wilber ssembajjwe - Academia.edu (original) (raw)

Papers by wilber ssembajjwe

Background: This section effectively outlines the context. It would be beneficial to briefly ment... more Background: This section effectively outlines the context. It would be beneficial to briefly mention specific mental health challenges such as stigma, depression, anxiety, and suicidality. Methods: The methods are clearly described. It would be helpful to detail the inclusion criteria for the studies, such as types of study designs and language restrictions. Conclusion: This section is succinct and to the point. Mentioning the potential implications for clinical practice and policy could add value.

European archives of psychiatry and clinical neuroscience, Jan 8, 2017

In Germany, a regional social health insurance fund provides an integrated care program for patie... more In Germany, a regional social health insurance fund provides an integrated care program for patients with schizophrenia (IVS). Based on routine data of the social health insurance, this evaluation examined the effectiveness and cost-effectiveness of the IVS compared to the standard care (control group, CG). The primary outcome was the reduction of psychiatric inpatient treatment (days in hospital), and secondary outcomes were schizophrenia-related inpatient treatment, readmission rates, and costs. To reduce selection bias, a propensity score matching was performed. The matched sample included 752 patients. Mean number of psychiatric and schizophrenia-related hospital days of patients receiving IVS (2.3 ± 6.5, 1.7 ± 5.0) per quarter was reduced, but did not differ statistically significantly from CG (2.7 ± 7.6, 1.9 ± 6.2; p = 0.772, p = 0.352). Statistically significant between-group differences were found in costs per quarter per person caused by outpatient treatment by office-based...

Frontiers in reproductive health, Aug 15, 2023

Background: Adolescent girls and young women involved in risky behaviors are vulnerable to multip... more Background: Adolescent girls and young women involved in risky behaviors are vulnerable to multiple health problems, yet sexual and reproductive health services remain underutilized. We evaluated factors associated with non-uptake of contraceptives and barriers to use among adolescent girls and young women (14-24 years old) at high risk of HIV infection in an environment where contraceptives were provided at no cost. Methods: We conducted a mixed methods study, utilizing data from a baseline cross sectional survey and qualitative in-depth interviews. Survey participants tested negative for pregnancy and reported willingness to use contraception. Non-uptake of contraceptives was defined as not taking contraception at any study visit (baseline and throughout the study). Logistic regression model was used to assess factors associated with non-uptake of contraceptives. We purposively selected participants for interviews to discuss their knowledge and experiences with contraceptives and make suggestions to improve uptake. Qualitative data were analyzed thematically. Results: All 285 participants were included in the analysis. Out of the 285 participants 127 were not using contraceptives and of the 127, 44 (34.6%) did not take up any method throughout the study while 43 of the 83 remaining participants (who took up a method) chose male condoms only. Non-uptake of contraceptives was less likely among older women (20-24 years) (aOR = 0.32, 95% CI 0.16-0.89) compared to younger women (less than 20 years). Qualitative data showed that concerns about future fertility, fear of associated side effects and influence from close relations contributed to non-uptake of contraception. Conclusion: Non-uptake of contraceptives was common despite the promotion and provision of contraceptives in the context of a research study mainly because adolescents lack autonomy while making contraceptive decisions. Identifying and addressing their concerns and continued counselling on contraceptive use alongside condom promotion may improve uptake and utilization of contraceptives.

Frontiers in Public Health

PurposeThis study established the prevalence of physical and sexual victimization, associated fac... more PurposeThis study established the prevalence of physical and sexual victimization, associated factors and psychosocial consequences of victimization among 1,201 out-patients with severe mental illness at Butabika and Masaka hospitals in Uganda.MethodsParticipants completed structured, standardized and locally translated instruments. Physical and sexual victimization was assessed using the modified adverse life events module of the European Para-suicide Interview Schedule. We used logistic regression to determine the association between victimization, the associated factors and psychosocial consequences.ResultsThe prevalence of physical abuse was 34.1% and that of sexual victimization was 21.9%. The age group of > = 50 years (aOR 1.02;95% CI 0.62–1.66; p = 0.048) was more likely to have suffered physical victimization, while living in a rural area was protective against physical (aOR 0.59; 95% CI 0.46–0.76; p = <0.001) and sexual (aOR 0.48, 95% CI 0.35–0.65; p < 0.001) victi...

