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Browsing by Author "Pebolo, Francis Pebalo"

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Correlates and prevalence of overweight and obesity among women of reproductive age (15-49 years) in Sierra Leone. A secondary data analysis of the demographic health survey of 2019
(2023-07-12) Okot Atim, Pamela; Alema, Nelson Onira; Pebolo, Francis Pebalo; Okot, Christopher; Ochula, Denis; Okot, Smart Geoffrey; Ikoona, Eric Nzirakaindi; Toure, Mame Awa; Namulemo, Lucy; Kamara, Kassim; Oyat, Freddy Wathum Drinkwater; Aloyo, Judith; Njenga, Amon; Kaluya, Ronald; Matovu, John Bosco; Olal, Emmanuel; Kitara, David Lagoro
Background: Overweight and obesity are emerging public health problems globally and are independent risk factors for heart, blood vessels, reproductive health, and metabolic disorders. This study aimed to determine the correlates and prevalence of overweight and obesity among women of reproductive age (15-49 years) in Sierra Leone using secondary data analysis of the Demographic Health Survey of 2019. Methods: This study was based on the 2019 Sierra Leone Demographic Health Survey (SLDHS) that used a two-stage stratified cluster sampling technique. A total of 7514 non-pregnant women of reproductive age (15-49 years) were used in the analysis. Simple descriptive, bivariable, and multivariable regression analyses were conducted with a significant p-value set at <0.05. Results: The prevalence of overweight and obesity among women of reproductive age in Sierra Leone was 19.7% and 7.4%, respectively. Overweight was more likely among women of 15-19 age group (adjusted Odds Ratios, aOR=1.933,95%CI:1.532- 2.348;p<0.001); women from the north (aOR=1.308,95%CI:1.104-1.581;p<0.006); women without formal education (aOR=1.211,95%CI:1.009-1.454;p<0.040); in poorest (aOR=1.501,95%CI:1.231-1.853;p<0.001) and poorer (aOR=1.419,95%CI:1.154-1.745;p=0.001) wealth indices. However, overweight was 39.9% less likely among 30-39-year (aOR=0.601,95%CI:0.507-0.713;p<0.001) and 49% less likely among 40-49-year (aOR=0.510,95%CI:0.415-0.628;p<0.001) age-groups. It was 27.3% less likely among married women (aOR=0.727,95%CI:0.613-0.863;p<0.001), 24.9% less likely in the south (aOR=0.751,95%CI:0.623-0.911;p=0.002), 38.2% and 48.7% less likely in richer (aOR=0.618,95%CI:0.494-0.773;p<0.001) and richest (aOR=0.513,95%CI:0.389-0.677;p<0.001) wealth indices, respectively. Also, obesity was more likely among women 15-19-year (aOR=2.051,95%CI:1.316-3.198;p=0.002); from the north (aOR=1.426,95%CI:1.038-1.958;p=0.044); in poorest (aOR=2.390,95%CI:1.618-3.532;p<0.001) and poorer (aOR=1.667,95%CI:1.151- 2.415;p=0.007) wealth indices. However, it was 68.3% and 79.6% less likely among women 30-39-year (aOR=0.317,95%CI:0.241-0.419;p<0.001) and 40-49-year (aOR=0.204,95%CI:0.149-0.278;p<0.001) age-groups, respectively. It was 36.8% less likely among female-headed households (aOR=0.732,95%CI:0.590-0.909;p=0.005) and 24% less likely among married women (aOR=0.760,95%CI:0.580-0.995;p=0.046); 26.2% less likely in the south (aOR=0.738,95%CI:0.550-0.992;p=0.044); 62.1% and 75.9% less likely in richer (aOR=0.379,95%CI:0.266-0.540;p<0.001) and richest (aOR=0.241,95%CI:0.159-0.367;p<0.001) wealth indices, respectively; and 39.9% less likely among women who listened to radios (aOR=0.601,95%CI:0.507-0.713;p<0.001). Conclusion: The prevalence of overweight and obesity among women of reproductive age (15-49 years) in Sierra Leone was higher compared to world data. Younger age groups, northern region, poorest and poorer wealth indices, and women without formal education were more likely to be overweight and obese. However, overweight and obesity were less likely among older age-groups, married, southern region, richer and richest wealth indices, female-headed households, and listening to radios. There is an urgent need for policymakers in Sierra Leone to tackle overweight and obesity among women of reproductive age (15-49 years) if the current trends are to be reversed.
