Background: Adherence to ART among children is a dynamic challenging process involving several factors. With use of effective ART therapy, survival of children with AIDS has extensively increased but the benefits of this therapy are limited by non-adherence. This study aimed at establishing the caregiver factors associated with adherence to ART among children infected with HIV at Kisugu Health Center III. Methodology: The study was carried out using a cross – sectional descriptive study design. The design used only quantitative methods of data collection while in the field and the study population included only caregivers of HIV sero – positive children at Kisugu Health Center III ART clinic by the time of the study and its where a sample of 188 respondents were selected by means of simple random sampling technique. Data was collected with use of pretested and structured questionnaires. Descriptive and summary statistics were employed. Uni-variate and Bi-variate logistic regressions and their 95% confidence intervals were computed to determine the level of statistical significance. Results: Less than half 40.4% of the caregivers indicated that their children were adherent to ART therapy in the last week preceding the interview. The study found out that primary caregivers relationship with the child (P=0.039], primary caregivers level of education (P=0.010), Social support (P=0.043) and ART counseling services (P=0.000) were independently associated with adherence. None of the treatment related factors was statistically significantly associated with adherence to ART among children. Conclusion Only 59.6 %(112) of pediatric patients had good adherence to ART in the previous week prior to study start. The fact that the primary caregiver was a parent of the infected child adversely affected adherence whereas adherence rates were seen to increase with increasing primary caregiver level of education. Recommendations Caregivers should be educated and provided with appropriate and accurate information on HIV/AIDS and about ART therapy as well as encourage support groups since social support improved adherence to ART therapy. There is thus need for assessments of the caregiver’s education level, relationship to the child and provision of social support and ART counseling services in an effort to ensure improved adherence to ART at Kisugu Health Center III.

Background: Drug and other substance abuse is a major important public health problem in Uganda affecting the adolescent’s mental growth and economic development which consequently impacts on their health and survival. In Uganda today, you can barely count the family, friends, and loved ones completely drawn to addictions. Promising students who pick habits from peers in school and forever loses their way, like an educated man who gets hooked to alcohol and ends up jobless, hopeless and useless to his family, and multiple young men in the suburbs becoming slaves to marijuana( Kidimu G. 2012). The main objective was to establish the determinants of drug and substances abuse among adolescents10-19 years in Katanga slum, Kampala district. Specific objectives were; to asses individual factors that lead to drug and substance abuse among adolescents 10-19 years in Katanga slum, Kampala district. To establish socio-economic factors that lead to drug and substance abuse among adolescent 10-19 years in Katanga slum, Kampala district. To asses community factors that influence drug and substance abuse among adolescent 10-19 years in Katanga slum, Kampala district. Methodology: A cross-sectional study was carried out with researcher administered questionnaires as a method of data collection from 280 respondents and 10 key informants. Descriptive bivariate analysis was undertaken into SPSS and frequency tables, graphs, pie charts and p values were generated using Epi Data software. Results: from the findings, 46.8% was the prevalence of drugs and other substances abuse among adolescents. The following were found to have a statistical significance with drugs and substances abuse; age (p=0.017), the single (p=0.001), received parental advice (p=0.006), how drugs are valued to them (P=0.001), adolescents showing off in public (p=0.002), parental influence to abuse drugs (p=0.001), easy accessibility (p=0.013), living in temporary homestead (p=0.001), and law enforcement practiced in the area (p=0.031). Conclusion and Recommendations: The study involved carrying out community health education, avoiding bad peer groups, parents guiding and being good example as far as drugs and other substances are concerned. The Ministry of Health collaborating with other stakeholders to introduce strategic policies on drug and other substances abuse preclusion especially in slums. Further research should be done on how to bridge the gap between adolescents abusing drugs and other substances and the stakeholders like government and Nongovernmental organizations to join hands in the abuse fight campaign.

