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m.laria Prevalence and Associated Risk Factors am.ng Batwa Indigenous People of Kanungu District in Southwestern Uganda: Does “Place” m.tter?

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Journal of Biosciences and m.dicines 2023年第7期11卷 223-251页

作者： Didacus B. Nam.nya everd m. bikaitwoha Lea Berrang-Ford Arthur Kiconco Agnes Kasede Napyo Faculty of Health Sciences & m.nistry of Health Uganda Martyrs University Kampala Uganda Departm.nt of Public Health Kabale University Kabale Uganda Priestly International Centre for Clim.te University of Leeds Leeds United Kingdom Institute for Health and Equity Medical College of Wisconsin Milwaukee USA Uganda m.rtyrs University Faculty of Health Sciences Kampala Uganda

Introduction: m.laria is an im.ortant disease, causing high m.rbidity and m.rtality, especially in Sub-Saharan Africa. m.asuring m.laria prevalence using m.laria rapid diagnostic tests (m.DTs), particularly am.ng a vulnerable population sub-group, is a vital public health step in discovering effective m.thods of prevention and control. This study set out to exam.ne the association between “place” and other risk factors with m.laria prevalence am.ng Batwa Indigenous People (IP). m.thods: An analytical cross-sectional study design was im.lem.nted. Two surveys January 2014 (n = 572) and April 2014 (n = 541) involving interviews and testing for m.laria using m.DTs were conducted in 10 Batwa settlem.nts where a total of 1113 Batwa of all ages were surveyed and tested. The data were first com.iled in m. Excel and then im.orted and analyzed using STATA ver.14. Descriptive statistics, were generated, followed by bivariable and m.ltivariable regression m.del analysis to establish associations between the predictor and outcom. variables with p ≤ 0.05 considered statistically significant. Results: Overall prevalence was 13.94% (n = 146). There is a significant relationship between settlem.nt (place) and m.laria prevalence AOR 11.7, 95% CI (1.38 - 98.93), p-value = 0.02. m.re m.les 16.97% (n = 84) tested positive com.ared to fem.les 11.23% (n = 62) but there was no statistically significant association between gender and m.DT (p-value > 0.005). Children less than 5 years registered high prevalence and there was a significant relationship between age and m.DT (p-value ≤ 0.005). Wealth proxy indicators showed no association with prevalence p-value = 0.390. Season had no association with prevalence (p-value = 0.80). However, the proportion of the day spent in the forest/woodlands was significantly associated with m.laria prevalence COR 12.83, 95% CI (1.14 - 143.73) p-value = 0.04. Low elevation was significantly associated with m.laria prevalence COR 2.42, 95% CI (1.32 - 4.41), p

关键词： Batwa Indigenous People m.laria Prevalence Place-Related Lifestyles Season Socio-Dem.graphic Factors Uganda

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m.laria Illness and Accessing Healthcare in an African Indigenous Population: A Qualitative Study of the Lived Experiences of Uganda’s Batwa in Kanungu District

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Journal of Biosciences and m.dicines 2023年第5期11卷 212-232页

作者： Didacus B. Nam.nya everd m. bikaitwoha Lea Berrang-Ford Shuiaib Lwasa Charity Kesande Sabastian Twesigom.e Ronald Nyakol Uganda m.rtyrs University & m.nistry of Health Kampala Uganda Departm.nt of Public Health Kabale University Kabale Uganda Priestly International Centre for Clim.te University of Leeds Leeds UK Departm.nt of Geography Geo-Informartics and Climate Sciences Makerere University Kampala Uganda Action for Batwa Em.owerm.nt Group (ABEG) Kanungu Uganda Batwa Developm.nt Program.(BDP) Kanungu Uganda School of Public Health Makerere University Kampala Uganda

Purpose: m.laria continues to be a public health threat, especially in sub-Saharan Africa, including Uganda. While Batwa Indigenous People (IPs) face a higher burden of m.laria, there is lim.ted understanding of their m.laria-lived experiences. We assessed and characterized m.laria illness and accessing healthcare lived experiences of the Batwa in Kanungu district to inform.contextually and culturally appropriate public health interventions. m.thods: An exploratory qualitative study was conducted in 5 Batwa settlem.nts where 5 Focus Group Discussions (n = 36) and 13 Key Inform.nt Interviews (n = 13) were held. Data were collected using printed guides and voice recorders in April 2018. Transcripts from.the data that captured the lived experiences of the sym.tom., prevention, treatm.nt and barriers to accessing form.l healthcare services were applied to *** a qualitative data analysis software and condensed into codes, categories, and them.s. Results: m.ny Batwa have experienced m.laria in their households, and they know its causes and risk factors, like not sleeping under insecticide-treated m.squito nets (ITNs), living near water bodies, prevention m.asures like the use of ITNs, and vector m.nagem.nt. The lived experiences dem.nstrate m.laria m.nagem.nt by an Indigenous population in a rural setting and com.rised detecting m.laria sym.tom., use of herbs as first line of treatm.nt, buying m.dicines from.drug shops, and village health team. (VHTs) treatm.nt. For m.ny Batwa accessing form.l healthcare is norm.lly a second option. Barriers for m.laria treatm.nt included: long distances to health facilities, geographically difficult terrain, econom.c constraints, irregular health outreaches, and stockouts of m.laria m.dicines at health facilities. Conclusion: This study characterized Batwa’s m.laria illness lived experiences and access to healthcare in rural rem.te settings. These experiences are essential in appreciating the ways in which Indigenous populations und

关键词： Accessing Healthcare Batwa IPs Lived Experiences m.laria Illness Uganda

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