Facemask wearing in COVID-19 pandemic:
(medRxiv, 2023-10-24) Alema, Nelson Onira; Okot, Christopher; Olal, Emmanuel; Ikoona, Eric Nzirakaindi; Oyat, Freddy Wathum Drinkwater; Baguma, Steven; Ochula, Denish Omoya; Olwedo, Patrick Odong; Oloya, Johnson Nyeko; Pebolo, Francis Pebalo; Atim, Pamela Okot; Okot, Godfrey Smart; Nantale, Ritah; Aloyo, Judith; Kitara, David Lagoro
Background: The WHO and the US. CDC documented that facemask-wearing in public situations is one of the most important prevention measures that can limit the acquisition and spread of COVID-19. Considering this, WHO and US. CDC developed guidelines for using facemasks in public settings. This study aimed to determine correlates and prevalence of facemask wearing during COVID-19 pandemic among adult population of Northern Uganda. Methods. We conducted a cross-sectional study on five hundred and eighty-seven adult population of northern Uganda. A single stage stratified, and systematic sampling methods were used to select respondents from twenty four Acholi subregion’s health facilities. Data was collected in a face-to-face questionnaire interview with an internal validity of Cronbach's α=0.72. A local IRB approved the study, and Stata 18 was used for data analysis at multivariable Poisson regression with a p-value set at ≤0.05. Results: The most substantial findings from this study were the high prevalence of face mask-wearing in public among respondents [88.7%,95%CI:86%-91%]. At a multivariable Poisson regression analysis, we found that obese respondents were 1.12 times more likely to wear facemasks than those who were not, [adjusted Interval Rates Ratios, aIRR=1.12,95%CI:1.04-1.19;p<0.01], and respondent who agreed to the lockdown measures were 1.23 times more likely to wear facemasks during COVID-19 pandemic than those who did not, [aIRR=1.23, 95%CI:1.07- 1.41;p<0.01]. Other sociodemographic characteristics such as sex, age, occupation, level of education, religion, tribes, marital status, nationality, race, and comorbidities were not statistically significant at 95% Confidence Intervals. Conclusion: The most significant findings from this study were the high prevalence of face mask-wearing among adult community members in northern Uganda. The correlates of facemask wearing in public were the obese and respondents who agreed with the presidential directives on the lockdown measures. Although this was within acceptable prevalence rates, the strict enforcement of face mask-wearing by security forces raised concerns among many community members and human rights advocates. We recommend more studies on communities' perspectives on the challenges and benefits of facemask-wearing during the COVID-19 pandemic.