The study was carried out in Kibera Estate, Nairobi Kenya with an objective to assess the factors affecting the feeding practices of mothers of infants zero to six (0-6) months. Methods: A descriptive cross-sectional study design was used to collect data through a quantitative approach. A total of 300 mothers of infants six months old and below were interviewed. Results: The study revealed that 89.3% of the sample lived in the urban informal settlements and average household size was 5 members per household, 78.3% were unemployed, 54.6% had little or no education, 40.3% were 25 years and above while 24.7% were 18 years or less. 37.7% were married. About 49.3% of infants were fed on breast milk while 50.7% received cow’s or formula milk. Mixed feeding was widely practiced with largely formula milk, porridge or gruel and herbal drinks. Discarding colostrums, giving pre-lacteal feeds, introduction of other foods too early were some of the common practices noted among the mothers. Conclusions: The study concluded that not all infants aged zero to six months are exclusively breastfed, social-demographic factors have a significant effect on infant feeding practices and culture is significantly related to infant feeding practices.

Background: Breast self examination has been promoted as a screening method for early detection of breast cancer. The promotion is mostly done in resource limited settings like Uganda where there is limited access to radiological imaging and other investigative modalities. Breast cancer incidence in Uganda is on the increase. There is need to strengthen efforts to ensure young women are aware of this screening method, hence better treatment outcomes and reduction of mortality. Objective: This study aimed to determine the prevalence and factors associated with breast self examination for breast cancer detection among female students of International Health Sciences University Kampala, Uganda. Methods: This was a cross sectional study that utilized quantitative methods. The study was carried out between May 2014 and September 2014. A standardized pre-coded, semi-structured and self-administered questionnaire was used to obtain information on socio demographic characteristics, individual factors, socio cultural factors and knowledge regarding breast self examination. A 6-point “thoroughness score” was used in assessing the proficiency and knowledge of conducting breast self examination. Data was analyzed using SPSS 13.0 Results: A total of 384 students were studied. The prevalence of breast self examination was found to be 49.5% (190/384). However only 23.2% (44/190) were found to be proficient in performing breast self examination. Only 28.1% (108/384) were able to correctly define breast self examination. The factors that were independently associated with breast self examination included age (O.R: 0.289 C.I: 0.102-0.818 P-value: 0.019), having ever had a breast exam from a health worker (O.R: 2.101 C.I: 1.228-3.595 P-value: 0.007), knowledge of breast self examination (O.R: 5.542C.I: 2.682-11.452 P-value: <0.001), knowledge of at least one screening method for breast cancer (O.R: 0.315 C.I: 0.102-0.977 P-value: 0.046) and receiving support from friends and family (O.R: 2.023 C.I: 1.085-3.772 P-value: 0.027). Conclusion: This study found that the prevalence of breast self examination among young female university students is low with only a few students being proficient at doing breast self examination. Despite the level of knowledge about breast cancer being high, this does not translate to regular breast self examination by the young women. In the study, five factors were found to be associated with breast self examination practice.

Background: Gastrointestinal cancers constitute one of the major health burdens to humans. The available options for treatment of gastrointestinal cancers, including chemotherapy and radiotherapy may impose nutrition risks, especially when patients develop gastrointestinal side effects. The effects may even become adverse if treatment is initiated in patients who are already malnourished. The aim of this study was to determine the prevalence of gastrointestinal cancer types and level of malnutrition in gastrointestinal cancer patients. Methods: This was a cross sectional study on 288 patients enrolling for care at the Uganda Cancer Institute (UCI). Clinical data and assessment of nutritional status was done with the help of study physicians. The relationship between malnutrition and gastrointestinal cancers was determined using one way ANOVA. For all statistical tests, P-values less than 0.05 were considered significant. The results: Gastrointestinal lymphomas and esophageal cancer were the most common gastrointestinal cancer types at 34% and 20.2% respectively. Of the total 288 cancer patients that were examined, 34 (11.8%) appeared with severe malnutrition (BMI <16 kg/m2), 27 (9.4%) presented with moderate malnutrition (BMI: 16-16.99 kg/m2), 21 (7.3%) with mild malnutrition. There was a significant difference in the level of malnutrition, according to gastrointestinal cancer type (F-statistic= 8.2; P-value=0.001). More severely malnourished patients had stomach cancer, followed by cholangiocarcinoma (biliarsy) which registered 21.4% patients with severe malnutrition. Conclusions and recommendations: The prevalence of gastrointestinal lymphomas, esophageal and liver cancer was high more especially among the men and also present among the young population. Larger surveys covering different regions of the country would be needed to provide a more comprehensive picture of the burden of gastrointestinal cancer in Uganda. The information then obtained may guide in planning and development of strategies that may be needed in the provision of appropriate care and treatment of the affected patients, such as free screenings for cancer, and improved accessibility to medical care. In addition, the constitution of an operational nutrition department at the UCI is also highly recommended to screen patients for malnutrition before treatment is initiated more especially among those presenting with stomach and biliary cancer were malnutrition is higher. Nutritional support can be given to these patients and those that are already affected can be further managed at this unit in order to improve their treatment outcomes.