Psychiatry Journal

Background. Children and adolescents infected with HIV/AIDS (CA-HIV) experience a considerable bu... more Background. Children and adolescents infected with HIV/AIDS (CA-HIV) experience a considerable burden of depressive and anxiety disorders that have a tendency to persist into adulthood. The aim of this study was to determine the prevalence of anxiety, depression, and their clinical correlates among children and adolescents with HIV/AIDS (CA-HIV) in Uganda. Methods. A random sample of 1339 CA-HIV (ages 5-18 years) and their caregivers completed a standardized DSM-5-referenced psychiatric rating scale, the Child and Adolescent Symptom Inventory-5 (CASI-5). The prevalence of “anxiety and depression” was estimated at 95% confidence intervals. Logistic and ordinal regression models were fitted for the clinical correlates and clinical outcomes. Results. The overall prevalence of “any anxiety and depressive disorders” was 13.7% at 95% CI (based upon the symptom count criteria); 4.0% (95% CI) met the clinical psychiatric disorder criteria (both symptom count and functional impairment criter...

SCIREA Journal of Sociology, Dec 11, 2022

To understand the perceptions of Risky Sexual Behavior(RSB) among individuals with Severe Mental ... more To understand the perceptions of Risky Sexual Behavior(RSB) among individuals with Severe Mental illness(SMI) in Uganda. Hypothesis Participants who perceive themselves as being at a high risk for RSB have a higher perception to RSB.

Schizophrenia Research: Cognition

<p>Progression of boys through the Make The Cut intervention program.</p

European Archives of Psychiatry and Clinical Neuroscience

<p>Circumcision knowledge and perceptions among secondary school boys in Entebbe sub-distri... more <p>Circumcision knowledge and perceptions among secondary school boys in Entebbe sub-district.</p

Open Journal of Psychiatry

Background: Persons living with severe mental illness (SMI) which includes schizophrenia, bipolar... more Background: Persons living with severe mental illness (SMI) which includes schizophrenia, bipolar affective disorder and recurrent major depressive disorder are predisposed to risky sexual behavior (RSB). There is a paucity of data on this problem in sub-Saharan Africa and where research has been undertaken, only a limited range of risk factors have been considered and most of it was undertaken before antiretroviral therapy was universally available, hence the need for this study. The objective of this study was to determine the prevalence and factors associated with risky sexual behavior among individuals with SMI attending care in central and south western Uganda. Methods: A cross sectional study was conducted among 393 persons with SMI attending two psychiatric outpatient facilities in Uganda. Psychiatric disorder was confirmed using MINI International Neuropsychiatric Interview version 7.2. RSB was defined as engaging in at least one of four risky sexual behaviours that have been associated with HIV infection in the Ugandan psychosocial environment in the last three months using an 8 item RSB questionnaire used for assessment of RSB. Prevalence of RSB and associated correlates were determined using multiple logistic regression. Results: The Prevalence of RSB in last 3 months' periods was 24.2% (95% CI: 20.2%-28.7%). The factors that were independently significantly associated with RSB were: trauma related

Additional file 1: Appendix 1. SPIRIT 2013 checklist.

Additional file 2: Appendix 2. Trial management committee.

Additional file 1. Figures S1 and S2 show the linkage disequilibrium map of TERT and TERC single ... more Additional file 1. Figures S1 and S2 show the linkage disequilibrium map of TERT and TERC single nucleotide polymorphisms respectively. Table S1 shows the genotype and aplotype frequencies for TERT and TERC single nucleotide polymorphisms.

medRxiv, 2020

Background: The reasons for the association between anxiety disorders and asthma are not fully es... more Background: The reasons for the association between anxiety disorders and asthma are not fully established, and data from Africa is sparse. We investigated whether the association between anxiety disorders and asthma among adolescents may be partly related to shared exposures in early life. Methods: We conducted a case-control study among adolescents (12-17 years) with and without asthma in Wakiso District, an urban area in Uganda. Anxiety disorders were diagnosed by the Youth Inventory-4R (YI-4R), a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) referenced instrument. For this report, we focus on generalized anxiety disorder (GAD), panic disorder and social anxiety disorder. Asthma was doctor-diagnosed by study clinicians. We used questionnaires to collect data on early life exposures. The data were analysed using multiple logistic regression models. Results: We enrolled 162 adolescents. Adolescents with asthma were more likely to have any of three anx...

