Use of tobacco and other illicit drugs among adolescent boys and young men in Kampala, Uganda: A result of low parental attention?

INTRODUCTION: Although the use of illicit drugs is common among young people, limited data exists on the use of illicit drugs among adolescent boys and young men (ABYM). We assessed the use of tobacco, marijuana and khat among ABYM to inform the design of harm-reduction interventions. METHODS: This secondary analysis uses data from a formative study conducted among 2,500 ABYM across the five divisions of Kampala between July and August 2020. Survey questions were adopted from the Global Youth Tobacco Survey and Global School-based Student Health Survey. We computed proportions of ABYM that had ever used any form of tobacco or marijuana or khat in the past year and the proportion that had used any of these products in the past 30 days (i.e. 'current users'). In a sub-group analysis, we assessed if any patterns existed between ABYM's use of illicit drugs and selected parental attention attributes. RESULTS: Of 2,500 ABYM, 47.3% (n = 1,182) were aged 15-19 years. Overall, 16.4% (n = 410) reported past-year use of tobacco products while 11.6% (n = 289) and 10.5% (n = 263) reported past-year use of marijuana and khat, respectively. Current use of any illicit drugs was higher among past-year khat (46%, n = 133) and marijuana users (36.9%, n = 97) than past-year tobacco users (4%, n = 17). Current use of any illicit drugs was higher among out-of-school than in-school ABYM and increased with increasing age and education levels. However, parental attention was lower among out-of-school than in-school ABYM and decreased with increasing age and education levels. CONCLUSION: Use of illicit drugs is common among ABYM and increased with age and education levels but parental attention among current illicit drug users decreased with increasing age and education levels. These findings suggest that interventions intended to improve parental attention among illicit drug users may help to reduce the prevalence of illicit drug use among ABYM.

Knowledge, attitudes, and practices of Crimean Congo hemorrhagic fever among livestock value chain actors in Kagadi district, Uganda.

BACKGROUND: Crimean Congo hemorrhagic fever (CCHF) is a zoonotic tick-borne disease with an increasing number of outbreaks among communities in Uganda. Following the disease outbreak in the western district of Kagadi on 20th February 2020, a KAP survey was conducted to identify knowledge gaps and at-risk behaviors related to the disease among livestock value chain actors. METHODS: A household survey using a semi-structured questionnaire was conducted in 399 households in the two sub counties of Bwikara and Ruteete, Kagadi district. A focus group discussion with members of the community was conducted as well as key informant interviews with at-risk individuals. Descriptive and inferential analysis was performed using STATA version 13 (Statacorp Texas; USA). Comparative analysis of the data from the two sub counties was also performed using cross tabulations in STATA, between each independent variable and the subcounty variable. The descriptive and comparative statistics used were minimum, mean and maximum values, standard deviations, frequencies, percentages, chi square values and t-statistics. A chi-square test was then employed on each tabulation, to determine whether there was an association between the two categorical variables or not. The test was set at an alpha level of 0.05, and where the p-value was less than or equal to the alpha value, we concluded that the 2 variables were associated. RESULTS: Although majority of the respondents believed in the existence of the disease, only 12.8% had knowledge of prevention measures against CCHF. 67.2% of the respondents reported regular interaction with ticks during routine farm operations and they employed tick control measures on their farms. Although the respondents believe the disease is fatal, almost all of them (99%) would welcome a CCHF survivor back into the community. 95.2% of the respondents actively attended to animals but only 25.8% participated in slaughtering animals. Qualitatively, the technical informants had knowledge about CCHF but non technical informants hardly knew about the disease. Limited funding appropriated for local governments, as well as limited engagement in One health activities were some of the barriers highlighted towards the infection prevention and control activities. Most of the focus group discussion participants knew about the disease, but lacked knowledge on its transmission and prevention. Limited access to personal protective equipment and high exposure to tick-prevalent areas when slaughtering and grazing animals respectively, were the major challenges highlighted. CONCLUSION: Knowledge on CCHF among majority of the respondents was poor. There is a need for educational programs to increase awareness of CCHF in communities. This awareness should be done by both the community leaders and technical people to ensure the community receives enough knowledge on how to prevent and control the disease. To ensure effectiveness of these programs a One health approach should be adopted to implement prevention and control strategies.

Knowledge, risk-perception, and uptake of COVID-19 prevention measures in sub-Saharan Africa: a scoping review.

Background: The COVID-19 pandemic has almost affected the entire globe and is currently in a resurgent phase within the sub-Saharan African region. Objective: This paper presents results from a scoping review of literature on knowledge, risk-perception, conspiracy theories and uptake of COVID-19 prevention measures in sub-Saharan Africa. Methods: We used the following search terms: 'COVID-19', 'knowledge', 'perceptions', 'perspectives', 'misconceptions', 'conspiracy theories', 'practices' and 'sub-Saharan Africa'. Basing on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines, we identified 466 articles for review; 36 articles met the inclusion criteria. We extracted data on knowledge, risk-perception, conspiracy theories and uptake of COVID-19 primary prevention measures. Results: Knowledge of COVID-19 was high (91.3-100%) and associated with age and education; risk-perception was equally high (73.3-86.9%) but varied across studies. Uptake of hand-washing with water and soap or hand-sanitizing ranged between 63-96.4%, but wearing of face masks and social distancing fared poorly (face masks: 2.7%-37%; social distancing: 19-43%). Conclusion: While knowledge of COVID-19 is nearly universal, uptake of COVID-19 prevention measures remains sub-optimal to defeat the pandemic. These findings suggest a need for continued health promotion to increase uptake of the recommended COVID-19 prevention measures in sub-Saharan Africa.