Browsing by Author "Epuitai, Joshua"

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    Enablers of and barriers to ART adherence among female sex workers in mid‑western Uganda : a qualitative study.
    (BMC, 2025) Apuulison, David Friday; Nabawanuka, Brenda; Muhoozi, Michael; Aryampa, Julian; Irumba, Pauline; Katsomyo, Edson; Asiimwe, Moses; Epuitai, Joshua; Akugizibwe, Pardon; George, Wasswa; Rubaihayo, John
    Introduction: Female sex workers (FSWs) in Uganda experience numerous barriers to antiretroviral therapy (ART) adherence. We used the planned behavior theory to help explore the enablers and barriers to ART adherence among FSWs. Understanding the barriers to ART adherence may help contribute to the development of interventions to improve ART adherence among the FSWs. Materials and methods: A descriptive qualitative study was conducted in Fort portal City. We conducted 30 in-depth interviews among FSWs who had been taking ART for at least six months. Furthermore, six key informant interviews were conducted with healthcare workers and leaders of the FSWs initiative. Data collection lasted for two months. Thematic deductive analysis was applied to analyse the data through the lens of the theory of planned behavior. Findings: The attitudes, subjective norms, and perceived behavioral control influenced adherence to ART. Positive attitudes including perceived benefits of ART, and experiencing positive outcomes from taking ART were seen to enable its adherence. Subjective norms such as social support, disclosure of HIV status, seeing others take ART, and aspirations of longer life enabled ART adherence. Taking ART in the morning, responsive and respectful healthcare workers, and availability of food/basic needs facilitated compliance with ART adherence. Negative attitudes such as misconceptions and fear of side effects hindered ART adherence. Social disapproval of sex work and or HIV, lack of social support, gender-based violence, non-disclosure, stigma, and abandonment hindered the use of ART among FSWs. Socio-economic constraints (e.g., food scarcity), and occupation-related factors (substance use, incarceration, busy and predictable schedules, and abrupt migrations) were the additional barriers to ART adherence. Conclusion: ART adherence among FSWs was influenced by attitudes, subjective norms, and perceived behavioral control. Addressing these barriers in ART adherence through targeted interventions could facilitate ART adherence and improve health outcomes among FSWs. Keywords: Adherence, ART, Female sex workers, Uganda
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    Factors affecting lifestyle modification among adults with type II diabetes mellitus attending care at Mbale regional referral hospital in Mbale city, Eastern Uganda: a mixed methods study.
    (Sage, 2025) Gidudu, Mariam; Nandutu, Lornah; Ankunda, Ronnet; Epuitai, Joshua; Lulenzi, Jalia; Ssenyonga, Lydia V. N.; Gavamukulya, Yahaya; Nabirye, Rose Chalo
    Background: Globally diabetes affects over 530million adults with Type II Diabetes (T2DM) accounting for approximately 98% of patients. T2DM is preventable, and its onset can be markedly postponed by increasing physical activity, reducing weight, and changing dietary habits, poor adherence to lifestyle modification was attributed to a number of factors such as poverty, and diet education. The main objective of this study was to explore factors affecting lifestyle modification among adults with type II diabetes mellitus at Mbale Regional Referral Hospital (MRRH)-Mbale City, Eastern Uganda. Design and methods: A descriptive cross-sectional study involving 262 participants was conducted in MRRH among T2DM patients attending the diabetic clinic. Quantitative data was collected through structured administered questionnaires. Simple random sampling was used to recruit respondents for the study. Quantitative data was analyzed at univariate, and bivariate levels using SPSS version 25. Qualitative data was analyzed using thematic analysis. Statistical significance was set at p-value of <0.05. Results: About 70.1% of the participants were females, 63.4% were above 50years, and 29.7% of participants had high knowledge on T2DM. Most participants engaged in health practices like recommended diet, regular physical activity, body weight monitoring, blood sugar monitoring, and health checkups. Gender, religion, occupation, physical exercise, smoking, and weight management significantly affected lifestyle modifications. Qualitative results revealed three main themes namely, social support, health education, and having a conducive environment as promoters to lifestyle modification, while two main themes namely lack of social support and religious and cultural beliefs were the main barriers. Conclusion: Generally, participants had good knowledge on the lifestyle modifications of T2DM. Gender, religion, occupation, physical exercise, smoking, and weight management significantly affected lifestyle modifications. Social support, health education, and having a conducive environment were reported as promoters to lifestyle modification, while lack of social support and religious and cultural beliefs were the main barriers. It is recommended that health care workers should continuously educate the patients on the lifestyle modifications considering their financial status, and all other limiting factors. A holistic approach to lifestyle modifications needs to be taken in order to help reduce the complications associated with the condition. Keywords: type II diabetes mellitus (T2DM), glycemic control, dietary management, physical exercise, social support, health education
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    “I can no longer give take-home exams”: health professionals educators’ experiences and perceptions regarding the use of artificial intelligence in health professions education in Uganda.
