Ronald Wesonga

The Epidemiology of Hypertension in Uganda: Findings from the National Non-Communicable Diseases Risk Factor Survey.

Background Hypertension is an important contributor to global burden of disease and mortality, and is a growing public health problem in sub-Saharan Africa. However, most sub-Saharan African countries lack detailed countrywide data on hypertension and other non-communicable diseases (NCD) risk factors that would provide benchmark information for design of appropriate interventions. We analyzed blood pressure data from Uganda’s nationwide NCD risk factor survey conducted in 2014, to describe the prevalence and distribution of hypertension in the Ugandan population, and to identify the associated factors. Methods The NCD risk factor survey drew a countrywide sample stratified by the four regions of the country, and with separate estimates for rural and urban areas. The World Health Organization’s STEPs tool was used to collect data on demographic and behavioral characteristics, and physical and biochemical measurements. Prevalence rate ratios (PRR) using modified Poison regression modelling was used to identify factors associated with hypertension. Results Of the 3906 participants, 1033 were classified as hypertensive, giving an overall prevalence of 26.4%. Prevalence was highest in the central region at 28.5%, followed by the eastern region at 26.4%, western region at 26.3%, and northern region at 23.3%. Prevalence in urban areas was 28.9%, and 25.8% in rural areas. The differences between regions, and between rural-urban areas were not statistically significant. Only 7.7% of participants with hypertension were aware of their high blood pressure. The prevalence of pre-hypertension was also high at 36.9%. The only modifiable factor found to be associated with hypertension was higher body mass index (BMI). Compared to participants with BMI less than 25 kg/m2, prevalence was significantly higher among participants with BMI between 25 to 29.9 kg/m2 with an adjusted PRR = 1.46 [95% CI = 1.25–1.71], and even higher among obese participants (BMI ≥ 30 kg/m2) with an adjusted PRR = 1.60 [95% CI = 1.29–1.99]. The un-modifiable factor found to be associated with hypertension was older age with an adjusted PRR of 1.02 [95% CI = 1.02–1.03] per yearly increase in age. Conclusions The prevalence of hypertension in Uganda is high, with no significant differences in distribution by geographical location. Only 7.7% of persons with hypertension were aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure. Thus a big percentage of persons with hypertension are at high risk of hypertension-related cardiovascular NCDs.

Prevalence and correlates of diabetes mellitus in Uganda: a population‐based national survey

We analysed fasting blood glucose (FBG) and other data collected as part of a population‐based nationwide non‐communicable disease risk factor survey, to estimate the prevalence of impaired fasting glycaemia (IFG) and diabetes mellitus and to identify associated factors in Uganda.

Airport utility stochastic optimization models for air traffic flow management

The complexity of air traffic flow management has its groundwork at an airport and increases with the number of daily aircraft departures and arrivals. To adequately contribute toward an accelerated air traffic flow management (ATfM), multivariate statistical models were developed based on airport utility. The utility functions were derived from daily probabilities of airport delay and inefficiencies computed using parameterized statistical models. The estimates were based on logistic and stochastic frontier models to derive distribution functions from which daily airport utilities were estimated. Data for testing and model simulations are daily aggregates spanning a five year period, collected from Entebbe International Airport.

Alcohol Use among Adults in Uganda: Findings from the Countrywide Non-Communicable Diseases Risk Factor Cross-Sectional Survey

