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HIV/AIDS knowledge, attitudes and behaviour of persons with and without disabilities from the Uganda Demographic and Health Survey 2011: Differential access to HIV/AIDS information and services

ABIMANYI-OCHOM, Juie
MANNAN, Hasheem
GROCE, Nora
McVEIGH, Joanne
April 2017

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Uganda is among the first to use the Washington Group Short Set of Questions on Disability to identify persons with disabilities in its Demographic and Health Survey. In this paper, we review the HIV Knowledge, Attitudes and Behaviour component of the 2011 Ugandan Demographic and Health Survey, analysing a series of questions comparing those with and without disabilities in relation to HIV/AIDS knowledge, attitudes and practices. We found comparable levels of knowledge on HIV/AIDS for those with and those without disabilities in relation to HIV transmission during delivery (93.89%, 93.26%) and through breastfeeding (89.91%, 90.63%), which may reflect increased attention to reaching the community of persons with disabilities. However, several gaps in the knowledge base of persons with disabilities stood out, including misconceptions of risk of HIV infection through mosquito bites and caring for a relative with HIV in own household (34.39%, 29.86%; p<0.001; 91.53%, 89.00%; p = 0.001, respectively). The issue is not just access to appropriate information but also equitable access to HIV/AIDS services and support. Here we found that persons with multiple disabilities were less likely than individuals without disabilities to return to receive results from their most recent HIV test (0.60[0.41–0.87], p<0.05). HIV testing means little if people do not return for follow-up to know their HIV status and, if necessary, to be connected to available services and supports. Additional findings of note were that persons with disabilities reported having a first sexual encounter at a slightly younger age than peers without disabilities; and persons with disabilities also reported having a sexually transmitted disease (STD) within the last 12 months at significantly higher rates than peers without disabilities (1.38[1.18–1.63], p<0.01), despite reporting comparable knowledge of the need for safer sex practices. This analysis is among the first to use HIV/AIDS-related questions from Demographic Health Surveys to provide information about persons with disabilities in Uganda in comparison to those without disabilities. These findings present a more complex and nuanced understanding of persons with disabilities and HIV/AIDS. If persons with disabilities are becoming sexually active earlier, are more likely to have an STD within the preceding 12 month period and are less likely to receive HIV test results, it is important to understand why. Recommendations are also made for the inclusion of disability measures in Uganda’s AIDS Indicator Survey to provide cyclical and systematic data on disability and HIV/AIDS, including HIV prevalence amongst persons with disabilities.

PLoS ONE 12(4): e0174877
https://doi.org/10.1371/journal.pone.0174877

World Health Statistics 2012

WORLD HEALTH ORGANISATION (WHO)
2012

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"World Health Statistics 2012 contains WHO’s annual compilation of health-related data for its 194 Member States, and includes a summary of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and associated targets. This year, it also includes highlight summaries on the topics of noncommunicable diseases, universal health coverage and civil registration coverage"
Note: The summary brochure, full report, report in English by section, the indicator compendium and printed copy order forms are available from the link above

CVD project evaluation : baseline diabetes study, Davao, Philippines 2010

PILLERON, Sophie
June 2011

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This study gathered baseline data for the CVD Project evaluation. "This study also concerned gathering information on the nature of diabetes and common practices in diabetes management and care, to improve project implementation strategy and data on promoting health care services in the community...This study was the first part of a quasi-experimental before-after here-there study conducted in 10 intervention barangays and 5 control barangays of Davao City. The study population consisted of people with diabetes aged 20 years and above who had visited the Barangay Health Centre and had proof of a doctor’s diagnosis for diabetes mellitus or proof of a relative-to-diabetes medicine prescription...Despite its limitations, this study provides a first insight on the people living with diabetes in Davao City. With 72% of diabetics having uncontrolled glycaemia, this study shows the relevance of the CVD project. As a baseline, this study provides comparison elements for the 2013 survey in order to test effectiveness of the CVD project with the percentage of diabetics with HbA1c<6.5% as effectiveness criterion"
DS/RD 01

Uganda demographic health survey 2006

UGANDA BUREAU OF STATISTICS (UBOS)
MACRO INTERNATIONAL INC
August 2007

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The 2006 Uganda Demographic and Health Survey (UDHS) is a nationally representative survey of 8,531 women age 15-49 years and 2,503 men age 15-54 years and is the first such survey to cover the entire country. The primary purpose of the UDHS is to furnish policymakers and planners with detailed information on fertility; family planning; infant, child, adult, and maternal mortality; maternal and child health; nutrition; and knowledge of HIV/AIDS and other sexually transmitted infections. In addition, in one in three households selected for the survey, women age 15-49, men age 15-54, and children under age 5 years were weighed and their height was measured to assess their nutritional status. Women, men, and children age 6-59 months, in this subset of households were also tested for anemia, and in addition the women and children were tested for vitamin A deficiency. In addition to the main report, the key findings, a preliminary report, a wall chart and fact sheet are also available online

