Browsing by Author "Hellen Akurut"

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Community perspectives and insights into cancer surveillance, prevention, and research: an engaged participatory approach to cancer epidemiology research in remote areas of Northeastern Uganda
(Springer Nature, 2026-04-24) Ronald Opito; Alfred Jatho; Wilber Sabiiti; Hellen Akurut; Emmanuel Othieno; Lawrence Obado Osuwat; Anthony Mugeere; Patrick Igulot; Jackson Orem
Background There is limited research on cancer screening, prevention and treatment in the remote areas of Northeastern Uganda. Specifically, there is limited research presenting cancer control stakeholder perspectives in remote settings, whereas stakeholders’ perspectives are critical for an engaged participatory approach to cancer control. This study therefore aimed to establish the community (patients, caretakers, opinion leaders, health managers and policy makers) perspectives on cancer surveillance, prevention, treatment and identify priorities for cancer research in Northeastern Uganda. Methods This qualitative research was part of a stakeholder’s consultation on cancer research priorities in Northeastern Uganda for Wellcome Trust research grant application, conducted by a consortium of research partners. Six semi structured Key Informant Interviews (KIIs), two focus group discussions (FGDs) and one community dialogue meeting were conducted between July and August 2025. Thematic data analysis was conducted to identify emergent themes from the interviews. Findings are presented using the key emergent themes, supporting quotes, and are presented in tables and text. This study is reported in accordance with Consolidated Criteria for Reporting Qualitative Research (COREQ). Key Findings There was delayed diagnosis in most cases for cancer patients. After the cancer diagnosis, patients were referred to Mulago Hospital, approximately 300Km away from their homes for further treatment, with many hesitations and incapacity to go to Mulago due to many social and economic challenges. There is no stand-alone cancer surveillance system in the country and currently it depends on health facility data which have lots of weaknesses including incompleteness and inaccuracy. Health facilities are ill-prepared to respond to the growing burden of cancers. Priorities for cancer research include epidemiology and etiology of cancer and a focus on population-based registry for unique populations in Uganda and strengthening cancer surveillance systems. Conclusion This study highlights the importance of an engaged approach based on Participatory Action Research theory to identify problems. Through this approach, the research team was able to accurately understand the research context, identify research issues, and priorities. Priorities for cancer research identified by this study include epidemiology and etiology of cancer, including the incidence studies and geographical mapping of these cancers, conducting cancer disease surveillance at the landing site and investigating the contribution of the locally available foods and environment to cancers. There is need for community sensitization and screening for cancers in the entire region. Involvement of community team leaders such as village health teams (VHTs), local council I (LCIs), traditional and church leaders in cancer surveillance should be encouraged and the community case definitions of common cancers should be refined and the capacity of the community workers (VHTs) built to detect cancers at community level. Through this preliminary research, the groundwork for science anchored on the realities of the affected people has been firmly laid upon which science can build on to solve the problem in a sustainable and equitable way.
Facilitators and Barriers to Cervical Cancer Screening Among Women in a Rural District of Northeastern Uganda, a Qualitative Study
(Dove Medical Press Limited, 2026-04-23) Ibra Mutyaba; Hellen Akurut; Racheal Nabaasa; Jonathan Limo; Emmanuel Okupa; Christine Acari Omuke; Ronald Opito
Introduction: Cervical cancer screening in Uganda has remained relatively low, with fewer than one in 10 of eligible women screened, despite the availability of cervical cancer screening services in most health facilities. The barriers and facilitators of cervical cancer screening in remote rural settings of Northeastern Uganda like Ngora are not yet well understood. This study therefore aimed to assess the barriers and facilitators to cervical cancer screening among women of reproductive age in a remote rural district Ngora, Northeastern Uganda. Methods: This study employed a qualitative approach to gather in-depth insight into the barriers and facilitators of cervical cancer screening. We conducted six focused group discussions (FGDs) (4 females and 2 males) with the community members and nine key informant interviews (KIIs) with the health workers in Ngora district. The participants for FGDs were chosen through convenient sampling while those for KIIs were chosen through purposive sampling methods. The interviews were audio-recorded and subse quently transcribed for analysis. Data was analyzed using thematic