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Recent Submissions

Christianity and Health: A Glimpse into the Evolution of Delivery of Modern Health Services in Uganda
(Bishop Stuart University Journal of Development, Education & Technology, 2025) Gad Ruzaaza Ndaruhutse
The Bible emphasizes how Jesus came to preach to teach and to heal, that Christians would attain life in all its fullness (Mattwew 4: 23- 25). This message was internalized by the early Christian Missionaries, since they would preach the word of God, teach initially reading and writing and provide health services. This is likely why among the early missionaries were teachers, doctors, nurses and builders (Ssekamwa, 1997). It is well documented that the earliest schools and health facilities, such as Mbarara Junior School, Nsanji Primary School, Gayaza Girls School, Kings College, Budo, Kigezi high School, Mengo Hospital and Kisiizi Hospital to be built in Uganda were founded by Christian Missionaries, with most of them still thriving today (Ssekamwa, 1997). Both the schools and health facilities have since further expanded their mandate and scope; with some of the schools becoming universities, such as the Nomal School in Kabale and Bishop Stuart College and the hospitals further enriching their teaching and training aspect to become centers of excellence and schools of health sciences. Conceived partly from the lived experience, anchored in literature and testimonies of missionaries, this paper aims at tracing the evolution of Uganda’s health sector and health professions’ education from the foundations. The Christian Missionary Doctors and Nurses, resiliently pursued the establishment of modern healthcare and later health professions’ education that became the springboard for Uganda government to establish her health sector on firm ground. At Uganda’s independence in 1962, Uganda had one of the best healthcare systems in Africa. The paper proposes the deliberate need for continuing support of church – founded health initiatives for quality health service delivery to Uganda’s population.
“Too poor to migrate”: A narrative of labor migration and land fragmentation in Uganda
(Land Use Policy, 2026) Kashi Kafle; Naureen Fatema; Shahriar Kibriya; Yuanhang Wang; Ronald Twongyirwe
Land fragmentation is a growing concern among smallholders in developing countries. As families grow and split off, per-capita land size declines significantly. Fragmented land holdings can have ramifications on agricultural production and labor migration. We investigate the relationship between land fragmentation and short-term labor migration using longitudinal household data from Uganda. We collate data from four periods of the Living Standard Measurement Study – Integrated Survey in Agriculture (LSMS-ISA) between 2013 and 2020. We use the two-way fixed effects estimator to estimate the effects of land fragmentation on migration. We find that land fragmentation is negatively correlated with labor migration. The relationship is more pronounced among rural, poor, and male-headed households compared to urban, rich, and female-headed households, respectively. We also conducted Focus Group Discussions (FGDs) with members of smallholder families in Southwest Uganda to qualitatively confirm the empirical findings. Results show that the negative relationship between land fragmentation and labor migration is mediated by the negative impacts of fragmented holdings on agricultural productivity. Public policies and programs that focus on land redistribution or consolidation may want to pay close attention to the consequences of fragmented holdings on agricultural production and smallholders’ migration behavior
Resolution of signs and symptoms of illnesses among self-medicating undergraduate students of Mbarara University of Science and Technology: a cross-sectional study
(Journal of Pharmaceutical Health Care and Sciences, 2025) Ronald Mushemeza; Hannah Mwebaza; Patience Amutuhaire; Diana Nakwanyi; Silvano Samba Twinomujuni; Silas Ojuka
Introduction: Self-medication(SM) is highly prevalent among university students in Uganda, This poses various challenges to the local healthcare system and the nation at large. SM is notorious for its undesirable effects like adverse drug events, drug addiction, antimicrobial resistance, progression of disease to more complicated forms, prolonged morbidity and death. However, some studies have documented reports of resolution of signs and symptoms among self-medicating individuals. This study purposed to investigate the association between patterns of SM and resolution of signs and symptoms among undergraduate students enrolled at Mbarara University of Science and Technology (MUST). Methods: A descriptive cross-sectional study was conducted at Mbarara University of Science and Technology in Uganda from February 2024 to April 2024. A physical close-ended self-administered questionnaire was used to collect data from respondents. Analysis was done using SPSS version 25. The patterns of SM and the proportion of respondents who reported resolution of signs and symptoms were analysed and presented using descriptive statistics. Pearson’s Chi-square was performed to analyse the association between patterns of SM and resolution of signs and symptoms at the significance level of P<0.05. Results; Out of 387 respondents, the prevalence of self- medication was 71.1% (275/387). Majority of respondents who self-medicated, 85.1% (234/275), reported resolution of signs and symptoms of their illnesses. Most respondents who self-medicated were treating cough, 65.1% (179/275), and headache, 58.5% (161/275). Most of them used cough medications, 63.3% (174/275), and over-the-counter pain relievers, 51.3% (141/275). In the current study there was a statistically significant association between resolution of signs and symptoms and; having cough, (X2 (1, N=178) =3.851, p=0.050), having sore throat, (X2 (1, N=64)=4.983, p=0.026), and use of cough or cold remedies, (X2 (1, N=173)=5.668, p=0.017) Conclusion: The findings of the current study are suggestive of the popularity of SM among students attending university in sub-Saharan Africa. This study also brings to light the significance of SM to the health care of this population. However, the convenience of resolution of signs and symptoms could mask looming dangers of SM that should be seriously considered by all stakeholders of public health.