Invasive Fungal Diseases in Africa:
(MDPI, 2022-11-22) Bongomin, Felix; Ekeng, Bassey E.; Kibone, Winnie; Nsenga, Lauryn; Olum, Ronald; Itam-Eyo, Asa; Ngouanom Kuate, Marius Paulin; Pebolo, Francis Pebalo; Davies, Adeyinka A; Manga, Musa; Ocansey, Bright; Kwizera, Richard; Baluku, Joseph Baruch
Invasive fungal diseases (IFDs) are of huge concern in resource-limited settings, particularly in Africa, due to the unavailability of diagnostic armamentarium for IFDs, thus making definitive diagnosis challenging. IFDs have non-specific systemic manifestations overlapping with more frequent illnesses, such as tuberculosis, HIV, and HIV-related opportunistic infections and malignancies. Consequently, IFDs are often undiagnosed or misdiagnosed. We critically reviewed the available literature on IFDs in Africa to provide a better understanding of their epidemiology, disease burden to guide future research and interventions. Cryptococcosis is the most encountered IFD in Africa, accounting for most of the HIV-related deaths in sub-Saharan Africa. Invasive aspergillosis, though somewhat underdiagnosed and/or misdiagnosed as tuberculosis, is increasingly being reported with a similar predilection towards people living with HIV. More cases of histoplasmosis are also being reported with recent epidemiological studies, particularly from Western Africa, showing high prevalence rates amongst presumptive tuberculosis patients and patients living with HIV. The burden of pneumocystis pneumonia has reduced significantly probably due to increased uptake of anti-retroviral therapy among people living with HIV both in Africa, and globally. Mucormycosis, talaromycosis, emergomycosis, blastomycosis, and coccidiomycosis have also been reported but with very few studies from the literature. The emergence of resistance to most of the available antifungal drugs in Africa is yet of huge concern as reported in other regions. IFDs in Africa is much more common than it appears and contributes significantly to morbidity and mortality. Huge investment is needed to drive awareness and fungi related research especially in diagnostics and antifungal therapy.
Is the 14% cesarean section rate in Gulu Regional Referral Hospital justifiable?
(. PAMJ Clinical Medicine, 2021-03-26) Pebolo, Francis Pebalo; Baguma, Steven; Auma, Anna Grace
Worldwide, cesarean section (CS) rates haveincreased tremendously in recent years, especially among high-income countries, raising concernsabout the over-utilization of CS without added benefits, and in the sub-Saharan African region, therate is at its lowest (7.3%). In Uganda, the CS rate stands at 6% and is seen to be higher (11%) among first-order births indicating a high incidence of primary CS. Despite the low rate of CS in Uganda,there are massive gaps in the provision of obstetric procedure with some women receiving unnecessary surgeries, and the facility-based CS rate is projected to increase to 32% by end of 2021. Notwithstanding the increasing facility rates of CS, Gulu Regional Referral Hospital (GRRH) rate has remained low in the years 2017-2019, with lower levels maternal mortality ratio and fresh stillbirths´ rates compared to the national average. Prolonged labor is one of the commonest indications for primary CS accounting for more than 50% among nulliparous women and this is linked to progress of labor usually measured using cervical dilatation. World Health Organization (WHO) recommended a change in cervical dilatation from 4cm to 5cm as a threshold for the active phase of the first stage of labor, as away to reduce unnecessary labor intervention including the CS. Lack of standard reporting tools such as the WHO Robson´s ten group classification in Uganda make comparisons of CS rate between/within facility/facilities worrisomely difficult.
Perceptions of COVID-19 vaccination among different adult age group populations in Northern Uganda. A cross-sectional study.
(Research squares, 2022-07-14) Oloya, Johnson Nyeko; Baguma, Steven; Okot, Christopher; Alema, Nelson Onira; Acullu, Denis; Ochula, Denis; Atim, Pamela; Olwedo, Patrick Odong; Okot, Smart Godfrey; Pebolo, Francis Pebalo; Freddy Wathum Drinkwater Oyat, Freddy Wathum Drinkwater; Ikoona, Eric Nzirakaindi; Aloyo, Judith; Oballim, Lawence; Kitara, David Lagoro
