The LRA and Its Costs on Economic Security in Gulu District, Northern Uganda

Background. Globally, 15 countries, mainly in Sub-Saharan Africa, account for 80% of malaria cases and 78% of malaria related deaths. In Uganda, malaria is endemic and the mortality and morbidity due to malaria cause significant negative impact on the economy. In Gulu district, malaria is the leading killer disease among children <5 years. In 2015, the high intensity of malaria infection in Northern Uganda revealed a possible link between malaria and rainfall. However, available information on the influence of climatic factors on malaria are scarce, conflicting, and highly contextualized and therefore one cannot reference such information to malaria control policy in Northern Uganda, thus the need for this study. Methods and Results. During the 10 year’s retrospective study period a total of 2,304,537 people suffered from malaria in Gulu district. Malaria infection was generally stable with biannual peaks during the months of June-July and September-October but showed a declining trend after introduction of indoor residual spraying. Analysis of the departure of mean monthly malaria cases from the long-term mean monthly malaria cases revealed biannual seasonal outbreaks before and during the first year of introduction of indoor residual spraying. However, there were two major malaria epidemics in 2015 following discontinuation of indoor residual spraying in the late 2014. Children <5 years of age were disproportionally affected by malaria and accounted for 47.6% of the total malaria cases. Both rainfall (P=0.04) and relative humidity (P=0.003) had significant positive correlations with malaria. Meanwhile, maximum temperature had significant negative correlation with malaria (P=0.02) but minimum temperature had no correlation with malaria (P=0.29). Conclusion. Malaria in Gulu disproportionately affects children under 5 years and shows seasonality with a generally stable trend influenced by rainfall and relative humidity. However, indoor residual spraying is a very promising method to achieve a sustained malaria control in this population.

Download Full-text

Prevention of spina bifida: folic acid intake during pregnancy in Gulu district, northern Uganda

Pan African Medical Journal ◽

10.11604/pamj.2015.20.90.5338 ◽

2015 ◽

Vol 20 ◽

Cited By ~ 3

Author(s):

Femke Bannink ◽

Rita Larok ◽

Peter Kirabira ◽

Lieven Bauwens ◽

Geert van Hove

Keyword(s):

Folic Acid ◽

Spina Bifida ◽

Northern Uganda ◽

Folic Acid Intake ◽

Acid Intake ◽

Gulu District

Download Full-text

Factors associated with use of long-acting reversible contraception among female sex workers operating in Gulu district, Northern Uganda – a cross-sectional study

10.21203/rs.3.rs-275872/v1 ◽

2021 ◽

Author(s):

Simple Ouma ◽

Nazarius Mbona Tumwesigye ◽

Catherine Abbo ◽

Rawlance Ndejjo

Keyword(s):

Sex Work ◽

Unintended Pregnancy ◽

Sex Workers ◽

Female Sex Workers ◽

Northern Uganda ◽

Sectional Study ◽

Factors Associated ◽

History Of ◽

Gulu District ◽

Long Acting

Abstract Background: Long-acting reversible contraception (LARC) are the most effective and reliable contraceptives for female sex workers (FSWs) and require periodic users’ involvement only at the time of application or re-application. However, information on LARC use among FSWs in Uganda is scarce. To fill this gap, we determined the prevalence of LARC use among FSWs and examined factors associated with LARC use among FSWs operating in Gulu district, Northern Uganda.Methods: Across-sectional study was conducted among 300 FSWs aged 18 years and above and operating in Gulu district. Semi-structured questionnaires were used to measure factors associated with the use of LARC: intrauterine device (IUD), Implants, and injectables. Data analyses were conducted using STATA 14.0 and restricted to 280 non-gravid adult FSWs aged 18-49 years who were not on permanent contraception method. To examine factors associated with LARC use, prevalence ratios (PR) with robust standard errors were computed using Poisson regression.Results: Among the participants, the mean age (SD, range) was 26.5 (5.9, 18 - 45) years, 53.2% never married, 66.1% reported consistent condom use independent of LARC, 58.9% had unintended pregnancy during a lifetime, 48.6% had at least one unintended pregnancy during sex work, and 37.4% had at least one induced abortion. The prevalence of LARC use was 58.6%; the majority were using Implants (48.2%), followed by injectables (42.7%), and IUDs (9.1%). Independent factors associated with LARC use included: longer duration of sex work [≥ two years] (adjusted PR=1.44, 95% CI: 1.03-2.02), higher parity [≥ two] (adjusted PR=1.13, 95% CI: 1.02-1.26), history of unintended pregnancy during sex work (adjusted PR=1.24 CI: 1.01-1.51), and being a brothel/lodge-based FSWs (adjusted PR=1.28, 95% CI: 1.01-1.63).Conclusions: There is a big gap in LARC use with only 58.6% of FSWs using LARC. LARC use was associated with longer duration of sex work, higher parity, history of sex work-related unintended pregnancy, and being a brothel/lodge-based FSW. Therefore, interventions to improve LARC use should intensively target the newly recruited FSWs, FSWs with low parity, and FSWs not based in brothels or lodges.

Download Full-text