12 results on '"MUKASA"'
Search Results
2. Estimating the costs of induced abortion in Uganda: A model-based analysis
- Author
-
Babigumira Joseph B, Stergachis Andy, Veenstra David L, Gardner Jacqueline S, Ngonzi Joseph, Mukasa-Kivunike Peter, and Garrison Louis P
- Subjects
Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background The demand for induced abortions in Uganda is high despite legal and moral proscriptions. Abortion seekers usually go to illegal, hidden clinics where procedures are performed in unhygienic environments by under-trained practitioners. These abortions, which are usually unsafe, lead to a high rate of severe complications and use of substantial, scarce healthcare resources. This study was performed to estimate the costs associated with induced abortions in Uganda. Methods A decision tree was developed to represent the consequences of induced abortion and estimate the costs of an average case. Data were obtained from a primary chart abstraction study, an on-going prospective study, and the published literature. Societal costs, direct medical costs, direct non-medical costs, indirect (productivity) costs, costs to patients, and costs to the government were estimated. Monte Carlo simulation was used to account for uncertainty. Results The average societal cost per induced abortion (95% credibility range) was $177 ($140-$223). This is equivalent to $64 million in annual national costs. Of this, the average direct medical cost was $65 ($49-86) and the average direct non-medical cost was $19 ($16-$23). The average indirect cost was $92 ($57-$139). Patients incurred $62 ($46-$83) on average while government incurred $14 ($10-$20) on average. Conclusion Induced abortions are associated with substantial costs in Uganda and patients incur the bulk of the healthcare costs. This reinforces the case made by other researchers--that efforts by the government to reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions are critical.
- Published
- 2011
- Full Text
- View/download PDF
3. Trends of notification rates and treatment outcomes of tuberculosis cases with and without HIV co-infection in eight rural districts of Uganda (2015 – 2019)
- Author
-
Baluku, Joseph Baruch, Nanyonjo, Resty, Ayo, Jolly, Obwalatum, Jehu Eleazer, Nakaweesi, Jane, Senyimba, Catherine, Lukoye, Deus, Lubwama, Joseph, Ward, Jennifer, and Mukasa, Barbara
- Published
- 2022
- Full Text
- View/download PDF
4. “The one who doesn’t take ART medication has no wealth at all and no purpose on Earth” – a qualitative assessment of how HIV-positive adults in Uganda understand the health and wealth-related benefits of ART
- Author
-
Saya, Uzaib, MacCarthy, Sarah, Mukasa, Barbara, Wabukala, Peter, Lunkuse, Lillian, Wagner, Zachary, and Linnemayr, Sebastian
- Published
- 2022
- Full Text
- View/download PDF
5. Suubi+Adherence-Round 2: A study protocol to examine the longitudinal HIV treatment adherence among youth living with HIV transitioning into young adulthood in Southern Uganda
- Author
-
Ssewamala, Fred M., Sensoy Bahar, Ozge, Nabunya, Proscovia, Thames, April D., Neilands, Torsten B., Damulira, Christopher, Mukasa, Barbara, Brathwaite, Rachel, Mellins, Claude, Santelli, John, Brown, Derek, Guo, Shenyang, Namatovu, Phionah, Kiyingi, Joshua, Namuwonge, Flavia, and McKay, Mary M.
- Published
- 2021
- Full Text
- View/download PDF
6. Suubi4Her: a study protocol to examine the impact and cost associated with a combination intervention to prevent HIV risk behavior and improve mental health functioning among adolescent girls in Uganda
- Author
-
Ssewamala, Fred M., Bermudez, Laura Gauer, Neilands, Torsten B., Mellins, Claude A., McKay, Mary M., Garfinkel, Irv, Sensoy Bahar, Ozge, Nakigozi, Gertrude, Mukasa, Miriam, Stark, Lindsay, Damulira, Christopher, Nattabi, Jennifer, and Kivumbi, Apollo
- Published
- 2018
- Full Text
- View/download PDF
7. Understanding mobility and sexual risk behaviour among women in fishing communities of Lake Victoria in East Africa: a qualitative study.