Introduction: Although COVID-19 first spread slowly in the African continent, confirmed virus cases have risen steadily since March 2020. The rapid spread of SARS-CoV-2 can be attributed to its numerous characteristics, including its high transmissibility, asymptomatic persons’ ability to shed the virus, vast numbers of asymptomatic persons, or mild symptoms but with the ability to transmit the virus, new variants, and super-spreading events. Poor public health practices,disbeliefs, myths, and misconceptions about the virus and its origin in many African communities are the other reasons for its rapid spread. This study aimed to determine the perceptions of the adult population in northern Uganda on the COVID-19 vaccine acceptance, disaggregated by age groups. Methods: A cross-sectional study was conducted between March and April 2022 to assess COVID-19 vaccine acceptance among seven hundred and twentythree adult populations selected randomly from the nine districts of the Acholi sub-region. A five-point Likert scale with responses categorized as Strongly Agree, "SA," Agree, "A," Neutral, "N," Disagree, "DA," and Strongly Disagree, "SD" was used to assess participants' acceptance of the COVID-19 vaccines. Ethical approval was obtained from a local IRB, and SPSS version 20.0 was used to perform multivariable logistic regression to identify factors associated with vaccine acceptance. A p-value less than 0.05 was considered significant. Results: The most significant finding was that COVID-19 vaccine acceptance among the adult population in northern Uganda disaggregated by age groups was not statistically significant (χ2=3.956; p=0.142). COVID-19 vaccine acceptance among the age groups was associated with trust in the information from the mainstream media χ2=20.105; p=0.000; Government of Uganda χ2=19.900; p=0.028 and social media 10.745; p=0.030. The independent predictors on perceptions of the COVID-19 vaccine acceptance among age groups were; Participants strongly agreed on its importance to protect them from the virus AoR=4.99;95% CI:1.626-15.337;p=0.005; Agreed that the vaccine would protect them from the virus AoR=3.44;95%CI:1.225-9.650;p=0.019; strongly agreed that the side effects of the vaccine would stop them from receiving the vaccine AoR=0.330; 95%CI:0.125-0.856; p=0.023; They were neutral on whether the side effects of the COVID-19 vaccine would stop them from getting a COVID-19 jab AoR= 0.320; 95%CI:0.108-0.952;p=0.027; would not accept to pay for the COVID-19 vaccine AoR=0.280;95%CI:0.093-0.866; p=0.027; Agreed that children could take a COVID-19 vaccine AoR= 0.260; 95%CI:0.105-0.626;p=0.003; Strongly agreed that children could return to school before the COVID-19 vaccination AoR= 2.330; 95%CI:1.103-4.916;p=0.027; and agreed that children could return to school before taking COVID-19 vaccines AoR= 3.320; 95%CI:1.225-9.014;p=0.018. Conclusion: COVID-19 vaccine acceptance among the study population disaggregated by age group was not significant despite the disinformation and misinformation in the Ugandan media. The independent determinants of COVID-19 vaccine acceptance were the importance of the vaccine in protecting against the virus, that the vaccine’s side effects could stop them from taking the vaccine, and that children could take the COVID-19 jab but could return to school before taking the COVID-19 jab. The fear of family members contracting the virus and self-isolation when infected contributed significantly to the COVID-19 vaccine acceptance among participants in northern Uganda. There is a need for health managers to engage, sensitize and mobilize the population by addressing concerns about long-term and immediate side effects to increase the COVID-19 vaccine uptake in this community.
Polycystic ovarian syndrome: diagnostic challenges in resource-poor settings (Ugandan perspectives)
(PAMJ Clinical Medicine., 2021-01-29) Pebolo, Francis Pebalo; Auma, Anna Grace; Alobo, Gasthony
Polycystic ovarian syndrome is the most common cause of anovulatory infertility accounting for up to 40% of the reasons for visiting a doctor. The Ugandan government has recognized infertility as a major problem affecting over five million people, yet polycystic ovarian syndrome is not included in the Ugandan Clinical Guidelines, hence it´s not part of the Uganda minimum healthcare package. Lack of guidelines means diagnosis is a challenge and many cases have delayed or no diagnosis. Early diagnosis is good for awareness of associated risks such as infertility, dysfunctional uterine bleeding,endometrial cancer, obesity, diabetes, dyslipidemia, hypertension, and cardiovascular diseases. Clinical laboratories are handy in the diagnosis as well as follow-up of PCOS cases and in most rural settings, these are lacking, confounded by the lack of skilled frontline workers such as gynecologists and reproductive endocrinologists
Prevalence of Teenage Pregnancy and Associated Factors in Agago District, Uganda:
(Taylor & Francis, 2023-08-07) Okot, Christopher; Laker, Florence; Okwir Apio, Pamela; Madraa, Grace; Kibone, Winnie; Pebolo, Francis Pebalo; Bongomin, Felix