Background There are limited data on levels of alcohol use in most sub-Saharan African countries. Objective We analyzed data from Ugandas non-communicable diseases risk factor survey conducted in 2014, to identify alcohol use prevalence and associated factors. Design The survey used the World Health Organization STEPS tool to collect data, including the history of alcohol use. Alcohol users were categorized into low-, medium-, and high-end users. Participants were also classified as having an alcohol-use-related disorder if, over the past 12 months, they were unable to stop drinking alcohol once they had started drinking, and/or failed to do what was normally expected of them because of drinking alcohol, and/or needed an alcoholic drink first in the morning to get going after a heavy drinking session the night before. Weighted logistic regression analysis was used to identify factors associated with medium- to high-end alcohol use. Results Of the 3,956 participants, 1,062 (26.8%) were current alcohol users, including 314 (7.9%) low-end, 246 (6.2%) medium-end, and 502 (12.7%) high-end users. A total of 386 (9.8%) were classified as having an alcohol-use-related disorder. Male participants were more likely to be medium- to high-end alcohol users compared to females; adjusted odds ratio (AOR)=2.34 [95% confidence interval (CI)=1.88–2.91]. Compared to residents in eastern Uganda, participants in central and western Uganda were more likely to be medium- to high-end users; AOR=1.47 (95% CI=1.01–2.12) and AOR=1.89 (95% CI=1.31–2.72), respectively. Participants aged 30–49 years and those aged 50–69 years were more likely to be medium- to high-end alcohol users, compared to those aged 18–29 years, AOR=1.49 (95% CI=1.16–1.91) and AOR=2.08 (95% CI=1.52–2.84), respectively. Conclusions The level of alcohol use among adults in Uganda is high, and 9.8% of the adult population has an alcohol-use-related disorder.Background There are limited data on levels of alcohol use in most sub-Saharan African countries. Objective We analyzed data from Ugandas non-communicable diseases risk factor survey conducted in 2014, to identify alcohol use prevalence and associated factors. Design The survey used the World Health Organization STEPS tool to collect data, including the history of alcohol use. Alcohol users were categorized into low-, medium-, and high-end users. Participants were also classified as having an alcohol-use-related disorder if, over the past 12 months, they were unable to stop drinking alcohol once they had started drinking, and/or failed to do what was normally expected of them because of drinking alcohol, and/or needed an alcoholic drink first in the morning to get going after a heavy drinking session the night before. Weighted logistic regression analysis was used to identify factors associated with medium- to high-end alcohol use. Results Of the 3,956 participants, 1,062 (26.8%) were current alcohol users, including 314 (7.9%) low-end, 246 (6.2%) medium-end, and 502 (12.7%) high-end users. A total of 386 (9.8%) were classified as having an alcohol-use-related disorder. Male participants were more likely to be medium- to high-end alcohol users compared to females; adjusted odds ratio (AOR)=2.34 [95% confidence interval (CI)=1.88-2.91]. Compared to residents in eastern Uganda, participants in central and western Uganda were more likely to be medium- to high-end users; AOR=1.47 (95% CI=1.01-2.12) and AOR=1.89 (95% CI=1.31-2.72), respectively. Participants aged 30-49 years and those aged 50-69 years were more likely to be medium- to high-end alcohol users, compared to those aged 18-29 years, AOR=1.49 (95% CI=1.16-1.91) and AOR=2.08 (95% CI=1.52-2.84), respectively. Conclusions The level of alcohol use among adults in Uganda is high, and 9.8% of the adult population has an alcohol-use-related disorder.

On multivariate imputation and forecasting of decadal wind speed missing data

This paper demonstrates the application of multiple imputations by chained equations and time series forecasting of wind speed data. The study was motivated by the high prevalence of missing wind speed historic data. Findings based on the fully conditional specification under multiple imputations by chained equations, provided reliable wind speed missing data imputations. Further, the forecasting model shows, the smoothing parameter, alpha (0.014) close to zero, confirming that recent past observations are more suitable for use to forecast wind speeds. The maximum decadal wind speed for Entebbe International Airport was estimated to be 17.6 metres per second at a 0.05 level of significance with a bound on the error of estimation of 10.8 metres per second. The large bound on the error of estimations confirms the dynamic tendencies of wind speed at the airport under study.

Health and human rights: a statistical measurement framework using household survey data in Uganda

BackgroundHealth is intertwined with human rights as is clearly reflected in the right to life. Promotion of health practices in the context of human rights can be accomplished if there is a better understanding of the level of human rights observance. In this paper, we evaluate and present an appraisal for a possibility of applying household survey to study the determinants of health and human rights and also derive the probability that human rights are observed; an important ingredient into the national planning framework.MethodsData from the Uganda National Governance Baseline Survey were used. A conceptual framework for predictors of a hybrid dependent variable was developed and both bivariate and multivariate statistical techniques employed. Multivariate post estimation computations were derived after evaluations of the significance of coefficients of health and human rights predictors.ResultsFindings, show that household characteristics of respondents considered in this study were statistically significant (p < 0.05) to provide a reliable assessment of human rights observance. For example, a unit increase of respondents’ schooling levels results in an increase of about 34% level of positively assessing human rights observance. Additionally, the study establishes, through the three models presented, that household assessment of health and human rights observance was 20% which also represents how much of the entire continuum of human rights is demanded.ConclusionFindings propose important evidence for monitoring and evaluation of health in the context human rights using household survey data. They provide a benchmark for health and human rights assessments with a focus on international and national development plans to achieve socio-economic transformation and health in society.

Burden of cumulative risk factors associated with non-communicable diseases among adults in Uganda: evidence from a national baseline survey