Counselling and depressive symptoms in older adults with HIV/AIDS in mbarara, Uganda
(BMC psycholog, 2025) Jordan Mutambi Amanyire; Irene Aheisibwe; Ronald Asiimwe; Godfrey Zari Rukundo
Background: Depression is a mood disorder characterized by persistent low mood, loss of interest, hopelessness, sleep disturbances, difficulty concentrating, and low self-esteem. Among people living with HIV (PLWH), depression is linked to poor psychological and medical outcomes, including lower quality of life, higher viral load, and increased mortality risk. Various psychotherapy methods, such as cognitive behavioral therapy (CBT), interpersonal psychotherapy, group counselling, and rational emotive behavior therapy (REBT), have been used to treat depression. Counselling, an interpersonal process between a client and a counselor, has been shown to reduce stress, anxiety, and hopelessness among PLWH. This study assessed the role of counselling on reducing depressive symptoms in older adults with HIV/AIDS in Mbarara, Uganda. Methods: We recruited 265 older adults (mean age 64.2±5.1 years; 150 women, 115 men) receiving HIV/ AIDS services at four care centers. The Patient Health Questionnaire assessed depression levels, while additional questionnaires evaluated the frequency and perceived benefits of counselling. Reported benefits included improved self-esteem, better illness management, reduced stigma, increased medication adherence, and financial empowerment. Logistic regression was used to analyze the relationship between counselling and depression, with a significance level set at 5%. We used stepwise logistic regression to select the final model, with a p-value threshold of 0.05 for variable inclusion and p-value of 0.10 for variable retention. Findings: Most participants (216; 83.4%) reported that counselling helped them cope with their illness, reducing their likelihood of depression. Factors associated with counselling and depression included lack of home visits (AOR=2.54, 95% CI 1.57–13.07, p=0.019) and infrequent counselor interactions (AOR=1.24, 95% CI 1.09–3.84, p=0.014). Conclusion: Regular home visits and counselling are associated with significant reductions in depressive symptoms among older adults living with HIV/AIDS. Incorporating home-based counselling services and regular home visits can enhance the well-being of this population.
Effects of educational intervention on knowledge of Full Outline of Un Responsiveness score among health workers in uganda: a quasi -experimental pilot study
(BMC Medical Education, 2025) Obongo Tom; Kinkuhaire Betty; Tibaijuka Leevan; Kaddumukasa Mark; Nantongo Hanifah
Background: The Full Outline of Un-Responsiveness (FOUR) score is a new and better coma grading scale in critically ill patients. However, there is a paucity of data on its knowledge among health workers in sub-Saharan Africa. This study assessed the effects of an educational intervention on knowledge of FOUR Score among health workers at a Regional Referral Hospital in Southwestern Uganda. Methods: This was a one-group quasi-experimental study among conveniently sampled health workers attending to critically ill patients. Using a pretested questionnaire, data was collected pre and post intervention. Participants with low and moderate pre-test knowledge attended a theory session of 45-minutes and hands on sessions using the FOUR Score reference chart for one week, on ward. The post-test data was collected for all trained participants seven days after training. Data was analysed using STATA-17. Results: Of the 146 health workers (HWs) recruited, 50.7% and 45.2% were nurses and doctors, respectively. Over 113 (77.0%) were degree holders and 114 (78.1%) had no prior FOUR Score training. The median knowledge score was 8 (34.8%) and 19 (82.6%) in the pre- and post-test, respectively. A Wilcoxon Signed-Rank test showed a significant knowledge score difference in the median pre- and post-test (Z=10.4; p<0.001). Higher level of education (X2 [1]=10.3, P=0.016), working in ICU (X2 [2]=13.8, P=0.001), and prior FOUR Score training (Z=6.3, P<0.001) were significantly associated with high pre-test knowledge score but were not significant in the post-test. Conclusion: This educational intervention was effective in increasing the knowledge of health workers regarding the FOUR score, indicating that it can be easily learned and mastered. When properly done, this intervention could potentially improve the management of critically ill patient in similar (low- and middle-income countries) settings.