medRxiv, 2020

This study established the prevalence of physical and psychiatric comorbidity and associated risk... more This study established the prevalence of physical and psychiatric comorbidity and associated risk factors among 1,201 out-patients with severe mental illness (SMI) attending Butabika and Masaka hospitals in Uganda. Participants completed an assessment battery; structured, standardized and locally translated instruments. SMIs were established using the MINI International Neuropsychiatric Interview version 7.2. We used logistic regression to determine the association between physical and psychiatric comorbidity and risk factors. Prevalence of physical and psychiatric comorbidity was 13.1 %. Childhood sexual abuse (aOR 1.06, 95% CI 1.03 -1.10, P=0.001), sexual abuse in adulthood (aOR 2.22, 95% CI 1.60 - 3.08, P<0.001), childhood physical abuse (aOR 1.07, 95% CI 1.03 - 1.10, P<0.001) and physical abuse in adulthood (aOR 1.69, 95% CI 1.30 - 2.20, P<0.001) were associated with an increased risk of having comorbid psychiatric and physical disorders. Emerging healthcare models in U...

Frontiers in Genetics, 2021

Background: Internalizing mental disorders (IMDs) among HIV-positive (HIV+) children and adolesce... more Background: Internalizing mental disorders (IMDs) among HIV-positive (HIV+) children and adolescents are associated with poor disease outcomes, such as faster HIV disease progression. Although it has been suggested that the development of IMDs is moderated by interaction of stressful life events and vulnerability factors, the underlying etiology is largely unknown. Serotonin transporter gene [solute carrier family 6 member A4 (SLC6A4)] and human tryptophan hydroxylase 2 gene (TPH2) polymorphisms have been implicated in the development of IMDs. This study investigated the association between acute stress and IMDs, and moderation by chronic stress and genetic variants in SLC6A4 and TPH2.Hypothesis: Acute stress acts through genetic and environmental vulnerability factors to increase the risk of developing IMDs.Methods: Polymorphisms in SLC6A4 (5-HTTLPR, rs25531, 5-HTTLPR-rs25531, and STin2 VNTR) and TPH2 (rs1843809, rs1386494, rs4570625, and rs34517220) were genotyped in 368 HIV+ chil...

Background: This section effectively outlines the context. It would be beneficial to briefly ment... more Background: This section effectively outlines the context. It would be beneficial to briefly mention specific mental health challenges such as stigma, depression, anxiety, and suicidality. Methods: The methods are clearly described. It would be helpful to detail the inclusion criteria for the studies, such as types of study designs and language restrictions. Conclusion: This section is succinct and to the point. Mentioning the potential implications for clinical practice and policy could add value.

European archives of psychiatry and clinical neuroscience, Jan 8, 2017

In Germany, a regional social health insurance fund provides an integrated care program for patie... more In Germany, a regional social health insurance fund provides an integrated care program for patients with schizophrenia (IVS). Based on routine data of the social health insurance, this evaluation examined the effectiveness and cost-effectiveness of the IVS compared to the standard care (control group, CG). The primary outcome was the reduction of psychiatric inpatient treatment (days in hospital), and secondary outcomes were schizophrenia-related inpatient treatment, readmission rates, and costs. To reduce selection bias, a propensity score matching was performed. The matched sample included 752 patients. Mean number of psychiatric and schizophrenia-related hospital days of patients receiving IVS (2.3 ± 6.5, 1.7 ± 5.0) per quarter was reduced, but did not differ statistically significantly from CG (2.7 ± 7.6, 1.9 ± 6.2; p = 0.772, p = 0.352). Statistically significant between-group differences were found in costs per quarter per person caused by outpatient treatment by office-based...

