Browsing by Author "Olum, Ronald"

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    Distribution of Candida Species Isolated from People Living with Human Immunodeficiency Virus With Oropharyngeal and Oral Candidiasis in Africa in the Era Of Universal Test and Treat Policy: A Systematic Review and Meta-Analysis.
    (Kabale University, 2024) Musinguzi, Benson; Obuku, Ekwaro A.; Mwesigwa, Alex; Migisha, Richard; Kinengyere, Alison Annet; Ndagire, Regina; Baguma, Andrew; Okek, Erick Jacob; Olum, Ronald; Itabangi, Herbert; Mboowa, Gerald; Sande, Obondo James; Achan, Beatrice
    Background The introduction of antiretroviral therapy (ART) and the implementation of the human immunodeficiency virus (HIV) universal test and treat (UTT) policy have led to a decline in the incidence of opportunistic infections. However, oropharyngeal and oral candidiasis remain prevalent and continue to pose challenges among people living with human immunodefciency virus (PLHIV) in Africa, indicating the need for a better understanding of the distribution of Candida species responsible for these infections. This systematic review and meta-analysis aimed to determine the distribution of Candida species isolated from PLHIV with oropharyngeal and oral candidiasis in Africa in the era of UTT policy. Methods The review followed the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. A comprehensive search was conducted to identify eligible studies to be included in the meta-analysis and analyzed using a random effects model in STATA version 17. The risk of bias was assessed using the Joanna Briggs Institute quality assessment tool. Results Fourteen studies with 4281 participants were included in the review. Overall, 2095 Candida isolates were reported, 78.7% (1650/2095) of which were C. albicans, 19.6% (410/2095), non-albicans Candida (NAC), and 1.7% (35/2095) could not be identified to the Candida specific species level. The most prevalent NAC species were C. glabrate (26.3%), followed by C. tropicalis (24.9%), C. krusei (15.6%), C. parapsilosis (11%), and C. dubliniensis (6.3%). The pooled prevalence of oropharyngeal and oral candidiasis was 48% (95% CI 34–62%). The prevalence of oropharyngeal candidiasis was higher in the pre-UTT era, at 56% (95% CI 40–72%, p<0.001), than in the post-UTT era, at 34% (95% CI 10–67%, p<0.001). The risk of bias assessment revealed that 71.4% (10/14) of the included studies had a low risk of bias and that 28.6% (4/14) had a moderate risk of bias. Conclusions While C. albicans remains, the predominant species causing oropharyngeal and oral candidiasis among PLHIV in Africa, NAC species also contribute significantly to the infection burden. Despite ART and UTT policies, oropharyngeal candidiasis remains prevalent, emphasizing the need for targeted interventions.
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    Factors Associated with Healthcare-Seeking Behavior among Health Profession Students in Selected Universities in Southwestern Uganda.
    (Kabale University, 2024) Wamaani, Hannington Gamukama; Olum, Ronald; Ajuna, Noble; Atwijukire, Humphrey; Kabami, Jane; Asiimwe, John Baptist
    Introduction: Health professional students (HPS) tend to seek informal health care associated with self-medication (SM). Therefore, this study investigated the factors associated with healthcare-seeking behavior (HSB) among HPS. Methods: The study employed a cross-sectional design. Four hundred (400) HPS from two universities Bishop Stuart University (BSU) and Kampa- la International University Western Campus (KIU)] in southwestern Uganda were selected using a convenience sampling method. Data was collected using a Google form containing structured questions. The link to the questionnaire was sent to prospective participants via WhatsApp platform or email between September and November 2021. Ethical clearance was obtained from the Mbarara University Research Ethics Committee. Data were entered into SPSS software and analyzed using descriptive chi-square statistics, and logistic regression. HSB was considered formal or appropriate if the participant usually sought healthcare from a health worker. Results: A total of 400 HPS were enrolled, 60.3% were males, and the mean age of the participants was 23.06 (SD =2.74) years. Fifty-seven percent (57.5%) of the participants consulted a health worker when ill in the last 12 months (had formal HSB). Most participants’ main reason for seeking health care was to treat the underlying illness (73.3%). About sixty-nine percent (68.6%) of the participants treated themselves during the most recent illness or health problem. Most of the partici- pants searched the internet for health-related information when ill at some point. (Sometimes = 35.8%, Always = 27%, Often = 16%).The academic year of HPS (P < 0.001), access to health facilities (P = 0.018), being too busy (P =0.028), and minor illnesses (P < 0.001) were significantly associated with healthcare-seeking behavior. The lower academic years 1 & 2 (OR = 0.453, P < 0.001, 95% CI = 0.296 - 0.695) and easy access to the health facility (OR = 0.447 P < 0.001, 95% CI = 0.287 - 0.696) were predictors of formal HSB, being too busy (OR = 1.620, P = 0.049, 95% CI = 1.002 - 2.621) and having a minor illness (OR = 2.465, P< 0.001, 95% CI = 1.597 - 3.803) were predictors of informal healthcare seeking behavior. Conclusion: Our study findings indicate that a larger proportion of the participants sought formal health advice upon getting ill although others resorted to self-medication. Accessibility to health facilities and lower academic years predicted formal healthcare-seeking behavior while minor illnesses and being too busy predicted informal HSB among health profession students. Health training institutions should have easily accessible student-friendly healthcare facilities to promote formal healthcare-seeking behavior.