Prevalence and Factors Associated With Compliance With COVID-19 Presidential Lockdown Measures: A Cross-Sectional Study.

The coronavirus disease 2019 (COVID-19) is one of the most severe global health uncertainties to date. Although significant global effort has been put into implementing COVID-19 pandemic control measures such as lockdowns, travel restrictions, and hygiene precautions, the transmission is expected to resurface once these efforts are discontinued. We aimed to determine the prevalence and factors associated with compliance with presidential 53-day lockdown measures in June-July 2021 in northern Uganda. In this cross-sectional study, 587 adult participants (≥18 years old) from northern Uganda were selected using a systematic sampling method. Data collection involved interviewer-administered questionnaires with an internal validity of Cronbach's α = .72. Socio-demographic characteristics of participants were described, and multivariable modified Poisson regressions were performed to assess prevalence ratios between dependent and selected independent variables, with respective P values at 95% confidence intervals. All analyses were conducted using Stata 17.0. Participants' compliance with the presidential lockdown directives was high at 88%(95% CI: 85%-90%). Compliance with the presidential directives was more likely among participants who agreed to the lockdown measures [adjusted Prevalence Ratio, aPR = 1.28 (95% CI: 1.10-1.49; P = .001)] compared to those who did not, and more likely among those who were afraid of death from COVID-19 [aPR = 1.08 (95% CI: 1.01-1.15; P = .023)] than those who did not. However, compliance was less likely among males [aPR = 0.91 (95% CI: 0.86-0.97; P = .002)] compared to females, those aged 35 to 44 years [aPR = 0.87 (95% CI: 0.79-0.97; P = .013)] compared to those less 25 years; and unmarried [aPR = 0.89 (95% CI: 0.82-0.97; P = .011)] compared to the married. Compliance with the COVID-19 presidential lockdown measures in northern Uganda was high. The factors associated with compliance were the fear of death and agreement with presidential lockdown measures. However, compliance was less likely among males, unmarried persons, and persons aged 35 to 44. The authors recommend more community engagements, participation, sensitization, mobilization, and simultaneous application of multiple public health approaches to improve compliance and control of COVID-19.

Prevalence of borrowing and sharing prescription medicines and associated socio-demographic factors: findings from COBERS health centres in northern Uganda.

BACKGROUND: The use of prescription medications without the involvement of medical professionals is a growing public health concern. Therefore this study was conducted to determine the prevalence of borrowing and sharing prescription medicines and associated socio-demographic factors among community members who had sought health care from COBERS health centres. METHODS: We conducted analytical cross - sectional study among former patients who sought treatment during the two months period prior to data collection in nine COBERS health centres. We used cluster proportional-to-size sampling method to get the numbers of research participants to be selected for interview from each COBERS site and logistic regression model was used to assess the associations. RESULTS: The prevalence of borrowing prescription medication was found to be 35.9% (95% CI 33.5-38.2%) and sharing prescription medication was 32.7% (95% CI 30.4-34.9%). The Socio-demographic factors associated with borrowing prescription medicines were: age group ≤19 years (AOR = 2.64, 95%CI 1.47-4.74, p-value = 0.001); age group 20-29 years (AOR = 2.78, 95%CI 1.71-4.50, p-value≤0.001); age group 30-39 years (AOR = 1.90, 95%CI 1.18-3.06, p-value = 0.009); age group 40-49 (AOR = 1.83, 95%CI 1.15-2.92, p-value = 0.011); being a female (AOR = 2.01, 1.58-2.55, p-value< 0.001); being a Pentecostal by faith (AOR = 1.69, 95%CI 1.02-2.81, p-value = 0.042) and being Employed Salary Earner (AOR = 0.44, 95%CI 0.25-0.78, p-value = 0.005). The socio-demographic factors associated with sharing prescription medicines were: age group ≥19 years (AOR = 4.17, 95%CI 2.24-7.76, p-value< 0.001); age group 20-29 years (AOR = 3.91, 95%CI 2.46-6.29, p-value< 0.001); age group 30-39 years (AOR = 2.94, 95%CI 2.05-4.21, p-value< 0.001); age group 40-49 years (AOR = 2.22, 95%CI 1.29-3.82, p-value = 0.004); being female (AOR = 2.50, 95%CI 1.70-3.47, p-value< 0.001); being Pentecostal by faith (AOR = 2.15, 95%CI 1.15-4.03, p-value = 0.017); and being engaged in business (AOR = 1.80, 95%CI 1.16-2.80, p-value = 0.009). CONCLUSION: A high proportion of study participants had borrowed or shared prescription medicines during the two months prior to our study. It is recommended that stakeholders sensitise the community members on the danger of borrowing and sharing prescription medicines to avert the practice.

Reduced plasma concentrations of vitamin B6 and increased plasma concentrations of the neurotoxin 3-hydroxykynurenine are associated with nodding syndrome: a case control study in Gulu and Amuru districts, Northern Uganda.

INTRODUCTION: Nodding syndrome was first reported in Uganda in 2003 among internally displaced populations. Risk factors for the syndrome remain unknown. We therefore explored vitamin B6 deficiency and resulting high 3-hydroxykynurenine (3-HK) levels as risk factor for nodding syndrome in Northern Uganda. METHODS: Case-control study conducted in Gulu and Amuru districts. Cases were children/young adults with nodding syndrome. Healthy children/young adults were recruited as controls from same community as cases. Data on socio-demographic and other risk factors was collected using questionnaires. Whole blood was collected in EDTA tubes for assay of 3-HK and vitamin B6 using sandwich ELISA. Conditional logistic regression model was used to assess associations. RESULTS: 66 cases and 73 controls were studied. Factors associated with nodding syndrome were being positive for 3-HK (AOR=4.50, p=0.013), vitamin B6 concentration below mean (AOR=7.22, P=0.001), child being taken care of by mother only (AOR=5.43, p=0.011), child being taken care of by guardian (AOR=5.90, p=0.019) and child consuming relief food at weaning (AOR=4.05, p=0.021). CONCLUSION: Having low vitamin B6 concentration which leads to a build up of 3-hydroxykynurenine concentration in cases as a main risk factor. Therefore, cases should be treated with vitamin B6 and community members should be sensitise to ensure adequate dietary intake of vitamin B6 so that the risk of nodding syndrome among children is averted. We encourage future prospective intervention study to be conducted to assess the effect of low vitamin B6 on the development of nodding syndrome via raised 3-HK concentration.