Generalized anxiety disorder and major depressive disorder among healthcare professionals in Mbarara city, southwestern Uganda: the relationship with professional quality of life and resilience
(BMC Public Health, 2025) Joan Abaatyo; Alain Favina; Margaret Twine; Dan Lutasingwa; Rosemary Ricciardelli; Godfrey Zari Rukundo
Background: Marking the lives of healthcare professionals (HCPs) are tensions arising from the conflict between fulfilling their duty of care and the demands of the healthcare setting, creating concern for HCPs’ mental. In our study, we aim to determine the prevalence of major depressive disorder (MDD) and generalized anxiety disorder (GAD) among HCPs in Southwestern Uganda and to establish how the disorders’ prevalence affects professional quality of life and resilience. Method: In total, 200 HCPs from two health facilities (one private and one public) in Southwestern Uganda enrolled in an analytical cross-sectional study. We used the Patient Health Questionnaire-9 (PHQ-9) to determine MDD, the Generalized Anxiety Disorder-7 (GAD-7) to determine GAD, the Professional Quality of Life Scale-5 (ProQOL-5) to determine professional quality of life and the Nicholson McBride Resilience Questionnaire (NMRQ) to determine resilience. Results: The prevalence of MDD was 11.0% and of GAD was 14.5%. High compassion fatigue increased the likelihood of MDD [aPR=3.38, pvalue<0.001]. However, high compassion satisfaction and exceptional resilience reduced the likelihood of GAD i.e., [aPR=0.50, pvalue<0.001] and [aPR=0.50, pvalue<0.001] respectively. Being male [aPR=2.41, pvalue=0.005] and being married [aPR=1.79, pvalue=0.017] increased the likelihood of having MDD. The likelihood of GAD among HCPs decreased with age, [aPR=0.97, pvalue=0.022]. Conclusion: There is a significant occurrence of MDD and GAD among healthcare professionals (HCPs) in Southwestern Uganda. Compassion fatigue is linked to an elevated prevalence of MDD, while compassion satisfaction and high resilience scores are associated with a reduced prevalence of GAD. We recommend creation and execution of extensive mental health initiatives designed for HCPs.
Prevalence of, and Factors Associated with Hemodynamic Instability Among Women Presenting with Incomplete Abortion at a Tertiary Hospital in Southwestern Uganda
(International Journal of Women's Health, 2025) Caxton Kakama; David Collins Agaba; Onesmus Byamukama; Rogers Kajabwangu; Elizabeth Kengonzi; Mathiang Agany Akol; Amos Muhumuza; Julius Businge; Stuart Turanzomwe; Brenda Ainomugisha; Kato Paul Kalyebara; Musa Kayondo; Joseph Ngonzi; Wasswa George Muganwa; Henry Mark Lugobe
Background: Sub-Saharan Africa has a high abortion case-fatality rate, and most of these maternal deaths are due to hemodynamic instability which results from hemorrhage, especially in cases of incomplete abortion. Timely identification and management of hemodynamic instability is an important strategy for addressing the morbidity and mortality associated with incomplete abortion. This study, therefore, aimed at determining the prevalence and factors associated with hemodynamic instability among women presenting with incomplete abortion at Mbarara Regional Referral Hospital (MRRH). Methods: We conducted a cross-sectional study at the gynaecology ward of MRRH from January 2024 to April 2024. We consecutively enrolled women with incomplete abortion and collected data on socio-demographic, abortion- and medical-related factors, and measured their blood pressure and heart rate at admission. Obstetric shock index (OSI), the ratio of the heart rate to systolic blood pressure, was used as a measure of haemodynamic stability. A participant whose OSI was ≥0.9 was considered haemodynamically unstable. We performed a modified Poisson regression analysis to determine the factors associated with hemodynamic instability. Results: A total of 137 women with incomplete abortion were enrolled in this study with a mean age of 26.3 (±5.93) years. The majority of the participants had first-trimester abortions (65.7%), were married (70.8%), and were from rural areas (60.0%). The prevalence of hemodynamic instability was 41.6% (95% CI: 33.6–50.1). At multivariable regression analysis, gestation age ≥13 weeks (aPR 1.67, 95% CI: 1.12–2.49) and post-abortion infection (aPR 1.75, 95% CI: 1.18–2.60) were significantly associated with hemodynamic instability. Conclusion: Approximately two in every five women with incomplete abortion at MRRH were hemodynamically unstable at admission during the study period. Women with second trimester abortion and those with post-abortion infection are more likely to present with hemodynamic instability. We recommend strengthening routine assessment and management of hemodynamic instability among women with incomplete abortion