- Author
-
Kwena, Zachary, Nakamanya, Sarah, Nanyonjo, Gertrude, Okello, Elialilia, Fast, Pat, Ssetaala, Ali, Oketch, Bertha, Price, Matt, Kapiga, Saidi, Bukusi, Elizabeth, Seeley, Janet, the LVCHR, Grosskurth, Heiner, Kamali, Anatoli, Kaleebu, Pontiano, Kibengo, Freddie Mukasa, Kidega, William, De Bont, Jan, and LVCHR
- Subjects
FISHING villages ,HIV prevention ,HIV infections ,WOMEN'S sexual behavior ,WOMEN - Abstract
Background: HIV-prevalence and incidence is high in many fishing communities around Lake Victoria in East Africa. In these settings, mobility among women is high and may contribute to increased risk of HIV infection and poor access to effective prevention and treatment services. Understanding the nature and patterns of this mobility is important for the design of interventions. We conducted an exploratory study to understand the nature and patterns of women's mobility to inform the design of HIV intervention trials in fishing communities of Lake Victoria.Methods: This was a cross-sectional formative qualitative study conducted in six purposively selected fishing communities in Kenya, Tanzania and Uganda. Potential participants were screened for eligibility on age (18+ years) and having stayed in the fishing community for more than 6 months. We collected data using introductory and focus group discussions, and in-depth interviews with key informants. Data focused on: history and patterns of mobility, migration in and out of fishing communities and the relationship between mobility and HIV infection. Since the interviews and discussions were not audio-recorded, detailed notes were taken and written up into full scripts for analysis. We conducted a thematic analysis using constant comparison analysis.Results: Participants reported that women in fishing communities were highly mobile for work-related activities. Overall, we categorized mobility as travels over long and short distances or periods depending on the kind of livelihood activity women were involved in. Participants reported that women often travelled to new places, away from familiar contacts and far from healthcare access. Some women were reported to engage in high risk sexual behaviour and disengaging from HIV care. However, participants reported that women often returned to the fishing communities they considered home, or followed a seasonal pattern of work, which would facilitate contact with service providers.Conclusion: Women exhibited circular and seasonal mobility patterns over varying distances and duration away from their home communities. These mobility patterns may limit women's access to trial/health services and put them at risk of HIV-infection. Interventions should be tailored to take into account mobility patterns of seasonal work observed in this study. [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
- View/download PDF
8. Suubi + Adherence4Youth: a study protocol to optimize the Suubi Intervention for Adherence to HIV treatment for youth living with HIV in Uganda
- Author
-
Fred M. Ssewamala, John A. Sauceda, Rachel Brathwaite, Torsten B. Neilands, Proscovia Nabunya, Derek Brown, Ozge Sensoy Bahar, Flavia Namuwonge, Noeline Nakasujja, Allan Mugarura, Abel Mwebembezi, Portia Nartey, Barbara Mukasa, and Marya Gwadz
- Subjects
Optimization ,Suubi + adherence ,Youth ,Economic empowerment ,Viral suppression ,Adherence ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Suubi is an evidenced based multi-component intervention that targets psychosocial and economic hardships to improve ART adherence, viral suppression, mental health, family financial stability, and family cohesion for adolescents living with HIV (ALHIV) in Uganda. Suubi was originally tested as a combined package of four components: 1) Financial Literacy Training; 2) incentivized matched Youth Savings Accounts with income-generating activities; 3) a manualized and visual-based intervention for ART adherence and stigma reduction; and 4) engagement with HIV treatment-experienced role models. However, it is unknown if each component in Suubi had a positive effect, how the components interacted, or if fewer components could have produced equivalent effects. Hence, the overall goal of this new study is to identify the most impactful and sustainable economic and psychosocial components across 48 health clinics in Uganda. Methods A total of 576 ALHIV (aged 11–17 years at enrollment) will be recruited from 48 clinics and each clinic will be randomized to one of 16 study conditions. Each condition represents every possible combination of the 4 components noted above. Assessments will be conducted at baseline, 12, 24, 36 and 48- months post-intervention initiation. Using the multi-phase optimization strategy (MOST), we will identify the optimal combination of components and associated costs for viral suppression, as well as test key mediators and moderators of the component-viral suppression relationship. Discussion The study is a shift in the paradigm of research to use new thinking to build/un-pack highly efficacious interventions that lead to new scientific knowledge in terms of understanding what drives an intervention’s success and how to iterate on them in ways that are more efficient, affordable and scalable. The study advances intervention science for HIV care outcomes globally. Trial Registration This project was registered at clinicaltrials.gov (NCT05600621) on October, 31, 2022. https://clinicaltrials.gov/ct2/show/NCT05600621