Frontiers in reproductive health, Aug 15, 2023

Background: Adolescent girls and young women involved in risky behaviors are vulnerable to multip... more Background: Adolescent girls and young women involved in risky behaviors are vulnerable to multiple health problems, yet sexual and reproductive health services remain underutilized. We evaluated factors associated with non-uptake of contraceptives and barriers to use among adolescent girls and young women (14-24 years old) at high risk of HIV infection in an environment where contraceptives were provided at no cost. Methods: We conducted a mixed methods study, utilizing data from a baseline cross sectional survey and qualitative in-depth interviews. Survey participants tested negative for pregnancy and reported willingness to use contraception. Non-uptake of contraceptives was defined as not taking contraception at any study visit (baseline and throughout the study). Logistic regression model was used to assess factors associated with non-uptake of contraceptives. We purposively selected participants for interviews to discuss their knowledge and experiences with contraceptives and make suggestions to improve uptake. Qualitative data were analyzed thematically. Results: All 285 participants were included in the analysis. Out of the 285 participants 127 were not using contraceptives and of the 127, 44 (34.6%) did not take up any method throughout the study while 43 of the 83 remaining participants (who took up a method) chose male condoms only. Non-uptake of contraceptives was less likely among older women (20-24 years) (aOR = 0.32, 95% CI 0.16-0.89) compared to younger women (less than 20 years). Qualitative data showed that concerns about future fertility, fear of associated side effects and influence from close relations contributed to non-uptake of contraception. Conclusion: Non-uptake of contraceptives was common despite the promotion and provision of contraceptives in the context of a research study mainly because adolescents lack autonomy while making contraceptive decisions. Identifying and addressing their concerns and continued counselling on contraceptive use alongside condom promotion may improve uptake and utilization of contraceptives.

Frontiers in Public Health

PurposeThis study established the prevalence of physical and sexual victimization, associated fac... more PurposeThis study established the prevalence of physical and sexual victimization, associated factors and psychosocial consequences of victimization among 1,201 out-patients with severe mental illness at Butabika and Masaka hospitals in Uganda.MethodsParticipants completed structured, standardized and locally translated instruments. Physical and sexual victimization was assessed using the modified adverse life events module of the European Para-suicide Interview Schedule. We used logistic regression to determine the association between victimization, the associated factors and psychosocial consequences.ResultsThe prevalence of physical abuse was 34.1% and that of sexual victimization was 21.9%. The age group of > = 50 years (aOR 1.02;95% CI 0.62–1.66; p = 0.048) was more likely to have suffered physical victimization, while living in a rural area was protective against physical (aOR 0.59; 95% CI 0.46–0.76; p = <0.001) and sexual (aOR 0.48, 95% CI 0.35–0.65; p < 0.001) victi...

Psychiatry Journal

Background. Children and adolescents infected with HIV/AIDS (CA-HIV) experience a considerable bu... more Background. Children and adolescents infected with HIV/AIDS (CA-HIV) experience a considerable burden of depressive and anxiety disorders that have a tendency to persist into adulthood. The aim of this study was to determine the prevalence of anxiety, depression, and their clinical correlates among children and adolescents with HIV/AIDS (CA-HIV) in Uganda. Methods. A random sample of 1339 CA-HIV (ages 5-18 years) and their caregivers completed a standardized DSM-5-referenced psychiatric rating scale, the Child and Adolescent Symptom Inventory-5 (CASI-5). The prevalence of “anxiety and depression” was estimated at 95% confidence intervals. Logistic and ordinal regression models were fitted for the clinical correlates and clinical outcomes. Results. The overall prevalence of “any anxiety and depressive disorders” was 13.7% at 95% CI (based upon the symptom count criteria); 4.0% (95% CI) met the clinical psychiatric disorder criteria (both symptom count and functional impairment criter...

SCIREA Journal of Sociology, Dec 11, 2022

To understand the perceptions of Risky Sexual Behavior(RSB) among individuals with Severe Mental ... more To understand the perceptions of Risky Sexual Behavior(RSB) among individuals with Severe Mental illness(SMI) in Uganda. Hypothesis Participants who perceive themselves as being at a high risk for RSB have a higher perception to RSB.

Schizophrenia Research: Cognition

<p>Progression of boys through the Make The Cut intervention program.</p

European Archives of Psychiatry and Clinical Neuroscience

<p>Circumcision knowledge and perceptions among secondary school boys in Entebbe sub-distri... more <p>Circumcision knowledge and perceptions among secondary school boys in Entebbe sub-district.</p

