Richardson Mafigiri
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ABOUT THE FELLOWRichardson Mafigiri holds a MSc in International Infectious Diseases Management from Makerere University in collaboration with University of GhanaLegon and a Bachelor of Science degree in Zoology and Chemistry from Makerere University. After his under graduate degree, Richardson taught sciences (Biology and Chemistry) in many schools in and outside Uganda. Thereafter, he worked as a research assistant at Makerere University College of Veterinary Medicine and Noguchi Memorial Institute of Medical Research at University of Ghana 2012- 2014. In 2015, Richardson joined the Uganda Public Health Fellowship Program (PHFP), and his host institution was Rakai District Health Office (DHO) and Rakai Health Sciences Program (RHSP). While at the host sites, he worked with the District led HIV programming which aimed at training district health workers to manage and execute HIV/AIDS care and treatment services. He also worked with RHSP which is the District Implementing Partner where he acquired extensive knowledge and skills in monitoring and evaluation of HIV/AIDS projects, day to day management of Non-government Organization and local government. As a resident, Richardson conducted a number of outbreak investigations for instance; measles, typhoid, food poisoning and bleeding illness. With the PHFP, he acquired fellowship training in field epidemiology and gained key skills in surveillance, data management and analysis, leadership, management and report writing. At the host institution, Richardson also participated in many activities and trainings in health related fields and data management. He was assigned to monitor timely and complete reporting of health data from health facilities in the district. Achievements at the host site
Program-specific achievements (key deliverables)
Summary of Planned study: Title: Under-five diarrheal disease mortality and household sanitary practices in Kakuuto County Rakai District, April 1st, 2014-March 30th, 2016 Methods: A community based case-control design. Cases were mothers with anU5 child who died and controls were mothers with a child U5 years who were alive between April 1, 2014 and March 31, 2016. Controls were randomly picked from neighboring households which had a child <5 years. No controls were selected from the same household with a child-case. Trained VHTs identified households with deceased children, and surviving children that were recruited in the study. A list of cases and controls was generated. Questionnaires were administered by well-trained research assistants. Data were collected on respondent’s demographic characteristics and household sanitary practices and child health Data analysis: Data were edited and checked for completeness, accuracy and uniformity before analysis, then stored into a password protected computer only accessible by researchers. Chi square was used to compare variables for cases and controls with sanitary practices, P-values <0.05 was considered significant. At 95% CI, odds ratios for the association of children U5 diarrheal diseases mortality and sanitary practices was determined. Results:Majority 98% (n=386) of the households had the latrine compared to 2% (n=9) who never had the latrine, P<0.05. Despite the high latrine coverage, only 42.4%(n=32)of cases and 51% (n=204) of controls reported that they washed their hands all the time after visiting the latrine. Conversely, 46.0% of cases and 43.1% of cases washed their hands some of the time but not always. Factors that were significantly associated with diarrheal diseases mortality after adjusting, for potential and suspected confounders were; no latrine in a household (adjusted Odds Ratio [aOR] = 48, 95% CI, 2.9-309); never washing hands after visiting the latrine aOR=24 (95% CI, 1.4- 405); sweeping the compound once in a week, aOR= 5.3 (95% CI, 1.03-27) or twice a week, aOR= 3.8 (95% CI, 1.03-14); and spending time 30 to one hour fetching water from water source, aOR= 6 (95%CI, 1.1-31). 36.2% of all cases among children U5 were attributable to irregular washing of hands after visiting the latrine, 33.4% were attributable to taking between 30 and 60 minutes fetching water, 26% was attributable to never wash hands after visiting latrine, 18.2% was attributable to irregular sweeping of the compound and least 7.8% was attributable to lack of latrine in household. Conclusion: Diarrheal diseases mortality among children Under-five years of age in Kakuuto County are caused by not washing hand after visiting latrine, spending a lot of time fetching water, and lack of latrine in households. Key skills/competences acquired, and next steps
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