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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
Severe malaria burden, clinical spectrum and outcomes at Apac district hospital, Uganda: a retrospective study of routine health facility based data
(Malaria Journal, 2023-10-25) Emmanuel Ocen; Ronald Opito; Crispus Tegu; Alex Oula; Peter Olupot‑Olupot
Background Most data describing severe malaria (SM) in sub‑Saharan Africa (SSA) are from research settings out
side disease endemic areas. Using routinely collected data from Apac District Hospital, this study aimed at determin
ing the burden and clinical spectrum of severe malaria.
Methods This was a retrospective study that reviewed all paediatric admission records for malaria in the 24 months
period from Jan 2019 to Dec 2020 at Apac District Hospital. Data on children aged 60 days to 12 years who at admis
sion tested positive for malaria and fulfilled the World Health Organization clinical criteria for surveillance of severe
malaria were abstracted using a customized proforma designed to capture variables on social demographic, clinical
presentation, treatment, and outcomes. In addition, the tool included laboratory variables for complete blood counts,
haemoglobin, and glucose levels. Data were analysed using STATA V15.0. The study had ethical approval from Mbale
Regional Referral Hospital REC, Approval No. MRRH‑REC 053/2019.
Results A total of 5631 admission records were retrieved for this study period. Of these, 3649 (64.8%) were malaria
admissions and 3422/3649 were children below 12years, with only 1864 (54.5%) of children having complete data.
Of the 1864 children, 745 (40.0%) fulfilled the severe malaria inclusion criteria. Of the 745 children, 51.4% (n = 381)
were males. The median age at admission was 31 months (IQR = 17–60). The most common clinical presentations
among children with severe malaria were fever 722 (97.3%), cough 478 (64.2%), and difficulty in breathing 122 (17.9%).
The median length of hospital stay was 2 (IQR; 2–4) days and 133 (17.9%) had prolonged hospital stay (> 4 days).
Factors independently associated with prolonged hospital stay were, presenting with difficulty in breathing, aOR 1.83
(95% CI 1.02–3.27, P = 0.042) and prostration aOR 8.47 (95% CI 1.94–36.99, P = 0.004). A majority of admitted children,
735 (98.7%) survived, while 10 (1.3%) died of SM.
Conclusion A high proportion (40.0%) of malaria admissions were due to SM. Prolonged Hospital stay was associ
ated with prostration and difficulty in breathing. Overall mortality was low, 1.3% compared to mortality in the previ
ously reported series. This study was able to use routinely collected data to describe the burden and clinical spectrum
of SM. Improvement in the quality of data from such settings would improve disease descriptions for policy, monitor
ing of epidemics, response to interventions and to inform research.
Diagnostic and pre-treatment intervals among patients with cervical cancer attending care at the Uganda Cancer Institute: a cross-sectional study
(BMC Women's Health, 2023-11-03) Jackie Lalam Lacika; Henry Wabinga; Joseph Kagaayi; Ronald Opito; Christopher Garimoi Orach; Amos Deogratius Mwaka
Background Majority of patients with cervical cancer in the low- and middle-income countries experience long
diagnostic and pre-treatment intervals. This study sought to determine the factors associated with the diagnostic and
pre-treatment intervals among patients with cervical cancer.
Methods This was a cross-sectional study conducted at the Uganda Cancer Institute (UCI) during October 2019 to
January 2020. Patients aged ≥ 18 years with histological diagnosis of cervical cancer were consecutively sampled. Data
were collected using a pre-tested semi-structured questionnaire and a data abstraction form. Diagnostic intervals,
defined as the time between first visit of a patient to a primary healthcare provider to time of getting confirmed
diagnosis, of ≤ 3 months was defined as early & >3 months as late. Pre-treatment intervals, which is the time from
histological diagnosis to starting cancer chemo-radiotherapy of ≤ 1 month was defined as early and > 1 month as late.
Data were analysed using STATA version 14.0. We used modified Poisson regression models with robust variance to
determine socio-demographic and clinical factors associated with the intervals.
Results The mean age of the participants was 50.0 ± 11.7 years. The median diagnostic and pre-treatment intervals
were 3.1 (IQR: 1.4–8.2) months and 2.4 (IQR: 1.2–4.1) months respectively. Half of the participants, 49.6% (200/403)
were diagnosed early; one in 5 patients, 20.1% (81/403) promptly (within one month) initiated cancer chemo
radiotherapy. Participants more likely to be diagnosed early included those referred from district hospitals (level 5)
(aPR = 2.29; 95%CI: 1.60–3.26) and with squamous cell carcinomas (aPR = 1.55; 95%CI: 1.07–2.23). Participants more
likely to be diagnosed late included those who first discussed their symptoms with relatives, (aPR = 0.77; 95%CI:
(0.60–0.98), had > 2 pre-referral visits (aPR = 0.75; 95%CI (0.61–0.92), and had advanced stage (stages 3 or 4) (aPR = 0.68;
95%CI: 0.55–0.85). Participants more likely to initiate cancer chemo-radiotherapy early included older patients (≥ 60
years) (aPR = 2.44; 95%CI: 1.18–5.03). Patients likely to start treatment late were those who had ≥2 pre-referral visits (aPR = 0.63; 95%CI: 0.41–0.98) and those that took 3 - 6 months with symptoms before seeking healthcare (aPR =
0.52;95%CI: 0.29 - 0.95).