BackgroundModification of known risk factors has been the most tested strategy for dealing with non-communicable diseases (NCDs). The cumulative number of NCD risk factors exhibited by an individual depicts a disease burden. However, understanding the risk factors associated with increased NCD burden has been constrained by scarcity of nationally representative data, especially in the developing countries and not well explored in the developed countries as well.MethodsAssessment of key risk factors for NCDs using population data drawn from 3987 participants in a nationally representative baseline survey in Uganda was made. Five key risk factors considered for the indicator variable included: high frequency of tobacco smoking, less than five servings of fruit and vegetables per day, low physical activity levels, high body mass index and raised blood pressure. We developed a composite indicator dependent variable with counts of number of risk factors associated with NCDs per participant. A statistical modeling framework was developed and a multinomial logistic regression model was fitted. The endogenous and exogenous predictors of NCD cumulative risk factors were assessed.ResultsA novel model framework for cumulative number of NCD risk factors was developed. Most respondents, 38 · 6% exhibited one or two NCD risk factors each. Of the total sample, 56 · 4% had at least two risk factors whereas only 5.3% showed no risk factor at all. Body mass index, systolic blood pressure, diastolic blood pressure, consumption of fruit and vegetables, age, region, residence, type of residence and land tenure system were statistically significant predictors of number of NCD risk factors (p < 0 · 05). With exception to diastolic blood pressure, increase in age, body mass index, systolic blood pressure and reduction in daily fruit and vegetable servings were found to significantly increase the relative risks of exhibiting cumulative NCD risk factors. Compared to the urban residence status, the relative risk of living in a rural area significantly increased the risk of having 1 or 2 risk factors by a multiple of 1.55.ConclusionsThe non-communicable disease burden is on the increase, with more participants reporting to have at least two risk factors. Our findings imply that, besides endogenous factors, exogenous factors such as region, residence status, land tenure system and behavioral characteristics have significant causal effects on the cumulative NCD risk factors. Subsequently, while developing interventions to combat cumulative risk factors of NCDs, the Ministry of Health needs to employ a more holistic approach to facilitate equitable health and sensitization across age, residence and regional divide.

Autoantibodies and HLA class II DR-DQ genotypes in Ugandan children and adolescents with type 1 diabetes mellitus

The aims were to determine the prevalence of autoantibodies in type 1 diabetes mellitus (T1DM) and further to investigate the human leukocyte antigen (HLA) class II DR-DQ genotypes associated with T1DM in Ugandan children and adolescents. Cross-sectional data were collected between January and December 2015 from 85 recently detected T1DM children and adolescents and 79 age-matched healthy controls. We measured serum concentrations of C-peptide, vitamin D, insulin autoantibodies (IAA), zinc transporter family member 8 antibodies (ZnT8-Ab), and glutamic acid decarboxylase autoantibodies (GADA). HLA-DBR1 and HLA-DQB1 typing was performed on EDTA-anticoagulated blood samples. The t test, chi-square test, and univariate logistic test were performed and multivariate logistic regression model fitted to identify associated factors of T1DM. Positive IAA and ZnT8-Ab were significantly higher in T1DM than in controls. GADA showed no difference between TIDM and controls. HLA-DQB1*02, unadjusted odds ratio (UOR) 4.2 (95% CI 1.4–12.7), and HLA-DBR1*04, adjusted odds ratio (AOR) 30.6 (95% CI 5.7–161.7), were significantly associated with T1DM. IAA and ZnT8-Ab are the likely significant positive antibodies in Ugandan children and adolescents with T1DM. The T1DM was associated with HLA-DQB1*02 and HLA-DBR1*04 (HLA-DR3 and HLA-DR4) genotypes.

Polytechnic engineering mathematics: assessing its relevance to the productivity of industries in Uganda

BackgroundThe main objective of the study was to examine the relevance of engineering mathematics to the emerging industries. The level of abstraction, the standard of rigor, and the depth of theoretical treatment are necessary skills expected of a graduate engineering technician to be derived from mathematical knowledge. The question of whether these skills are imparted to benefit emerging economies still remains a big area of investigation. This study investigated the relevancy of engineering mathematics to the benefit of local industry in a developing economy, Uganda.ResultsThere was a significant difference between the mathematics being taught to the engineering technical students and the mathematics relevant to the engineering technical work in the industries (p value < 0.05). Implying that the mathematics taught to engineering technical students, though relevant, is not in the form of what the industries require. The use, practicability, depth, rigor, modernity, relevancy, and usefulness of the taught mathematics were all statistically different from the desired mathematical skills for the industry. Moreover, the extent of use of the engineering mathematics did not differ between the required and taught and among the civil, electrical, and mechanical branches of engineering.ConclusionsThe mathematics syllabi for polytechnic institutes should be developed to directly support innovations and efficiency in the local industries. Therefore, a close collaboration between the polytechnic colleges and the local industries should be facilitated to achieve a sustainable industrial.

Airline Delay Time Series Differentials: Autoregressive Integrated Moving Average Model

Flight delays affect passenger travel satisfaction and increase airline costs. The authors explore airline differences with a focus on their delays based on autoregressive integrated moving averages. Aviation daily data were used in the analysis and model development. Time series modelling for six airlines was done to predict delays as a function of airport’s timeliness performance. Findings show differences in the time series prediction models by airline. Differential analysis in the time series prediction models for airline delay suggests variations in airline efficiencies though at the same airport. The differences could be attributed to different management styles in the countries where the airlines originate. Thus, to improve airport timeliness performance, the study recommends airline disaggregated studies to explore the dynamics attributable to determinants of airline unique characteristics. Airline Delay Time Series Differentials: Autoregressive Integrated Moving Average Model