    (BMC, 2025) Mukunya, David; Nantale, Ritah; Paungholi, Kennedy; Epuitai, Joshua; Kayemba, Frank; Jemba, Brian; Ajalo, Elizabeth; Afodun, Adam; Musaba, Milton W.; Munabi, Ian G.; Kiguli, Sarah; Mubuuke, A. G.
    Introduction: Artificial intelligence (AI) tools offer immense opportunities and challenges for medical education. However, there is limited information about the use of AI among health professional educators, particularly in low and middle-income countries. We aimed to explore the experiences and perceptions regarding AI use in health professional education. Methods and materials: We collected qualitative data using in-depth interviews with 19 health professional educators. The interviews were audio-recorded and transcribed verbatim. We used Atlas Ti version 9.1 to organise the data. We used Braun and Clarke’s six-step thematic analysis for data analysis. The study was approved by the Busitema University Research and Ethics Committee (BUFHS-2023-79). Results: Three major themes were identified from the data: uptake and use of AI, perceived benefits of AI in health professional education, and concerns regarding AI use. We noted initial reluctance to support AI use, while its use varied from no or infrequent use to frequent use. Health professional educators used AI for various reasons, such as for teaching, student assessment, research, and personal work. AI was perceived to be beneficial in improving the clarity of writing, providing access to individual-tailored information, teaching, learning, and assessment, and research purposes. The barriers to AI use included a lack of institutional policies to guide AI use, limited capacity to afford paid AI versions, and reluctance to use AI. AI was seen to have inherent limitations, which included inaccurate information and a lack of contextual information for resource-limited settings. The fears of AI use included the risk of over-reliance on AI, academic misconduct, examination malpractice, ethical conflicts, and integrity. Conclusion: AI use in health professional education was perceived to have some benefits, amidst concerns that may derail its use in health professional education. The lack of policy and guidelines to govern the use of AI in health professions education underscores the need to develop policies and guidelines that safeguard and promote responsible and ethical use of AI. Keywords Health professional education, Artificial intelligence, Educators, Uganda
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    Severe malaria readmissions in Northern Uganda : a cross‑sectional study.
    (Malaria Journal, 2025) Olum, James; Mukunya, David; Nambozo, Brendah; Nantale, Ritah; Oguttu, Faith; Epuitai, Joshua; Lume, Ivan; Wanume, Benon; Olupot‑Olupot, Peter; Amanya, Daphine; Kakuru, Abel
    Background: Malaria is a critical global health issue, particularly for children in endemic regions. However, factors associated with recurrent severe malaria in children under 5 years of age in Northern Uganda are poorly understood. This study aimed to identify factors associated with readmission due to severe malaria within six months post-discharge among children in this age group. Methods: A cross-sectional study was conducted in Otuke district, encompassing twelve health facilities. A total of 760 caregivers of children admitted with severe malaria were interviewed, and hospital records were reviewed to verify the readmission data. The primary outcome assessed was readmission with severe malaria within six months after initial discharge. Data analysis was performed via Stata version 15.0. Results: The prevalence of readmission with severe malaria among children under 5 years of age was 26.8% (198/739). Factors significantly associated with readmission included having sickle cell anaemia [adjusted prevalence ratio (aPR) 1.72; 95% confidence interval (CI) (1.95–3.14)], living in houses constructed with straw and thatch walls [(aPR 2.10; 95% CI (1.19–3.69)] and seeking care after 12 h when the child has a fever [aPR 2.01; 95% CI (1.23–3.29)]. Conclusion: The findings indicate a high proportion of severe malaria readmissions in children under 5 years of age. Sickle cell anaemia, living in houses built using straw and thatch walls and seeking care after 12 h when a child has fever were the key risk factors for readmission with severe malaria. This study highlights the importance of targeted post-discharge interventions, such as prophylactic anti malarials in addition to bed nets, to prevent recurrent infections especially among children with sickle cell disease. In addition, improvements in housing quality and timely treatment of children with malaria are essential for reducing the burden of malaria, particularly in endemic regions. Keywords Children under 5 years of age, Readmission, Associated factors, Severe malaria, Children, Uganda