Background: Teenage pregnancy remains a common public health and social problem associated with negative health outcomes. Wedetermined the prevalence and factors associated with teenage pregnancy among teenage girls aged 13–17 years in Agago district,Uganda. Methods: We conducted a community-based, cross-sectional study between October and November 2020 in Lapono Sub-County, Agago district among teenage girls 13–17 years. Multi-stage sampling technique was used. Parishes, villages, and households were randomly selected (computer generated random numbers were used for household selection). In each household, one participant was randomly selected for interview and pregnancy testing. We collected data on socio-demographic factors using a pre-tested semistructured questionnaire. All eligible participants were tested for urine human chorionic gonadotropin (hCG). Multivariable logistic regression analysis was done to determine independent predictors of teenage pregnancy, with p<0.05 considered statistically significant. Results: A total of 289 eligible participants, with a mean age of 15.1±1.5 years, were enrolled. Most (n=246, 81.5%) participants had attained primary education, 18 (6.2%) were married, 41 (14.2%) used alcohol, 62 (21.5%) had a history of sexual intercourse and 32 (11.1%) were sexually abused. The prevalence of teenage pregnancy was 2.8% (n=8). Factors significantly associated with teenage pregnancy were alcohol consumption (adjusted odds ratio (aOR): 13.2, 95% Confidence Interval (95% CI): 1.7–100.6, p=0.013) and having secondary/tertiary education (aOR: 10.2, 95% CI: 1.5–71.9, p=0.02). Conclusion: The study findings suggest that teenage pregnancy is still a public health and social problem in Agago district, Uganda. Interventions discouraging alcohol consumption and promoting education among teenagers are key in addressing the burden of teenage pregnancies in the district.
Primary Uterine Perforation with Tcu 380a Intrauterine Device: A Case Report of 32 Years Old Lady in Gulu Hospital
(JOURNAL OF CASE REPORTS, 2015-09-20) Pebolo, Francis Pebalo; Ocaya, Anthony
Introduction: Intrauterine device (IUD) is one of the most frequent methods of modern contraception due to its cost effectiveness and low complication rate. Uterine perforation is among the most serious complication associated with IUD insertion. The incidence of perforation is between 1.3 and 1.6 per 1000 insertion. Objective: To describe a case of primary uterine perforation by TCu 380A intra-uterine device. Method: We report a case of primary uterine perforation in a 32-year-old para 4 lady. She had TCu 380A intrauterine device inserted for contraception. She had sharp lower abdominal pain during the insertion and presented one month post-insertion with persistent lower abdominal pain and pain and increased frequency of passingurine. Result: Ultrasound scan showed an empty endometrial cavity but IUD was noted in right adnexal region. An elective exploratory laparatomy showed IUD embedded into the myometrium just visibly seen in the vesico-uterine peritoneal reflection. Conclusion: Uterine perforation by IUD is a rare but potentially dangerous complication of IUD insertion. Health workers should have high index of suspicion for possible uterine perforation and vesicle involvement if a patient presents with history of persistent lower abdominalpain and urinary symptoms
Trusted sources of information on COVID-19 vaccines during the pandemic in Uganda. A crosssectional study
(Research squares, 2023-10-17) Oloya, Johnson Nyeko; Alema, Nelson Onira; Okot, Christopher; Olal, Emmanuel; Ikoona, Eric Nzirakaindi; Oyat, Freddy Wathum Drinkwater; Steven, Baguma; Ochula, Denish Omoya; Olwedo, Patrick Odong; Pebolo, Francis Pebalo; Atim, Pamela Okot; Okot, Godfrey Smart; Nantale, Ritah; Aloyo, Judith; Kitara, David Lagoro
Background. COVID-19 has dramatically impacted communities worldwide, especially in developing countries. To successfully control the COVID-19 pandemic, more than 80% vaccination coverage was required, and the flow of correct information to the population was critical. However, misinformation and disinformation could impact this, increasing COVID-19 vaccine hesitancy in some communities. Several studies have assessed the effect of misinformation and disinformation on COVID-19 vaccine acceptance and other responses to the pandemic in the African continent. Thus, the most trusted sources of information on COVID-19 vaccines to the population is critical for successfully managing and controlling the pandemic. This study aimed to assess the most trusted sources of information on COVID-19 vaccines during the pandemic in northern Uganda.