Background: This study was carried out to investigate the factors influencing uptake of cervical cancer screening services among female health workers in Wakiso district. Cervical cancer is the second most common cancer in women worldwide, with over 500 000 new cases being diagnosed every year and worldwide cancer deaths are projected to continue rising, with an estimated 13.1 million deaths in 2030. More than 85% of the global burden of cancers occurs in developing countries, where it accounts for 13% of all female cancer deaths. In Uganda, cervical cancer is the commonest malignancy among women with an estimated age standardized incidence rate of 45.6 per 100,000 women, accounting for 40% of all cancers recorded in the Kampala cancer registry. In Uganda Wakiso district, is believed to have one of the highest incidence rates of cervical cancer in Africa and probably in the world at 60% and only 2 % of the female health workers in Wakiso district seek cervical cancer screening services with the greatest percentage reporting for the service when the disease is in advanced stage. However, the factors leading to this low uptake are not known. Objective: We therefore, in this study set out to assess the factors influencing uptake of cervical cancer screening services among female health workers in Wakiso district. Methods: This was a cross sectional study with a sample size of 261 female health workers working in government and private not for profit health facilities in Wakiso district and 15 key informers were interviewed and used as study respondents. We purposively included all the female health workers in Wakiso district but 261 were selected by systematic random sampling. We collected quantitative data and analyzed it using SPSS and Epidata, and presented the results in form of tables, graphs and charts. We also collected the qualitative data which was manually analyzed and presented in form of verbatim as quotations from the respondents. Results: The results reveal that uptake of cervical cancer screening services among female health workers was still low despite the high level of awareness of screening services. The study established that majority 173/261 (66.5%) of the respondents have never screened for cervical cancer with only 87/261(33.5%) of the respondents who had screened. The study revealed that availability of continuous medical education sessions in the working facility of a female health worker was significantly associated with uptake of cervical cancer screening services though less than half of those who said they had continuous medical education sessions had screened due to other factors such as age as the young female health workers felt not susceptible to cervical cancer so felt no need to screen. The study also revealed that lack of the knowledge of the frequency of cervical cancer screening procedure, poor attitudes towards Cervical Cancer screening such as cultural beliefs and lack of a follow up system for clients suspected to have cancer lesions had a significant influence on the uptake of cervical cancer screening services. Conclusion and recommendations: Uptake of cervical cancer screening services is still low among female health workers in Wakiso district so there’s need to increase it by encouraging and conducting continuous medical education sessions related to cervical cancer and its screening services in the working facilities of female health workers in Wakiso district and need to establish more screening and referral centers to improve service accessibility in order to reduce cervical cancer related prevalence, morbidity and mortality among female health workers.