- Published
- 2023
- Full Text
- View/download PDF
9. 'The one who doesn’t take ART medication has no wealth at all and no purpose on Earth' – a qualitative assessment of how HIV-positive adults in Uganda understand the health and wealth-related benefits of ART
- Author
-
Uzaib Saya, Sarah MacCarthy, Barbara Mukasa, Peter Wabukala, Lillian Lunkuse, Zachary Wagner, and Sebastian Linnemayr
- Subjects
HIV/AIDS ,Antiretroviral therapy (ART) adherence ,Uganda ,Long-term benefits ,Semi-structured interviews ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Increases in life expectancy from antiretroviral therapy (ART) may influence future health and wealth among people living with HIV (PLWH). What remains unknown is how PLWH in care perceive the benefits of ART adherence, particularly in terms of improving health and wealth in the short and long-term at the individual, household, and structural levels. Understanding future-oriented attitudes towards ART may help policymakers tailor care and treatment programs with both short and long-term-term health benefits in mind, to improve HIV-related outcomes for PLWH. Methods In this qualitative study, we conducted semi-structured interviews among a subsample of 40 PLWH in care at a clinic in Uganda participating in a randomized clinical trial for treatment adherence in Uganda (clinicaltrials.gov: NCT03494777). Interviews were transcribed verbatim and translated from Luganda into English. Two co-authors independently reviewed transcripts, developed a detailed codebook, achieved 93% agreement on double-coded interviews, and analyzed data using inductive and deductive content analysis. Applying the social-ecological framework at the individual, household, and structural levels, we examined how PLWH perceived health and wealth-related benefits to ART. Results Our findings revealed several benefits of ART expressed by PLWH, going beyond the short-term health benefits to also include long-term economic benefits. Such benefits largely focused on the ability of PLWH to live longer and be physically and mentally healthy, while also fulfilling responsibilities at the individual level pertaining to themselves (especially in terms of positive long-term habits and motivation to work harder), at the household level pertaining to others (such as improved relations with family and friends), and at the structural level pertaining to society (in terms of reduced stigma, increased comfort in disclosure, and higher levels of civic responsibility). Conclusions PLWH consider short and long-term health benefits of ART. Programming designed to shape ART uptake and increase adherence should emphasize the broader benefits of ART at various levels. Having such benefits directly integrated into the design of clinic-based HIV interventions can be useful especially for PLWH who face competing interests to increase medication adherence. These benefits can ultimately help providers and policymakers better understand PLWH’s decision-making as it relates to improving ART-related outcomes.
- Published
- 2022
- Full Text
- View/download PDF
10. Trends of notification rates and treatment outcomes of tuberculosis cases with and without HIV co-infection in eight rural districts of Uganda (2015 – 2019)
- Author
-
Joseph Baruch Baluku, Resty Nanyonjo, Jolly Ayo, Jehu Eleazer Obwalatum, Jane Nakaweesi, Catherine Senyimba, Deus Lukoye, Joseph Lubwama, Jennifer Ward, and Barbara Mukasa
- Subjects
Case notification rate ,Tuberculosis ,Rural ,Uganda ,HIV ,TB/HIV ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background The End TB Strategy aims to reduce new tuberculosis (TB) cases by 90% and TB-related deaths by 95% between 2015 – 2035. We determined the trend of case notification rates (CNRs) and treatment outcomes of TB cases with and without HIV co-infection in rural Uganda to provide an interim evaluation of progress towards this global target in rural settings. Methods We extracted retrospective programmatic data on notified TB cases and treatment outcomes from 2015 – 2019 for eight districts in rural Uganda from the District Health Information System 2. We estimated CNRs as the number of TB cases per 100,000 population. Treatment success rate (TSR) was calculated as the sum of TB cure and treatment completion for each year. Trends were estimated using the Mann–Kendall test. Results A total of 11,804 TB cases, of which 5,811 (49.2%) were HIV co-infected, were notified. The overall TB CNR increased by 3.7-fold from 37.7 to 141.3 cases per 100,000 population in 2015 and 2019 respectively. The increment was observed among people with HIV (from 204.7 to 730.2 per 100,000, p = 0.028) and HIV-uninfected individuals (from 19.9 to 78.7 per 100,000, p = 0.028). There was a decline in the TSR among HIV-negative TB cases from 82.1% in 2015 to 63.9% in 2019 (p = 0.086). Conversely, there was an increase in the TSR among HIV co-infected TB cases (from 69.9% to 81.9%, p = 0.807). Conclusion The CNR increased among people with and without HIV while the TSR reduced among HIV-negative TB cases. There is need to refocus programs to address barriers to treatment success among HIV-negative TB cases.
