A cross-sectional study of prevalence and predictors of risky sexual behavior among school-going adolescents in Mbarara municipality, Uganda

Background

Adolescents in Sub-Saharan Africa are at a greater risk of experiencing the adverse consequences of risky sexual behavior such as unwanted pregnancy and school drop-out than adolescents from other regions.

Objectives

This study determined the prevalence and identified the demographic, school and social factors associated with risky sexual behavior among secondary school students in Uganda.

Methods

This was a quantitative cross-sectional study conducted in 12 secondary schools in Mbarara Municipality, Uganda. A self-reported questionnaire was used to estimate the prevalence and predictors of risky sexual behavior among the students.

Results

Out of the 910 students, 314 (34.6%) were sexually active and almost two in every ten adolescents had engaged in risky sexual behavior 171 (18.8%). About 27 (8.7%) had been pregnant or impregnated their sexual partner while 143 (45.6%) used condoms consistently. Risky sexual behavior was associated with age, gender of the student as well as alcohol consumption, smoking and substance use.

Conclusion

Most of the participants were not sexually active, however, among the sexually active students, more than half engaged in risky sexual behavior. This finding suggests the need to introduce comprehensive sex education with a focus on safe sex practices in secondary schools in Uganda.

Problem Gambling Among Adolescents in Uganda: A Cross-sectional Survey Study

In recent years, gambling has evolved and grown substantially with new gambling activities and facilities being introduced, making gambling products and opportunities more available than ever before in Uganda. While the growth of gambling industry is considered to have a beneficial impact on the economy, it is increasingly becoming a social and public health issue especially among a minority of young people who experience problem gambling, which can damage personal, family, vocational, and academic pursuits. The present study estimated the prevalence of problem gambling and identified the socio-demographic, school, environmental and health risks of problem gambling among secondary school students in Mbarara Municipality, Uganda. A cross-sectional study was conducted among secondary school students in Mbarara Municipality. A total of 921 students from 12 schools were recruited using cluster sampling. An ordinal logistic regression model was used to explore the relationship between problem gambling and the socio-demographic, academic, environmental and health variables. Of 905 participants, 362 reported having ever gambled (40%), and 160 were classified as problem gamblers (17.7%; 44.2% among those who had ever gambled). Problem gambling was significantly associated with being male, being non-religious, other religion (African traditional religion), having employment (outside of school), distance to nearest gambling venue, parental gambling, peer gambling, substance use, risky sexual behavior, and psychological distress. The present study found a very high prevalence of problem gambling among Ugandan secondary school students. Therefore, there is need to institute public health measures towards raising awareness, prevention and treatment of problem gambling among Ugandan adolescents.

Occurrence, antibiogram, high-level vancomycin and aminoglycosides resistance and potential virulence factors of enterococci in dogs in Nigeria

AbstractThis study was conducted to isolate enterococci from dogs in Nigeria, and to determine the potential virulence, antibiotic susceptibility, phenotypic vancomycin (VAN), high-level ampicillin (AMP) and aminoglycosides susceptibility profile of the isolates. Rectal swabs were collected from 295 randomly-selected, clinically-healthy dogs. The isolation of enterococci was done using Slanetz and Bartley enterococcal selective medium. The resistance of 150 non-repetitive isolates was determined using disc diffusion method. VAN resistance was assessed by high-level disc diffusion and agar-screening methods. High-level AMP and aminoglycosides (gentamicin and streptomycin) resistance was determined by agar-screening method. Potential virulence factors were assayed using phenotypic methods. Out of 295 samples, 234 (80.7%) gave positive growth. From these, 250 enterococcal isolates comprised 229 (91.6%) non-pigmented and 21 (8.4%) pigmented strains, were obtained. Resistance of the isolates was 89% to erythromycin, 92% to rifampicin, 77% to chloramphenicol, 83% to tetracycline, 64% to ciprofloxacin, 32.7% to VAN, 24.7% to high-level streptomycin (HLS) and 6% to high-level gentamicin (HLG). Among 150 non-repetitive resistant isolates, 144 (96%), including all the VAN-, HLS- and HLG-resistant strains, exhibited resistance to at least 3 classes of antibiotics. The mean multiple antibiotic resistance index was 0.54 (range = 0.22 – 0.89). Of these 150 isolates, 94 (62.7%), including all the VAN-, HLS- and HLG-resistant strains, displayed virulence potentials as biofilm (44.7%), surface-layer (13.8%), haemolysin (21.3%), gelatinase (40.4%), caesinase (10.6%) and deoxyribonuclease (12.8%) activities. This study showed that dogs in Nigeria are potential reservoirs and disseminators of potentially-virulent, multidrug-, VAN- and high-level aminoglycosides-resistant enterococci.

