Background Uganda has been making progress towards universal HIV test and treat since 2013 and the 2016 test and treat policy was expanded from the 2013 guidelines. The expanded policy was rolled out in 2017 across the country. The treatment outcomes of this new policy have not yet been assessed at program level. The objective of this study was to determine the treatment outcome of the HIV test and treat policy in TASO Tororo Clinic, Eastern Uganda. Methodology This was a retrospective cohort study using secondary data. The study involved 580 clients who were newly diagnosed HIV positive in TASO Tororo clinic between June 2017 and May 2018, who were then followed up for ART initiation, retention in care, viral load monitoring and viral load suppression. The data was analyzed using Stat 14.0 version statistical software application. Results Of the 580 clients, 93.1%(540) were adults aged �20 years. The uptake of test and treat was at 92.4%(536) and 12 months retention was at 78.7% (422). The factors associated with retention in care were a) being counselled before ART initiation, AOR 2.41 (95%CI, 1.56-3.71), b) having a treatment supporter, AOR 1.57 (95%CI, 1.02-2.43) and having an opportunistic infection, AOR 2.99 (95%CI:1.21-7.41). The viral load coverage was 52.4% (221) and viral load suppression rate was 89.1% (197) of clients monitored. Age <20 years was the only identified factor associated with vial load non suppression, AOR 7.35 (95% CI = 2.23-24.24).
Introduction: HIV testing services is the entry point to HIV prevention, care, treatment, and support services. According to Uganda Population HIV impact assessment preliminary report released in 2018, 72.5% of people living with HIV in Uganda knew their status, which is below the UNAIDS target of 90%. We proposed a double layered screening of the population using the Ministry of Health HIV Testing Services (HTS) screening tool to identify more HIV positives and start them on treatment. The objective of this study was to assess the impact of the double layered screening approach on HIV test yield. Methods: A double layered screening approach involved using community and technical teams from TASO Tororo HIV clinic through the surge strategy. The community team (first layer) comprised of expert clients, local council 1, market and church leaders who were trained on how to screen the people in the community using the HTS screening tool. The technical team (second layer) comprised of medical personnel and counselors who subjected all people mobilized and screened by the community team to a second layered screening before offering an HIV test. We compared proportions of HIV test yields before and after the implementation of the double layered HTS strategy using proportions test and we assessed the impact of the double layered screening using a difference in difference (DID) evaluation method. Results; There was a general increase in HIV test yield from 4.75% with single screening (period: January-March 2018) to 12.25% with double screening (period: April-June 2018) (P<0.001). The increase was more in males (from 3.51% to 11.06%) than in females (from 6.36% to 13.31%) and this difference was significant (P=0.035). The increase in HIV test yield did not differ by age (P=0.060), by marital status (P=0.606) or by first time tester (P=0.167), Conclusion: The double layered screening before HIV test could be an effective strategy to maximize HIV test yield in the general population, which if scaled up can save huge resources, time and help focus on actual targets for HIV testing services, leading to early attainment of the UNAIDS 1 st target of 90-90-90.
Introduction In Uganda, the proportion of women having another live birth before age 20 years (repeat adolescent birth) has not declined in 30 years. More women want to delay the next birth. We determined the prevalence and factors associated with postpartum contraceptive use among teenage mothers in Mbale City. Patients and Methods We conducted a cross-sectional study in all the six government-supported health facilities within Mbale City. Over a period of 3 months, 511 teenage mothers in the postpartum period were consecutively enrolled by midwives/nurses. Data were collected using a pretested interviewer-administered questionnaire. We used logistic regression in STATA version 14, to determine the association between various sociodemographic characteristics and utilization of contraception. We set the level of significance at 5% and report odds ratios and the corresponding 95% confidence intervals. Results Most of the respondents – 314/511 [61.5%, 95% CI= 57.1–65.6%] – were using contraceptives. More than three-fourth (238/314) of the respondents opted for short-term methods of contraception. In the adjusted analyses, intention to resume school [AOR 1.79 (1.16–2.74)], and utilization of maternal Child Heath services such as postnatal care services [AOR 0.40 (0.25–0.63)] were significantly associated with utilisation of postpartum contraception. Conclusion We found a high prevalence of postpartum contraceptives use – over 6 in 10 women – although they were using mainly short-term methods. Those with intentions of resuming schooling and utilised postnatal care services were most likely to use contraceptives. This is encouraging and calls for inquiry into why their use is higher than the national averages. Further, the results call for renewed efforts to maintain adolescent mothers in school.
Introduction Isoniazid preventive therapy (IPT) is effective in treating tuberculosis (TB) infection and hence limiting progression to active disease. However, the durability of protection, associated factors and cost-effectiveness of IPT remain uncertain in low-and-middle income countries, Uganda inclusive. The Uganda Ministry of health recommends a single standard-dose IPT course for eligible people living with HIV (PLHIV). In this study we determined the incidence, associated factors and median time to TB diagnosis among PLHIV on Antiretroviral therapy (ART) who initiated IPT. Materials and methods We conducted a retrospective cohort study at eleven The AIDS Support Organization (TASO) centers in Uganda. We reviewed medical records of 2634 PLHIV on ART who initiated IPT from 1st January 2016 to 30th June 2018, with 30th June 2021 as end of follow up date. We analyzed study data using STATA v.16. Incidence rate was computed as the number of new TB cases divided by the total person months. A Frailty model was used to determine factors associated with TB incidence. Results The 2634 individuals were observed for 116,360.7 person months. IPT completion rate was 92.8%. Cumulative proportion of patients who developed TB in this cohort was 0.83% (22/2634), an incidence rate of 18.9 per 100,000 person months. The median time to TB diagnosis was 18.5 months (minimum– 0.47; maximum– 47.3, IQR: 10.1–32.4). World Health Organization (WHO) HIV clinical stage III (adjusted hazard ratio (aHR) 95%CI: 3.66 (1.08, 12.42) (P = 0.037) and discontinuing IPT (aHR 95%CI: 25.96(4.12, 169.48) (p = 0.001)), were associated with higher odds of TB diagnosis compared with WHO clinical stage II and IPT completion respectively. Conclusion Incidence rates of TB were low overtime after one course of IPT, and this was mainly attributed to high completion rates.
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