This study is to asses the use of herbal medicines in preparation for labor and its determinants among pregnant women attending Kiganda health centre IV. Background: Pregnancy related ailments and the need to have a vaginal birth usually result in some pregnant women self-medicating using over-the-counter (OTC) medications, seeking prescribed medications, or using herbs. Often, herbal medicines have been used as a complementary therapy, concurrent with pharmaceutical drugs rather than strictly as an alternative. One of the greatest obstetric risks of using herbal medicines in preparation for labor and/or inducing labor is precipitate delivery. Precipitate labour may result in complications such as extensive tearing of the birth canal leading to extensive bleeding after birth (post-partum haemorrhage), failure of the uterus to contract back to normal size. Sometimes uteral rapture occurs and if not detected early, the woman may bleed to death. Despite the effect of herbal medicines use in labor induction, use of traditional and complementary medicines for maternity related health complaints is very common. Although international estimates vary considerably, there appears to be increasing herbal medicines use in maternity with research from many regions showing that up to 87% of women are using some form of traditional and complementary therapies, with more conservative estimates ranging between 20 and 60. Method: A cross-sectional design was for this study that was done among pregnant women in their third trimester, receiving antenatal care services from Kiganda health center IV. Kiganda health center IV was purposively sampled. The pregnant women sampled using a random sampling method. This study used structured interviews and structured questionnaires. For data processing and analysis, SPSS version 20.0 was used. Results: The proportion of pregnant women at Kiganda health center IV who use herbal medicines in preparation for labour in Mubende district, is 42.9% (n = 81). Only one individual characteristic significantly influenced herbal medicine use in preparation for labour among pregnant women at Kiganda health center IV – Mubende district. It is the history of use of herbal medicine in any previous pregnancies (x2 = 11.295, 0.001). Two socio demographic characteristics of the pregnant women had a significant association with herbal medicine use in preparation for labour among pregnant women at Kiganda health center IV. They included; Residence of the pregnant woman (x2 = 5.152, P = 0.023), and reception of any formal education (x2 = 4.101, p = 0.043). Conclusion: The proportion of pregnant women at Kiganda health center IV who use herbal medicines in preparation for labor in Mubende district, is 42.9%, implying that about 4 out of every 10 pregnant women who seek Antenatal care services from Kiganda health center IV in Mubende district use herbal medicine in preparation for labor. Herbal medicine use in preparation for labour among pregnant women at Kiganda health center IV – Mubende district is determined by only the history of use of herbal medicine in any previous pregnancies, residence and education of a pregnant woman Recommendations: Health care service providers working in the Antenatal department of Kiganda health center are urged to conduct routine screening exercises meant to identify multigravida women, with an aim of finding out which of them has ever used herbal medicines in their previous pregnancies. Secondly, as part of the focused antenatal care health education sessions, the administration of Kiganda health center IV should incorporate and/or strengthen the content of herbal medicine use during pregnancy, including its effects on the fetus.

Background to the study: In Uganda, 2.3 million children below the age of five years are chronically malnourished (Government of Uganda, 2011). Statistics show that nationally an estimate of 6% of children is acutely malnourished and almost 2% of these have severe acute malnutrition. (UD H S, 2006). The integrated management of acute malnutrition guidelines deals with acute malnutrition identification, treatment and management. It seeks to improve acute malnutrition management in children by treating cases with severe acute malnutrition that have medical complications. Objective of the study: To assess the average length of hospital stay for children aged 6-59 months managed for severe acute malnutrition at Nalufenya Children’s Nutritional Unit in Jinja District, Uganda Methodology: this was a cross sectional study involing 119 parents/caretakers of children aged between 6 to 59 months being managed for severe acute malnutrition at Nalufenya children’s hospital nutritional unit in Jinja. Respondents were selected using sampling non probability method (convenience and purposive) for both quantitative and qualitative data. Data was collected using a questionnaire and key informant guide for the key informants. Data was analyzed using SPSS were chi- square test and logistic regression at bivariate and multivariate analysis respectively were done. Variables were significant at p< 0.05. Results: A total of 18.6 % of the children admitted had long hospital stay. Children that resided in the villages were 0.36 times less likely to have a shorter hospital stay (p= 0.027). Children that had a history of pervious admission were0.176 times less likely to have a shorter length of hospital stay (p= 0.020). children whose parents/ caretakers were in the formal sector were 8.167 times more likely to have a shorter length of hospital stay, those who reported adequate staff were 0.452 times less likely to have a shorter hospital length of staff (p=0.034). Children whose parents bought medicine for themselves were 0.462 times less likely to have a shorter length of hospital stay (0.040). Conclusion and recommendations: 18.6% of the children had long stay influenced by village residence, informal employment of the parents/caretakers, inadequate staff and shortage of medicines at the unit. The following recommendations are suggested; village outreaches to sensitize parents on prevention of malnutrition, advocacy for early seeking of health services, the government to provide income generating activities for those parents in the informal sector, so that they can make extra income, increase the staff at Nalufenya children’s hospital nutritional unit and provide the required medicines for managing acute server malnutrition and also support the unit with children feeds.