analysis techniques to identify significant patterns and themes related to cervical cancer screening behaviors, while inductive coding was conducted to identify codes and create meaning around the texts. Results: The facilitators of cervical cancer screening were active community sensitization, availability of screening services at designated facilities, supportive national policies, and integration with other health services, while the barriers included myths and misconceptions about cervical cancer screening, stock-outs of essential commodities for screening, long distances to the health facilities, limited human resources, and informal costs charged by the health facilities. Conclusion: Improving cervical cancer screening uptake requires a multi-pronged approach that strengthens health systems, addresses myths and misinformation, reduces financial and logistical burdens, and mobilizes community support. Keywords: cervical cancer, facilitators, barriers, community sensitization
Factors Associated with Cervical Cancer Screening Uptake Among Women Attending Outpatient Department in a Rural District Hospital in Uganda. A Cross-Sectional Study
(International Journal of Women's Health, 2025-08-21) Jimmy Ekinu; Emmanuel Tiyo Ayikobua; Elizabeth Icodu; Hellen Akurut; Olympia Olivia Akot; Steven Oder; John Micheal Opinya; Tonny Egau; David Aderu; Moses Eremu; James Daniel Odongo; Walter Dreak Erabu; Ronald Opito
Background: Sub-Saharan Africa (SSA) faces persistently low cervical cancer screening uptake, averaging only 13% over the past f ive years, with Uganda reporting less than 5%. This study aimed to assess the factors influencing cervical cancer screening uptake in a rural district hospital to inform targeted interventions that enhance screening coverage for the rural community. Methods: This was a cross-sectional study conducted at Kaberamaido General Hospital (KGH) outpatient department. A total of 422 participants aged between 25 and 49 years were interviewed and data analyzed using STATA version 16.0. Bivariate and multivariate analyses were performed using modified Poisson regression with robust error estimates to identify key factors associated with cervical cancer screening uptake. Variables with P-value <0.05 were considered statistically significant. Results: The average age of participants was 32 (SD ±7) years. 77.5% (n=327) of participants were married, had primary level of education, 69.2% (n=292), and were unemployed, 89.3% (n=377). Awareness about screening was high as 85.5% (n=360) of respondents had heard about cervical cancer screening. Cervical cancer screening uptake was low, as only 20.4% (n=86) had been screened in the past five years. Factors significantly associated with increased screening uptake, including age older than 35 years, adjusted Prevalence Ratio [aPR]= 1.7 (95% CI: 1.08–2.69), availability of free government screening services, aPR = 1.6 (95% CI: 1.09–2.38), provision of screening service at the nearest health facility, aPR = 2.1 (95% CI: 1.09–3.97), and a positive family history of cervical cancer, aPR = 1.7 (95% CI: 1.14–2.65). Conclusion: Our study confirms that cervical cancer screening uptake in Kaberamaido District remains low, highlighting the need for enhanced awareness campaigns and improved access to screening services. Our findings emphasize the need for policies that strengthen community outreach programs and expand cervical cancer screening services at primary healthcare facilities. Keywords: uterine cervical neoplasms, cervical cancer screening, women, cervical cancer awareness
Factors Associated with Cervical Cancer Screening Uptake Among Women Attending Outpatient Department in a Rural District Hospital in Uganda. A Cross-Sectional Study
(International Journal of Women’s Health, 2025-08-21) Jimmy Ekinu; Emmanuel Tiyo Ayikobua; Elizabeth Icodu; Hellen Akurut; Olympia Olivia Akot; Steven Oder; John Micheal Opinya; Tonny Egau; David Aderu; Moses Eremu; James Daniel Odongo; Walter Dreak Erabu; Ronald Opito
Background: Sub-Saharan Africa (SSA) faces persistently low cervical cancer screening uptake, averaging only 13% over the past five years, with Uganda reporting less than 5%. This study aimed to assess the factors influencing cervical cancer screening uptake in a rural district hospital to inform targeted interventions that enhance screening coverage for the rural community. Methods: This was a cross-sectional study conducted at Kaberamaido General Hospital (KGH) outpatient department. A total of 422 participants aged between 25 and 49 years were interviewed and data analyzed using STATA version 16.0. Bivariate and multivariate analyses were performed using modified Poisson regression with robust error estimates to identify key factors associated with cervical cancer screening uptake. Variables with P-value <0.05 were considered statistically significant. Results: The average age of participants was 32 (SD ±7) years. 