PLACE in Central Asia : a regional strategy to focus AIDS prevention in Almaty and Karaganda, Kazakhstan; Osh, Kyrgyzstan; Tashkent, Uzbekistan. 2002

MEASURE EVALUATION
July 2004

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The PLACE method is designed to expose sexual and injection drug use networks, identify sites where high-risk populations overlap and help focus interventions where they are most needed. This report presents both a baseline assessment of HIV/AIDS risks and an evaluation of condom promotion programmes in four cities in Central Asia. The report shows that sexual and drug use networks are extensive and diffuse. The rate of new partnership formation is also very high, and the use of condoms with new partners is "quite high". Injection drug use is common, and needles are often shared. The report calls for programmes and interventions to concentrate their efforts on sites at high risk, where there is an overlap of high-risk populations (people meeting new partners, youth, injection drug users, sex workers)

How high is infant mortality in Central and Eastern Europe and the CIS?

ALESHINA, Nadezhda
REDMOND, Gerry
November 2003

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Official statistics seem to suggest that in post-communist Europe infant mortality rates have significantly decreased through the 1990s. As infant mortality rate is a key indicator of the Millennium Development Goals, reliable measurement is crucial to assess progress. This paper argues that official counts may understate the gravity of the problem in at least 15 countries in the region. This may be due to unclear definitions of 'live birth' and 'stillbirth', misreporting of infant deaths, nonregistration of births or deaths. The paper also discusses the uncertainties associated with survey based estimates, and call for further work to be done to improve collection of data and effectiveness of surveys

Information, education and communication : lessons learned from the past; perspectives for the future

CLIFT, Elayne
2001

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This document discusses the lessons learned from 25 years of the World Health Organization's experience in information, education and communication (IEC). It provides information on the lessons learned from general health programmes and reproductive health programmes. The lessons reflect a retrospective view of what is now known about planning, implementing , monitoring and evaluating IEC interventions. The focus is on practical steps, what has worked, and special considerations to be taken when applying IEC to reproductive health initiatives

Spatial patterns of leprosy in an urban area of central Brazil

MARTELLI, C M T
et al
1995

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Reported is the spatial variation of leprosy in an urban area of Brazil and its correlation with socioeconomic indicators. From November 1991 to October 1992 a total of 752 newly diagnosed leprosy patients who were attending all outpatient clinics in Golania city, central Brazil, were indentified. A database of leprosy cases was set up linking patients' addresses to 64 urban districts. Leprosy cases were detected in 86 of the districts and three risk strata were identified. The highest risk area for leprosy was in the outskirts of the city and detection rates increased on moving from more developed to poorer areas. The risk of detecting leprosy cases was 5.3-fold greater (95CL: 3.8-7.4) in the outskirst of the town than in the central zone.
Discussed are the methodological issues related to leprosy case ascertainment, completeness and reliability of information, and the interpretation of the spatial distribution of leprosy per unti area. High lighted also are the lack of deprosy control activities in primary health care units and the usefulness of geographical analysis in planning health services.

Epidemiological evidence from Zaire for a dietary aetiology of konzo, an upper motor neuron disease

TYELLESKAR, T
et al
1991

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A clear association between seasonal outbreaks of a paralytic disease called konzo and toxic effects from consumption of insufficiently processed bitter cassava roots has been demonstrated in Bandundu region, Zaire. A community-based survey of 6764 inhabitants identified 110 live and 254 dead konzo-affected persons with a history of isolated non-progressive spastic paraparesis of abrupt onset. The start of these annual outbreaks of konzo in 1974 coincided with the completion of a new tarmac road to the capital, which facilitated the transport of cassava and made it the main cash crop. The extensive cassava sales encouraged the consumption by the peasant families of roots that had not been adequately processed; frequent acute cyanide intoxications resulted when the naturally occurring cyanogens in the roots were eaten. The disease mainly appeared in the dry season when there was high consumption of insufficiently processed cassava and the diet lacked supplementary foods with sulfur-containing amino acids which promote cyanide detoxification. These results, which confirm the earlier findings in East Africa, show that, owing to the high cyanide and low sulfur dietary intake, there is an increased risk of konzo outbreaks in cassava-growing areas during periods of adverse agro-economic changes

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