Trusted sources of information on COVID-19 vaccines during the pandemic in Uganda:
(Research squares, 2023-10-17) Oloya, Johnson Nyeko; Alema, Nelson Onira; Okot, Christopher; Olal, Emmanuel; Ikoona, Eric Nzirakaindi; Oyat, Freddy Wathum Drinkwater; Steven, Baguma; Ochula, Denish Omoya; Olwedo, Patrick Odong; Pebolo, Francis Pebalo; Atim, Pamela Okot; Okot, Godfrey Smart; Nantale, Ritah; Aloyo, Judith; Kitara, David Lagoro
Background. COVID-19 has dramatically impacted communities worldwide, especially in developing countries. To successfully control the COVID-19 pandemic, more than 80% vaccination coverage was required, and the flow of correct information to the population was critical. However, misinformation and disinformation could impact this, increasing COVID-19 vaccine hesitancy in some communities. Several studies have assessed the effect of misinformation and disinformation on COVID-19 vaccine acceptance and other responses to the pandemic in the African continent. Thus, the most trusted sources of information on COVID-19 vaccines to the population is critical for successfully managing and controlling the pandemic. This study aimed to assess the most trusted sources of information on COVID-19 vaccines during the pandemic in northern Uganda. Methods. We conducted a cross-sectional study on 587 adult population members in northern Uganda. Stratified and systematic sampling methods were used for selecting participants from twenty-four health facilities in the Acholi subregion. Data were collected using an interviewer-administered questionnaire with an internal validity of Cronbach's α=0.72. A local IRB approved the study, and Stata version 18 was used for data analysis. A Pearson Chi-square (χ2) analysis was conducted to assess the association between trusted sources of information on COVID-19 vaccines among study participants and selected independent variables. Fisher's exact test assessed association when cell value following crosstabulation was ≤5. A P-value <0.05 was used as evidence for an association between the trusted sources of information and independent variables. All results were presented as frequencies and proportions and Chi-square or Fisher's exact test P-values at 95% Confidence Intervals (CI). Results: In a study of 587, most participants were males, 335(57.1%), in the age group of 25-34 years, 180(31.4%), and the most trusted source of information on COVID-19 vaccines were the traditional media sources such as Televisions, Radios, and Newspapers, 349(33.6%). There was no significant association between sex and sources of information on COVID-19 vaccines. However, by age group population, it was significantly associated with internet use (14.7% versus 85.3%; p=0.02), information from family members (9.4% versus 90.6%; p<0.01), and the Government/Ministry of Health (37.9% versus 62.1%; p<0.01). In addition, it was significantly associated with internet use (32.2% versus 67.8%; p=0.03), healthcare providers (32.5% versus 67.5%; p<0.018), the Government/Ministry of Health (31.1% versus 68.9%; p<0.01), and scientific articles (44.7% versus 55.3%; p<0.01) in healthcare workers compared to non-health workers. Conclusion. The most substantial finding from our study was that the most trusted sources of information on COVID-19 vaccines in northern Uganda were Television, Radio, and Newspapers. There were no significant differences in the most trusted sources of information on COVID-19 vaccines between the sexes but significant differences by age groups and occupations, with the younger age groups and non-healthcare workers having more trust in TVs, Radios, and Newspapers. For effective management of an epidemic, there is a need for accurate communication so that misinformation, disinformation, and malinformation do not disrupt the flow of information to communities.

Browsing by Author "Pebolo, Francis Pebalo"

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