclusions: The effect of the IHC secondary school intervention on students’ ability to assess health-related claims was largely sustained for at least 1 year. Trial registration: Pan African Clinical Trial Registry PACTR202204861458660. Registered on 4 April 2022.