Healthcare providers can play a major role in tobacco control by providing smoking cessation interventions to smoking patients. The objective of this study was to establish healthcare providers’ practices regarding smoking cessation interventions in selected health facilities in Kiambu County, Kenya. This was a descriptive cross-sectional study carried out among healthcare providers working in public health facilities in Kiambu County, Kenya. Self-administered questionnaires were distributed to 400 healthcare providers selected using a two-stage stratified sampling technique. Only 35% of the healthcare providers surveyed reported that they always asked patients about their smoking status. Less than half (44%) reported that they always advised smoking patients to quit. Respondents who had received training on smoking cessation interventions were 3.7 times more likely to have higher practice scores than those without training (OR = 3.66; 95%CI: 1.63-8.26; P = 0.003). Majority of the healthcare providers do not routinely provide smoking cessation interventions to their patients. Measures are needed to increase health worker’s involvement in provision of smoking cessation care in Kenya.
BACKGROUND The 2002-06 measles control strategy for Uganda was implemented to strengthen routine immunization, undertake large-scale catch-up and follow-up vaccination campaigns, and to initiate nationwide case-based, laboratory-backed measles surveillance. This study examines the impact of this strategy on the epidemiology of measles in Uganda, and the lessons learnt. METHODS Number of measles cases and routine measles vaccination coverage reported by each district were obtained from the National Health Management Information System reports of 1997 to 2007. The immunization coverage by district in a given year was calculated by dividing the number of children immunized by the projected population in the same age category. Annual measles incidence for each year was derived by dividing the number of cases in a year by the mid-year projected population. Commercial measles IgM enzyme-linked immunoassay kits were used to confirm measles cases. RESULTS Routine measles immunization coverage increased from 64% in 1997 to 90% in 2004, then stabilized around 87%. The 2003 national measles catch-up and 2006 follow-up campaigns reached 100% of children targeted with a measles supplemental dose. Over 80% coverage was also achieved with other child survival interventions. Case-based measles surveillance was rolled out nationwide to provide continuous epidemiological monitoring of measles occurrence. Following a 93% decline in measles incidence and no measles deaths, epidemic resurgence of measles occurred 3 years after a measles campaign targeting a wide age group, but no indigenous measles virus (D(10)) was isolated. Recurrence was delayed in regions where children were offered an early second opportunity for measles vaccination. CONCLUSION The integrated routine and campaign approach to providing a second opportunity for measles vaccination is effective in interrupting indigenous measles transmission and can be used to deliver other child survival interventions. Measles control can be sustained and the inter-epidemic interval lengthened by offering an early second opportunity for measles vaccination through other health delivery strategies.
In 1999-2001, a national measles control strategy was implemented in Uganda, including routine immunization and mass vaccination campaigns for children aged 6 months to 5 years. This study assesses the impact of the campaigns on measles morbidity and mortality. Measles cases reported from 1992 through 2001 were obtained from the Health Management Information System, and measles admissions and deaths were assessed in six sentinel hospitals. Measles incidence declined by 39%, measles admissions by 60%, and measles deaths by 63% in the year following the campaigns, with impact lasting 15 to 22 months. Overall, 64% of measles cases were among children <5 years of age, and 93% were among children =15 years old. The cost per child vaccinated was $0.86. Routine immunization coverage remained low, at 61% in 2001. To eliminate measles in Uganda, routine immunization should be strengthened, campaigns should be conducted among those <15 years of age, and nationwide case-based measles surveillance should be put in place.
Background Although Uganda has a relatively low prevalence of smoking, no data exists on cigarette use among military personnel. Studies in other countries suggests military service is a risk factor for tobacco use. Objectives To assess prevalence and risk factors for and costs of smoking among military personnel assigned to a large military facility in Uganda. Design A mixed methods study including focus groups, interviews, and a cross-sectional survey of military personnel. Setting Kakiri Barracks, Uganda Subjects Key informants and focus group participants were purposively selected based on the objectives of the study, military rank and job categories. A multi stage sample design was used to survey individuals serving in Uganda People’s Defense Forces (UPDF) from June-November 2014 for the survey (n = 310). Results Participants in the qualitative portion of the study reported that smoking was harmful to health and the national economy and that its use was increasing among UPDF personnel. Survey results suggested that smoking rates in the military were substantially higher than in the general public (i.e., 34.8% vs. 5.3%). Significant predictors of smoking included lower education, younger age, having close friends who smoked and a history of military deployment. Estimated costs of smoking due to lost productivity was US$576,229 and US$212,400 for excess healthcare costs. Conclusion Smoking rates are substantially higher in the UPDF compared to the general public and results in significant productivity costs. Interventions designed to reduce smoking among UPDF personnel should be included in the country’s national tobacco control plan.
Background: Uganda has a high rate of road traffic injuries (RTI). Alcohol use increases traffic injury risk and severity through impairment of road-use skills and hazard perception. Few studies have examined this problem in Uganda. We therefore assessed the prevalence and determinants of pre-injury alcohol use among road traffic injured patients at Mulago National Referral Hospital, Kampala Uganda. Methods: We enrolled 330 eligible adult RTI patients consecutively in a crosssectional study, at the emergency department in Mulago National Referral Hospital from March-May, 2016. We assessed pre-injury alcohol use using BACtrack professional Breathalyzer, alcohol intoxication assessment tool and alcohol use selfreport covering the period of 6 hours before the injury. We assessed injury severity using Glasgow Coma Scale and Kampala Trauma Score. We estimated prevalence ratios [PR] using modified Poisson regression. Results: Prevalence of pre-injury alcohol use among injured patients was 29.7%. Pedestrians (44%) had the greatest percentage of alcohol use when compared to other road users. Pre-injury alcohol use was associated with mortality at the Emergency Department, PR: 2.33 [1.39 – 3.9]. Conclusion and recommendations: Pre-injury alcohol use is high among pedestrians and yet prevention efforts target mostly motorists. Pre-injury alcohol use also resulted into increased mortality at Emergency Department. We recommend prevention efforts to not only target motorists but also pedestrians.
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