Introduction: Prostate Cancer is the leading cancer affecting men in Africa , with an estimated incidence of 40,000 cases and 28000 deaths in 2008 according to WHO.Therefore, the purpose of this study was to assess the knowledge attitude and practice of men aged 40-75 years towards prostate cancer screening in Nakawa division Kampala district. Method: This was a crossectional study in which 220 respondents were interviewed using a self administered questionnaire. Data was analyzed using SPSS and presented in form of frequency tables for easy interpretationof the findings. Results: This study found that 73.8% of respondents did not know signs and symptoms of prostate cancer, 52.4% did not know the risk age group and 67.2% did not know the predisposing factors, indicating low knowledge level about the disease. Majority of the respondents 142(67.6%) had positive attitude towards knowing their status, though 175(83.4%) had never screened indicating a poor prostate cancer screening practice. Conclusion: the study found low level of knowledge about Prostate cancer among men and also poor practice toward its screening since majority of the respondents had never screened. However most respondents had a positive attitude towards prostate cancer screening to know their status. Recommendation: Ministry of Health, hospital managers, all clinicians and nurses need to work together to improve on prostate cancer screening strategies and creating awareness about the disease.

Though 89% of the world‘s population had access to drinking water facilities, about 768 million people relied on unimproved drinking water-sources; 83% of them resided in rural areas by the end of 2013 (World Health Organization/ United Nations, 2013). Safe water use is use of water free from water borne diseases. The study assessed the level of knowledge, attitude and practices of community members of Go down Zone of lower Namuwongo Parish on safe water use. A sample size of 257 respondents with a response rate of 250(97%) respondents answered the research questions through interviews. These were selected by simple random sampling through a descriptive research design. Respondents had low knowledge about safe water use; because 210(84%) could not correctly define it. It could be due to the fact that 145(58%) had never had any formal education about safe water use, did not know; 158(63%) safe water sources, 140(56%) the ideal distance between a latrine and a natural water source (between 10 and 20 meters, 90(53%) the major effect of using unsafe water, 185(74%) the water borne diseases, 130(52%) the importance of fetching water in covered containers and 203(81%) that all clear water was unsafe for consumption. Respondents had negative attitude where, they believed that; 205(82%) that all clear water was safe for consumption, 210(84%) could consume unprocessed water, 233(93%) chemicals were not safe to treat water, 173(69%) filtered water was safe for drinking, 162(65%) could share water sources with animals. However, they recommended 240(96%) boiling as the best way to process water, 200(80%) it was good to cover water for consumption and 183(73%) acknowledge the importance of having an educational program on water use. It was observed that, most of the water containers were unclean, close to latrines, never protected water sources, did not usually cover drinking water, but never shared water sources with animals. About purification, majority of the respondents never left water to settle to use it, never used chemicals, but boiled, filtered and refrigerated water for consumption. All in all, there was poor knowledge, negative attitude and poor practices of community members towards safe water use. The researcher therefore recommends that; government and local administrators should promote education and sensitization programs on safe water use , avail safe water sources such as taps at friendly costs, community members should; fetch water from safe sources, protect water sources, maintain good hygiene of water containers and purify all water before use.