Uptake of COVID-19 Vaccination and Associated Factors among Persons Living with Diabetes Mellitus at Kiruddu Referral Hospital in Kampala, Uganda

Abstract

Background: Diabetes mellitus (DM) is associated with severe coronavirus disease (COVID-19) outcomes, including death, and full COVID-19 vaccination is the mainstay for preventing infection and severe disease among high-risk populations. In Uganda, over 5% of the population has DM, but while COVID-19 vaccination uptake in the general population is regularly tracked, the uptake among persons living with DM is unknown. This study sought to estimate the uptake of full COVID-19 vaccination and identify the factors associated with this uptake among persons living with DM at Kiruddu Referral Hospital (KRH).

Methods: This study used a cross-sectional design and collected data using an interviewer-administered questionnaire. A systematic sampling technique was used to select a random sample of 340 persons living with diabetes mellitus who attended the diabetic clinic of Kiruddu Referral Hospital between March 08 and May 25, 2023. The factors associated with the uptake of full vaccination were obtained using Modified Poisson Regression analysis and associations were presented through adjusted prevalence ratios with their 95% confidence intervals. All the data analysis was conducted using STATA version 14.0.

Results: A total of 340 participants with a mean age of 52 years (±12 years) and a mean duration of diabetes mellitus of 8 years (±8 years) were recruited. Of these, 75% (n=255) were female. Overall, 195 participants (57.35%) received the last dose in the primary series of a COVID-19 vaccine. The likelihood of full vaccination was higher when one was advised by a health provider to receive a vaccine [aPR=1.91 (95% CI: 1.2-3.02)] when one reported having a comorbidity [aPR=1.26 (95% CI: 1.06-1.53)], and when one had a strong perceived benefit of vaccination [aPR=1.76 (95% CI: 1.23-2.53)]. However, having a strong perceived barrier to vaccination was negatively associated with the likelihood of being fully vaccinated [aPR=0.71 (95% CI: 0.6-0.84)]

Conclusion: About 43% of persons living with DM in Uganda have either not received a single COVID-19 vaccine shot, or have an incomplete dose. The MoH needs to implement a provider-initiated vaccination strategy in diabetic clinics using the healthcare providers who regularly attend to DM clients to boost their uptake of full COVID-19 vaccination.