Open Journal of Psychiatry

Background: Persons living with severe mental illness (SMI) which includes schizophrenia, bipolar... more Background: Persons living with severe mental illness (SMI) which includes schizophrenia, bipolar affective disorder and recurrent major depressive disorder are predisposed to risky sexual behavior (RSB). There is a paucity of data on this problem in sub-Saharan Africa and where research has been undertaken, only a limited range of risk factors have been considered and most of it was undertaken before antiretroviral therapy was universally available, hence the need for this study. The objective of this study was to determine the prevalence and factors associated with risky sexual behavior among individuals with SMI attending care in central and south western Uganda. Methods: A cross sectional study was conducted among 393 persons with SMI attending two psychiatric outpatient facilities in Uganda. Psychiatric disorder was confirmed using MINI International Neuropsychiatric Interview version 7.2. RSB was defined as engaging in at least one of four risky sexual behaviours that have been associated with HIV infection in the Ugandan psychosocial environment in the last three months using an 8 item RSB questionnaire used for assessment of RSB. Prevalence of RSB and associated correlates were determined using multiple logistic regression. Results: The Prevalence of RSB in last 3 months' periods was 24.2% (95% CI: 20.2%-28.7%). The factors that were independently significantly associated with RSB were: trauma related

Additional file 1: Appendix 1. SPIRIT 2013 checklist.

Additional file 2: Appendix 2. Trial management committee.

Additional file 1. Figures S1 and S2 show the linkage disequilibrium map of TERT and TERC single ... more Additional file 1. Figures S1 and S2 show the linkage disequilibrium map of TERT and TERC single nucleotide polymorphisms respectively. Table S1 shows the genotype and aplotype frequencies for TERT and TERC single nucleotide polymorphisms.

medRxiv, 2020

Background: The reasons for the association between anxiety disorders and asthma are not fully es... more Background: The reasons for the association between anxiety disorders and asthma are not fully established, and data from Africa is sparse. We investigated whether the association between anxiety disorders and asthma among adolescents may be partly related to shared exposures in early life. Methods: We conducted a case-control study among adolescents (12-17 years) with and without asthma in Wakiso District, an urban area in Uganda. Anxiety disorders were diagnosed by the Youth Inventory-4R (YI-4R), a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) referenced instrument. For this report, we focus on generalized anxiety disorder (GAD), panic disorder and social anxiety disorder. Asthma was doctor-diagnosed by study clinicians. We used questionnaires to collect data on early life exposures. The data were analysed using multiple logistic regression models. Results: We enrolled 162 adolescents. Adolescents with asthma were more likely to have any of three anx...

medRxiv, 2020

This study established the prevalence of physical and psychiatric comorbidity and associated risk... more This study established the prevalence of physical and psychiatric comorbidity and associated risk factors among 1,201 out-patients with severe mental illness (SMI) attending Butabika and Masaka hospitals in Uganda. Participants completed an assessment battery; structured, standardized and locally translated instruments. SMIs were established using the MINI International Neuropsychiatric Interview version 7.2. We used logistic regression to determine the association between physical and psychiatric comorbidity and risk factors. Prevalence of physical and psychiatric comorbidity was 13.1 %. Childhood sexual abuse (aOR 1.06, 95% CI 1.03 -1.10, P=0.001), sexual abuse in adulthood (aOR 2.22, 95% CI 1.60 - 3.08, P<0.001), childhood physical abuse (aOR 1.07, 95% CI 1.03 - 1.10, P<0.001) and physical abuse in adulthood (aOR 1.69, 95% CI 1.30 - 2.20, P<0.001) were associated with an increased risk of having comorbid psychiatric and physical disorders. Emerging healthcare models in U...

Frontiers in Genetics, 2021

Background: Internalizing mental disorders (IMDs) among HIV-positive (HIV+) children and adolesce... more Background: Internalizing mental disorders (IMDs) among HIV-positive (HIV+) children and adolescents are associated with poor disease outcomes, such as faster HIV disease progression. Although it has been suggested that the development of IMDs is moderated by interaction of stressful life events and vulnerability factors, the underlying etiology is largely unknown. Serotonin transporter gene [solute carrier family 6 member A4 (SLC6A4)] and human tryptophan hydroxylase 2 gene (TPH2) polymorphisms have been implicated in the development of IMDs. This study investigated the association between acute stress and IMDs, and moderation by chronic stress and genetic variants in SLC6A4 and TPH2.Hypothesis: Acute stress acts through genetic and environmental vulnerability factors to increase the risk of developing IMDs.Methods: Polymorphisms in SLC6A4 (5-HTTLPR, rs25531, 5-HTTLPR-rs25531, and STin2 VNTR) and TPH2 (rs1843809, rs1386494, rs4570625, and rs34517220) were genotyped in 368 HIV+ chil...