Conclusion Interventions to promote prompt health-seeking and early diagnosis of cervical cancer need to target
primary healthcare facilities and aim to enhance capacity of primary healthcare professionals to promptly initiate
diagnostic investigations. Patients aged < 60 years require targeted interventions to promote prompt initiation of
chemo-radiation therapy.
Keywords Cervical cancer, Diagnostic intervals, Pre-treatment intervals, Advanced stage
Prostate Cancer Among Patients Presenting with Obstructive Lower Urinary Tract Symptoms at a Tertiary Hospital in South Western Uganda
(DovePress Taylor and Francis, 2025-09-30) Willy Kyegombe; Okidi Ronald; Anitah Nimusima; Yakobo Nsubuga; Brenda Nakitto; Christine Nannungi; Joseph Epodoi; Ronald Opito; Eddymond Ekuk
Background: Prostate cancer is currently the second commonest male cancer both globally and in Uganda. Men are often tested after
presenting with obstructive lower urinary tract symptoms (LUTS). We evaluated total prostate-specific antigen patterns (tPSA), digital
rectal examination (DRE) findings, histological findings and prostate cancer rates among patients presenting to Mbarara regional
referral hospital with obstructive LUTS.
Methods: This was a cross-sectional study of 140 patients aged ≥50 with obstructive LUTS. Data on demographics and severity of
LUTS was collected, plus the results of tPSA testing and DRE. Later, digitally guided transrectal tru-cut prostate biopsy was
performed, if necessary. Analysis was done using SPSS (Statistical Package for Social Scientists), version 14. Confidence interval
(CI) was set at 95% and P at 0.005.
Results: The majority of patients had severe LUTS (n=103, 73.57%), with a median tPSA of 14.4 ng/mL. Ninety-nine patients
experienced digitally guided transrectal tru-cut prostate biopsy (70.71%; Fisher’s exact test = 0.001). DRE abnormalities were found in
57.14% (n=80) of participants and these carried a higher risk for prostate cancer diagnosis (risk ratio = 5.895; Fisher’s exact test =
0.04; CI 95%: 1.59–21.822). The tru-cut biopsy positivity rate was high, at 46% (45/99; 95% CI: 30.1–46.3); all had prostate
adenocarcinoma and the majority (77.78%, n=35) had a total Gleason score of 8 and above. Of those who had a malignancy, more than
a quarter were between 60–80 years of age (37.8%, n = 17). There was no statistically significant relationship between LUTs and
prostate cancer diagnosis (Fisher’s exact test 2-sided = 0.84).
Conclusion: Although severity of LUTS was not predictive of cancer, there was a high rate of advanced prostate cancer among study
participants. DRE remains a valuable tool for identifying potential prostate cancer cases, especially in settings where PSA testing may be
limited. Further research is needed to explore effective screening strategies and improve outcomes for men with prostate cancer in Uganda.
Keywords: prostate cancer, prostate-specific antigen, lower urinary tract obstruction, digital rectal examinatio
Acceptability of pre-exposure prophylaxis and associated factors among HIV-negative young men in Kagwara fishing community-Serere district, Uganda: A cross-sectional study
(PLOS ONE, 2025-06-04) Alex Omoding; Ronald Opito; Paul Oboth; Francis Okello; Joseph K. B. Matovu
Background
Despite the potential efficacy of Pre-Exposure Prophylaxis (PrEP) in reducing HIV
risk, Oral PrEP acceptability remains strikingly varied by populations and locations.
We assessed PrEP acceptability and associated factors among at-risk HIV-negative
young men.
Methods
A cross-sectional analytical study design was used. Data were collected among
409 at-risk HIV-negative young men aged 15–24 years living in Kagwara fishing
community- Serere district, Uganda between August and October 2023. Quantitative
data were collected on socio-demographic characteristics, sexual risk behaviors
and concerns about PrEP. Data was analyzed using Stata version 15.0 statistical
software. Summary statistics were computed and presented as tables, frequencies
and proportions. Bivariate analysis was conducted using binary logistic regression to
identify independent factors associated with PrEP acceptability. All factors that had
p < 0.10 at the bivariate analysis and confounders were entered into the final logistic
regression model. All factors with p < 0.05 were considered significantly associated
with the primary outcome
Results
The average age of 409 respondents was 21.8 (Standard Deviation [SD]=1.9) years.
Majority, (97.8%, n = 393) had unprotected penetrative sex. PrEP acceptability was high as majority of the participants accepted to use PrEP based on the six constructs
of acceptability (93.6%, n = 383). Participants with perceived risk of getting HIV
infection had higher odds of PrEP acceptability, (adjusted odds ratio [aOR]=4.23,
95%CI = 1.05–17.04). Participants who knew their partner’s HIV status (aOR=0.25,
95%CI = 0.07–0.88), those who felt embarrassed to ask for PrEP from the facility
(aOR=0.12, 95%CI = 0.04–0.39), and those who had stigma associated with use of
PrEP (aOR=0.13, 95%CI = 0.04–0.41) had reduced odds of PrEP acceptability.
Conclusion
We found a high level of PrEP acceptability among young men at risk of HIV acqui
sition in Kagwara fishing community. Improving access to PrEP services among
high risk young men in the fishing communities may increase PrEP uptake in this
population and across similar settings. The Ministry of health needs to use multiple
approaches to provide PrEP such as peer-led models, drug distribution points, short
message reminders for refills, pharmacies and retail drug shops.