- Published
- 2022
- Full Text
- View/download PDF
11. Suubi+Adherence-Round 2: A study protocol to examine the longitudinal HIV treatment adherence among youth living with HIV transitioning into young adulthood in Southern Uganda
- Author
-
Fred M. Ssewamala, Ozge Sensoy Bahar, Proscovia Nabunya, April D. Thames, Torsten B. Neilands, Christopher Damulira, Barbara Mukasa, Rachel Brathwaite, Claude Mellins, John Santelli, Derek Brown, Shenyang Guo, Phionah Namatovu, Joshua Kiyingi, Flavia Namuwonge, and Mary M. McKay
- Subjects
Youth living with HIV ,cohort ,economic empowerment ,sub-Saharan Africa ,Uganda ,HIV/AIDS ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Youth living with HIV (YLHIV) in Sub-Saharan African (SSA) are less likely to adhere to antiretroviral therapy (ART) and other health-related regimens. As a consequence, YLHIV are not only at risk for health problems and mental health comorbidities, but are also at risk for cognitive deficits, including in areas of memory and executive functioning. The Suubi+Adherence study followed 702 adolescents (10-16 years of age) receiving bolstered standard of care and a family economic empowerment intervention comprising an incentivized youth financial savings account (YSA) augmented with financial literacy training (FLT) and peer mentorship. The study findings pointed to superior short-term viral suppression and positive adolescent health and mental health functioning among participants receiving the intervention. The original group of adolescents who received Suubi+Adherence are now transitioning into young adulthood. This paper presents a protocol for the follow-up phase titled Suubi+Adherence Round 2. Methods The original cohort in Suubi+Adherence will be tracked for an additional five years (2020-2025). Specifically, the long term follow-up will allow to: 1) ascertain the extent to which the short term outcomes identified in the first 6 years of the intervention are maintained as the same group transitions through young adulthood; and 2) address new scientific questions regarding ART adherence; HIV care engagement; protective health behaviors; and the potential of FEE to mitigate the development of HIV-associated neurocognitive disorders in YLHIV. Additionally, the team examines the potential mechanisms through which the observed long-term outcomes happen. Moreover, the Suubi+Adherence-Round 2 adds a qualitative component and extends the cost effectiveness component. Discussion Guided by asset and human development theories, Suubi+Adherence-R2 will build on the recently concluded Suubi+Adherence study to conduct one of the largest and longest running studies of YLHIV in SSA as they transition into young adulthood. The study will address new scientific questions regarding long-term ART adherence, HIV care engagement, protective health behaviors, and the potential of FEE to mitigate the development of HIV-associated neurocognitive disorders in YLHIV. The findings may inform efforts to improve HIV care among Uganda’s YLHIV, with potential replicability in other low-resource countries. Trial registration ClinicalTrials.gov , ID: NCT01790373
- Published
- 2021
- Full Text
- View/download PDF
12. Suubi4Her: a study protocol to examine the impact and cost associated with a combination intervention to prevent HIV risk behavior and improve mental health functioning among adolescent girls in Uganda
- Author
-
Fred M. Ssewamala, Laura Gauer Bermudez, Torsten B. Neilands, Claude A. Mellins, Mary M. McKay, Irv Garfinkel, Ozge Sensoy Bahar, Gertrude Nakigozi, Miriam Mukasa, Lindsay Stark, Christopher Damulira, Jennifer Nattabi, and Apollo Kivumbi
- Subjects
HIV ,Adolescent girls ,Assets ,Economic empowerment ,Family strengthening ,Combination interventions ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Asset-based economic empowerment interventions, which take an integrated approach to building human, social, and economic capital, have shown promise in their ability to reduce HIV risk for young people, including adolescent girls, in sub-Saharan Africa. Similarly, community and family strengthening interventions have proven beneficial in addressing mental health and behavioral challenges of adolescents transitioning to adulthood. Yet, few programs aimed at addressing sexual risk have applied combination interventions to address economic stability and mental health within the traditional framework of health education and HIV counseling/testing. This paper describes a study protocol for a 5-year, NIMH-funded, cluster randomized-controlled trial to evaluate a combination intervention aimed at reducing HIV risk among adolescent girls in Uganda. The intervention, titled Suubi4Her, combines savings-led economic empowerment through youth development accounts (YDA) with an innovative family strengthening component delivered via Multiple Family Groups (MFG). Methods Suubi4Her will be evaluated via a three-arm cluster randomized-controlled trial design (YDA only, YDA + MFG, Usual Care) in 42 secondary schools in the Central region of Uganda, targeting a total of 1260 girls (ages 15–17 at enrollment). Assessments will occur at baseline, 12, 24, and 36 months. This study addresses two primary outcomes: 1) change in HIV risk behavior and 2) change in mental health functioning. Secondary exploratory outcomes include HIV and STI incidence, pregnancy, educational attainment, financial savings behavior, gender attitudes, and self-esteem. For potential scale-up, cost effectiveness analysis will be employed to compare the relative costs and outcomes associated with each study arm. Conclusions Suubi4Her will be one of the first prospective studies to examine the impact and cost of a combination intervention integrating economic and social components to reduce known HIV risk factors and improve mental health functioning among adolescent girls, while concurrently exploring mental health as a mediator in HIV risk reduction. The findings will illuminate the pathways that connect economic needs, mental health, family support, and HIV risk. If successful, the results will promote holistic HIV prevention strategies to reduce risk among adolescent girls in Uganda and potentially the broader sub-Saharan Africa region. Trial registration Clinical Trials NCT03307226 (Registered: 10/11/17).
- Published
- 2018
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.