77.5% (n=327) of participants were married, had primary level of education, 69.2% (n=292), and were unemployed, 89.3% (n=377). Awareness about screening was high as 85.5% (n=360) of respondents had heard about cervical cancer screening. Cervical cancer screening uptake was low, as only 20.4% (n=86) had been screened in the past five years. Factors significantly associated with increased screening uptake, including age older than 35 years, adjusted Prevalence Ratio [aPR]= 1.7 (95% CI: 1.08–2.69), availability of free government screening services, aPR = 1.6 (95% CI: 1.09–2.38), provision of screening service at the nearest health facility, aPR = 2.1 (95% CI: 1.09–3.97), and a positive family history of cervical cancer, aPR = 1.7 (95% CI: 1.14–2.65). Conclusion: Our study confirms that cervical cancer screening uptake in Kaberamaido District remains low, highlighting the need for enhanced awareness campaigns and improved access to screening services. Our findings emphasize the need for policies that strengthen community outreach programs and expand cervical cancer screening services at primary healthcare facilities. Keywords: uterine cervical neoplasms, cervical cancer screening, women, cervical cancer awareness
Factors associated with uptake and acceptability of cervical cancer screening among female sex workers in Northeastern Uganda: A cross-sectional study
(PLOS One, 2025-01-24) Ronald Opito; Emmanuel Tiyo Ayikobua; Hellen Akurut; Susan Alwedo; Saadick Mugerwa Ssentongo; Walter Drake Erabu; Lazarus Oucul; Musa Kirya; Lameck Lumu Bukenya; Elly Ekwamu; Abraham Ignatius Oluka; Samuel Kabwigu; Emmanuel Othieno; Amos Deogratius Mwaka
Background Cervical cancer screening program in Uganda is opportunistic and focuses mainly on women aged 25–49 years. Female sex workers (FSWs) are at increased risk of developing invasive cervical cancer. There is limited data regarding the uptake and acceptability of cervical cancer screening among FSWs in Uganda. This study aimed at identifying factors associated with uptake and acceptability of cervical cancer screening among FSWs in Eastern Uganda. Methods This was a cross-sectional study conducted among 423 FSWs aged 18–49 years attending care at six health facilities serving Key Populations (FSWs, Men who have sex with men, transgender people, people who inject drugs and people in prisons) in the Teso sub-region. Data was collected using structured investigator administered questionnaire and analyzed using Stata statistical software version 15.0 (Stata Corp, Texas, USA). The primary outcome was uptake of cervical cancer screening measured as the proportion of female sex workers who have ever been screened for cervical cancer. Chi-square test was used to compare the differences in uptake of cervical cancer screening by HIV status. Modified Poisson regres sion model with a robust variance estimator was used to determine association between the outcome variables and selected independent variables including demographic charac teristics. Prevalence ratios (PR) with accompanying 95% confidence intervals have been reported. Statistical significance was considered at two-sided p-values ≤ 0.05. Results The mean age of the participants was 28.1 (±SD = 6.6) years. The self-reported HIV prevalence was 21.5% (n = 91). There were 138 (32.6%) participants who had ever been screened for cervical cancer (uptake), while 397 (93.9%) were willing to be screened (acceptability). There was a significant difference in cervical cancer screening uptake between women living with HIV (WLHIV) and those who were HIV negative, 59.3% vs 26.9% respectively (P < 0.001). The significant factors associated with uptake of cervical cancer screening included living with HIV, adjusted prevalence ratio (aPR) = 1.53 (95%CI: 1.15–2.07), increasing number of biological children, aPR = 1.14 (1.06–1.24) living near a private not for profit (PNFP) facility, aPR = 2.84 (95% CI; 1.68–4.80) and availability of screening services at the nearest health facility, aPR = 1.83 (95% CI, 1.30–2.57). Factors significantly associated with acceptability of cervical cancer screening included being 40 years or older, aPR = 1.22 (95%CI: 1.01–1.47), having a family history of cervical cancer, aPR = 1.05 (1.01–1.10), and living near a PNFP facility, aPR = 1.17 (95% CI, 1.09–1.27) and having ever screened before, aPR = 0.92 (0.86–0.98). Conclusion Female sex workers living with HIV are more likely to screen for cervical cancer than the HIV negative clients. Cervical cancer screening uptake is relatively low among the female sex workers. However, majority of the FSWs are willing to be screened for cervical cancer if the services are provided in the nearby healthcare facilities. There is need to make cer vical cancer screening services available to all eligible women especially the female sex workers and integrate the services with sexual reproductive health services in general and not just HIV/ART clinics services
Prevalence and factors associated with teenage pregnancy among girls aged 13 to 19 years in Atutur sub-county, Kumi district, Eastern Uganda: a community-based cross sectional study
(Reproductive Health, 2025-06-25) Michael Akol; Ronald Opito; Bonniface Oryokot; Hellen Akurut; James Kalema; Maxwell Chekwoti; John Paul Matovu; Nasta Mayamba Chelimo; Hannah Muwanguzi; Moses Eremu; Samuel Kabwigu