Psychological distress in adolescents: prevalence and its relation to high-risk behaviors among secondary school students in Mbarara Municipality, Uganda

BACKGROUND

Psychological distress among adolescents negatively affects their academic performance, relationships with family and friends, and ability to participate fully in the community. Stressful life events in low-income countries and risk-taking behavior of adolescents have raised concerns regarding the impact of psychological distress among adolescents. Therefore, the present study estimated the prevalence of psychological distress and examined the high-risk behaviors associated with psychological distress among Ugandan adolescents.

METHODS

A community based cross-sectional study was conducted among secondary school students in Mbarara Municipality, Uganda. Multistage cluster sampling was used to recruit 921 adolescents from 12 schools. Psychological distress was assessed using the 10-item Kessler Psychological Distress Scale (K10). Logistic regression was used with p-value estimating regression coefficient and 95% confidence interval for odds ratio and adjusted odds ratio (AOR).

RESULTS

The prevalence of psychological distress using the K10 was 57%. Logistic regression analyses showed that risky sexual behavior [AOR = 1.52; 95% confidence interval (CI) 1.02-2.28], substance use (AOR = 2.06; 95% CI 1.49-2.84) were associated with psychological distress. Students in mixed schools (comprising both sexes) (AOR = 1.94; 95% CI 1.19-3.15) and adolescents with chronic illness (AOR = 1.68; 95% CI 1.18-2.38) were more likely to report psychological distress.

CONCLUSION

The prevalence of psychological distress among school-going adolescents is high. Risky sexual behavior, substance use as well as chronic illness were associated with psychological distress. In addition, the type of school was significantly associated with psychological distress. The findings suggest the need for policy makers and stakeholders in health and education sectors to institute measures that will address mental health issues among adolescents.

The association between malaria prevalence and COVID-19 mortality

BACKGROUND

The number of persons infected with COVID-19 continues to increase with deaths reported daily across the globe. High income countries such as the US, the UK, Italy and Belgium have reported high COVID-19 related deaths but low-and-middle-income countries have recorded fewer deaths despite having poor healthcare system. This study aimed to investigate the association between malaria prevalence and COVID-19 mortality.

METHODS

An ecological study was conducted with data from 195 countries. Spearman's correlation was used to test the association between the population variables and COVID-19 mortality. Generalized linear model with Poisson distribution was used to determine the significant predictors of COVID-19 mortality.

RESULTS

There was a significant positive correlation between median age, life expectancy, 65+ mortality and COVID-19 mortality while malaria prevalence, sex ratio and cardiovascular mortality were negatively correlated with COVID-19 mortality. Malaria prevalence, life expectancy and mortality rate were significant on multivariate regression analysis.

CONCLUSION

The results of this study support the hypotheses that there are reduced COVID-19 deaths in malaria endemic countries, although the results need to be proved further by clinical trials.

Isolation and characterisation of colistin-resistant Enterobacterales from chickens in Southeast Nigeria

OBJECTIVES

Resistance to colistin (CST) mediated by mobile genetic elements has had a broad impact worldwide. There is an intensified call for epidemiological surveillance of mcr in different reservoirs to preserve CST for future generations. In Nigeria, the poultry industry is a key livestock sector. This study was undertaken to screen putative colistin-resistant Enterobacterales (CST-r-E) from poultry birds in Southeast Nigeria and to determine the genetic relatedness of mcr-harbouring isolates.

METHODS

Faecal and cloacal swab samples (n = 785) were collected from chickens in 17 farms located in three contiguous states in Southeast Nigeria between March-November 2018. Following selective culture, CST-r-E were isolated. Confirmation of CST resistance, antimicrobial susceptibility testing, molecular detection of genes mcr-1 to mcr-10, multilocus sequence typing (MLST) and randomly amplified polymorphic DNA (RAPD) analysis were performed on the isolates. A questionnaire was distributed to investigate the knowledge about CST and its use of chicken farm caretakers.

RESULTS

Of the 785 samples evaluated, 45 (5.7%) were positive for 48 CST-r-E, among which 23 harboured the mcr-1 gene (22 Escherichia coli and 1 Klebsiella pneumoniae). In two E.coli isolates, a new allelic variant (mcr-1.22) was detected. RAPD analysis allowed the identification of 11 different fingerprints. MLST also revealed 11 STs, with 3 of them being novel.

CONCLUSION

mcr has significantly spread in poultry birds of Southeast Nigeria, which poses a worrisome risk to veterinary and human health. Strategies to prevent indiscriminate use of CST in farms should be quickly adopted before CST resistance becomes a huge global health issue.