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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
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.
Ikoja Odongo, J. R. (2024). Information Needs and Uses of the Informal Sector Entrepreneurs: A Conceptual, Contextual and Historiographic Review.
(Springer, 2025-02-02) Ikoja, O. J. R.
This chapter reviews extant literature on information needs and uses of the informal sector entrepreneurs of Uganda. The review is based on the study conducted from 1999 to 2002. By this time, studies on information needs were already forty years old since the early writing and exposition by Taylor in 1962, 1968. Motivation to the study is that the informal sector whose entrepreneurs were studied, had during this time relatively few studies of information needs and uses undertaken in developing Africa and within Uganda there was no empirical evidence to rely on to the size, nature, range, and activities of the sector. There is also a wide information gap in government, NGOs and other stakeholders on the sector regarding what they do and yet the sector contributes to the national economy. However the sector is part of the Ugandan economy that is deeply rooted in the history, customs and culture of the country. It is the second economy that has demonstrated remarkable ability to survive and expand in recent years. To understand the information needs and uses of entrepreneurs, their demographic and business characteristics are highlighted and empirically tested. Qualitative research methodologies, applying critical incidence technique for interviews of informal entrepreneurs from various trades was employed. Observations of entrepreneurs’ work environments and historical methods were engaged. Results suggest modern/exotic models of information transfer based on textual media and ICT, exhibit less impact on the entrepreneurs’ information needs and use at macro levels because of illiteracy, low levels of education and poor information infrastructure. Most ‘elite’ models share a platform with information behavior of entrepreneurs at the micro levels. The conclusion is drawn that an appropriate model for information behavior for information poor communities like the informal entrepreneurs must be grounded on oral traditions and indigenous knowledge and should be sensitive to poverty, infrastructure and illiteracy. There is need for information repackaging and use of appropriate media for information provision.
Malignant mixed mullerian tumor: A case report about a uterine Tumor’s case
(International Journal of Surgery Open, 2022) Morgan, E. D; Okecha, T; Yahaya, J. J; Othieno, E
Introduction: Malignant mixed Mullerian tumor (MMMT) is an exceedingly rare and aggressive tumor which occurs predominantly in postmenopausal women though it has been reported rarely in premenopausal women.
Case presentation: A 54-year old nulliparous postmenopausal female presented with a 3-month history of vaginal bleeding, mild lower abdominal pain and weight loss. Ultrasound revealed markedly enlarged uterus with a hyper-echoic solid and cystic mass and a right adnexal complex mass. Total abdominal hysterectomy and bilateral salpingioopherectomy were done. Histopathological features were consistent with MMMT. The patient
is currently stable after 6 cycles of adjuvant chemotherapy which consisted of paclitaxel and carboplatin.
Clinical discussion: MMMT of the uterus is rare, high-grade neoplasms comprising only 1–2% of uterine cancers and 3–5% of all uterine malignancies. This tumor may arise in the ovaries, fallopian tubes and vagina. Histologically, MMMT is a biphasic tumor composed of both epithelial (carcinoma) elements and mesenchymal (sarcoma) elements; though, which component is responsible for the tumor’s aggressive biological behavior
remains undetermined.
Conclusion: MMMT is a rare and aggressive tumor which is commonly seen in postmenopausal women with high rate of recurrence therefore, Radical surgery and close follow-up is mandatory since the role of chemoradiotherapy remains unclear in the management of patients with this tumor. Both stage of the tumor and myometrial invasion are considered as potential prognostic factors.
Invasive ductal carcinoma of breast in a 73-year old male: A rare case report and literature review
(International Journal of Surgery Case Reports, 2023) Yahaya, J. J; Ngaiza, A. I; Morgan, E. D; Abraham, Z. S; Othieno, E
Introduction and importance: Male breast cancers despite being similar to female breast cancers in various aspects; however, they have important distinctive characteristics such as molecular biology, increased tendency for axillary lymph node metastasis and late age at presentation.
Presentation of case: We present the case of a 73-year old indigenous African male who had a 3-year history of right breast swelling which was associated with episodes of pain and tenderness. The assigned clinical stage for the patient was T2aNoMo. The mass was histologically confirmed to be invasive ductal carcinoma, not specified type (NST) without axillary lymph node involvement or distant metastasis. Immunohistochemistry also showed positive results for ER and PR hormonal receptors but negative for HER2.
Clinical discussion: Considering the rarity nature of male breast cancers, this contributes to lack of evidence of the specific treatment approaches despite the noticeable difference in clinical presentation and even biological characteristics of male breast cancers, which are more likely to contribute to poor prognosis.
Conclusion: The prevalence of male breast cancers has been reported to be less than 1 % of all male cancers. This contributes to the lack of analytical large studies that address the comprehensive data regarding the clinical outcomes of breast cancer among men and their predictors. Therefore, having prospective multicenter studies in future would help in providing high level of evidence on prognosis.