Abstract Background Teenage pregnancy remains a pressing public health issue with profound effects on health, education, and socio-economic outcomes. Rural areas, such as parts of Teso, often face higher prevalence of teenage pregnancy due to socioeconomic challenges. This study aimed at determining the prevalence of teenage pregnancy and associated factors in Atutur sub-county, Kumi district. Methodology The authors employed a cross-sectional study design and sampled 444 teenage girls aged 13–19 years from 12 randomly selected villages in Atutur sub-county, Kumi district in April 2024. They were interviewed using structured researcher administered questionnaire. Data was collected using kobo collect tool, downloaded, cleaned and exported to SPPS version 27.0 for further management and analysis. Descriptive statistics was conducted to determine the prevalence of teenage pregnancy. After adjusting for covariates, multivariate analysis was conducted using modified Poisson regression to determine predictors of teenage pregnancy. Results were reported with a 95% confidence interval (CI) and factors whose CI did not contain a null (1.0), with p-value (P < 0.05) for adjusted PR, were considered statistically significant. Results Of the 444 teenage girls, the mean age was 17 (standard deviation = 1.9) years. About one third of the participants, 132(29.7%) had ever conceived. Teenage girls in cohabitation were 3.0 times more likely to have conceived (aPR = 3.0, 95% CI: 2.23–4.10, P < 0.001) compared to those staying with their parents. Teenagers with both parents deceased were 1.9 times more likely to conceive (aPR = 1.9, 95% CI: 1.15–3.31, P = 0.032) compared to those whose parents were both alive. Teenage girls who were not satisfied with basic needs provided by parents were 3.3 times more likely to conceive (aPR = 3.3, 95% CI: 2.26–4.85, P < 0.001) compared to those satisfied with the basic needs provided by their parents. Conclusion Teenage pregnancy rates in Atutur sub-county Kumi district was higher than the national average, due to adverse socio-economic situation. Strengthening parental support of the girl child, with legal and community measures to reduce early marriages in rural settings may reduce teenage pregnancy. There is need to make deliberate efforts to provide socio-economic strengthening for the teenage girls to reduce their vulnerability. Keywords Teenage pregnancy, Prevalence, Cross-sectional, Early marriage
Prevalence and factors associated with mental health problems among adolescents living with HIV as screened by youth peers in rural Uganda: A cross-sectional study
(PLOS Global Public Health, 2026-04-29) Mary Abwola Olwedo; Simon Eleku; Emmanuel Ayikobua Tiyo; Richard Mpango; Alex Imalingat; Fred Kirya; Derrick Amone; Hellen Akurut; Nelson Bunani
Adolescents living with HIV face numerous psychosocial challenges that increase their vulnerability to mental health problems. However, limited evidence exists on the prev alence and contributing factors among this population in the Teso region of Uganda. This study assessed the prevalence of mental health problems and associated fac tors among adolescents living with HIV in the Teso region. A cross-sectional study was conducted among adolescents aged 10–19 years receiving HIV care in selected high-volume health facilities in the Teso region. Data were collected using the Home, Education/Employment, Activities, Drugs, Sexuality, Suicide/Depression psychosocial assessment tool (HEADSS tool), uploaded onto Kobo Collect for digital data collection. The data were exported to Microsoft Excel, cleaned, and analyzed using STATA version 17. Descriptive statistics were used to summarize sociodemo graphic characteristics and estimate the prevalence of mental health problems. Logistic regression analysis was used to identify factors associated with mental health prob lems. The prevalence of mental health problems was 35.2%, with suicidal tendencies being the most common (31%). Factors significantly associated with mental health problems included staying with one parent (AOR = 0.71; 95% CI: 0.55-0.92; p = 0.001) and not working (AOR = 4.4; 95% CI: 1.66–11.62; p = 0.03). Mental health problems are prevalent among adolescents living with HIV in the Teso region. Supportive living arrangements were protective, while employment was associated with increased risk. Peer-led screening can aid early identification, emphasizing the need to integrate men tal health services into adolescent HIV care, strengthen family and caregiver support
Profiling the disease burden in Teso subregion during community-based medical education and research services at Soroti University: a prospective study protocol
(Archives of Public Health, 2026-06-18) Opito Ronald; Amos Odiit; Hellen Akurut; Emmanuel Ayikobua Tiyo; Joash Okoboi; Letizia Maria Atim; Clement Munguiko; Lawrence Obado; Bonniface Oryokot; Fred Kirya; Ruth Muhindo; David Aderu; Patrick Lubogo; Stephen Econyu; Simon Icumar Omeke; Samuel Kabwigu; Amos Deogratius Mwaka
Background: Community-based medical education and research services (COBMERS) place medical students in primary health care facilities to strengthen their skills in community health service delivery, teamwork, leadership and professional ethics within limited-resource settings. Beyond training, COBMERS enables universities to generate evidence on local disease epidemiology, transmission dynamics, and control practices, resulting in a tangible, contextualized impact on the communities. There is however limited data on disease profile in Teso subregion, with limited epidemiological research in the area. This prospective study aims to profile the disease burden in the Teso subregion through COBMERS, thereby informing community-level interventions and health policy. Methods: The study will employ convergent parallel mixed-methods design, integrating quantitative and qualitative approaches. Quantitative ARTICLE IN PRESS components will include cross-sectional surveys to determine prevalence of non-communicable diseases (NCDs), neglected tropical diseases (NTDs), and ACCEPTED MANUSCRIPT ARTICLE IN PRESS infectious diseases, complemented by prospective cohort studies to assess temporal trends. Qualitative data will be gathered through focus group discussions and key informant interviews to explore community perceptions, health system capacity, and effectiveness of preventive measures. A community-based participatory research (CBPR) approach will guide all phases, ensuring that research is co-designed with community members, health practitioners, and local authorities. Medical students, under the supervision of faculty and site mentors, will serve as primary data collectors, integrating research with their COBMERS training. Discussion: The study is expected to provide evidence on the prevalence, trends, and risk factors of major diseases in the Teso subregion, alongside community perspectives on health priorities and barriers to care. Findings will stir up debates to inform tailored interventions, strengthen primary health care, and guide policy formulation. Additionally, embedding research within COBMERS is expected to build local research capacity among site mentors and students, fostering sustainability and continued community university collaboration. This protocol therefore provides an integrated framework that combines epidemiological surveillance, community engagement, and capacity building. By leveraging COBMERS and CBPR, the study seeks to provide actionable evidence to reduce the burden of NCDs, infectious diseases, and NTDs while promoting health system resilience in ARTICLE IN PRESS Eastern Uganda.
Uptake and Completion of Human Papilloma Virus Vaccination by Adolescent Girls Attending Primary Healthcare Facilities in Soroti City, Northeastern Uganda; A Cross Sectional Study
(Journal of Nursing & Healthcare, 2025-02-03) Lydia Dora Nagudi; James Kateregga; Clement Munguiko; Hellen Akurut; Josephine Namujju; Moses Esabu; Ronald Opito
Introduction: Uganda adopted and implemented Human Papilloma Virus (HPV) vaccination since 2015 for adolescent girls aged 9-13 years for primary prevention of cervical cancer. However, the vaccine uptake and dose completion have remained relatively low national wide. Therefore, this study aimed at determining the uptake and dose completion of HPV vaccination and associated factors in Soroti city, Northeastern Uganda. Methodology: This was a cross-sectional study that employed quantitative methods of data collection and analysis. A sample of 287 adolescent girls aged 10-19 years were selected consecutively from four health centers in Soroti City between March and April 2024. Data was analyzed using Stata statistical software, version 15.0. Descriptive statistical analysis was performed to determine the level of HPV vaccine uptake and dose completion. Bivariate and multivariate analyzes were performed using modified Poisson regression with robust error estimates to determine association between independent factors and uptake and dose completion. Results were reported with a 95% confidence interval (CI) and factors whose P-Values were less than 0.05 were considered statistically significant. Results: Of the 287 adolescent girls, their mean age was 14 years (SD=2.9). Most of the participants were in school, 231(80.5%). Majority, 79 % (n=228) had never heard about HPV Vaccination. HPV Vaccination uptake among the study participants was suboptimal as only 58.8% (n=166) had received at least one dose whereas only 30% (n=86) had completed the two doses of the vaccine. The factors that were significantly associated with vaccination uptake were school enrollment status (P=0.022), religion (P=0.010), and awareness about HPV vaccine (P<0.001), while factors that were significantly associated with completion of HPV vaccination were: School enrollment status (P=0.046) and awareness about HPV vaccine (P=0.007). Conclusion: The uptake and completion of HPV vaccination in Soroti was suboptimal compared to WHO target of 90%. School enrollment status and awareness about HPV vaccine were factors significantly associated with HPV uptake and dose completion. Strengthening the school-based HPV vaccination program and creating awareness about HPV vaccination, in schools, at the health facilities and in the community may significantly improve the HPV vaccination and dose completion in the region.