Exposure to pollutants for household cooking and lighting and pediatric post-discharge mortality following a severe infection in Uganda
(PLoS One, 2025) Gurvir S. Dhutt; Cherri Zhang; Elias Kumbakumba; Abner Tagoola; Peter Moschovis; Stephen Businge; Niranjan Kissoon; Nathan Kenya Mugisha; Jerome Kabakyenga; Matthew O. Wiens
Background: Particulate matter from household air pollution (HAP) is linked to half of all lower respiratory infection deaths among children under 5 years of age. In rural Uganda, similar number of children die 6-months post discharge as during hospitalization for severe infections. However, it is unclear whether exposure to HAP contributes to poor health and death after discharge. We investigated the association between cooking and household lighting practices and mortality 6-months post-discharge among children under 5 years of age treated for severe infection in rural Uganda. Methods: We conducted a secondary analysis of data from observational cohort studies, conducted between July 2017 to July 2021, among 6,955 children 0 to 5 years admitted to one of six Ugandan hospitals for a severe infectious illness. Clinical signs and symptoms, sociodemographic variables, and mortality up to 6-months post-discharge was collected for all participants, and follow-up rates were >95%. Exposure variables included type of cooking fuel used, location of cooking (e.g. indoors, outdoors), and primary source of household lighting. We assessed post-discharge mortality using simple and multivariate Poisson regression. Results: The unadjusted risk ratio of 6-month post-discharge mortality by dual or single exposure to pollutant fuel sources for cooking indoors and household lighting, when compared to minimal exposure, was 1.57 (95%CI 1.17, 2.11) and 1.20 (95%CI 0.94, 1.54), respectively. Adjusting for age, sex, distance to hospital, maternal education, and maternal HIV status, the adjusted risk ratios for dual and single exposure became 1.30 (95%CI 0.96, 1.76] and 1.08 (95%CI 0.84, 1.38). There was no significant interaction between exposure and age, sex, maternal education, or anemia status. Discussion: This analysis did not find a statistically significant association between HAP and 6-month post-discharge mortality. However, HAP cannot be ruled out as a contributor in this population where malnutrition, comorbidities and sociodemographic vulnerabilities are common.
Prevalence and antimicrobial resistance of Salmonella and pathogenic E. coli in broiler farms, Wakiso district, Uganda
(PloS one, 2025) Thomas Ssemakadde; Nalumaga Pauline Petra; Jude Collins Busingye; Joel Bazira; Kabanda Taseera
Background: The emergence and re-emergence of zoonotic bacterial infections and the upsurge reflected in current trends of antimicrobial-resistant bacteria is a major global concern. Salmonella spp and Escherichia coli (E. coli) are the two most important foodborne pathogens of public health interest incriminated in poultry products worldwide. AMR in poultry farming poses a significant public health risk in Uganda, as the misuse and overuse of antibiotics in livestock can lead to the emergence of resistant pathogens that may transfer to humans through direct contact, consumption of contaminated poultry products, or environmental exposure, further complicating the management of infection hence necessitating constant monitoring of microbial food safety measures. Methods: This study was a cross-sectional study that used a total of two hundred sixteen poultry samples from cloacae swabs and fecal swabs collected from broiler poultry farms. These were cultured on Chromagar TM Salmonella and Sorbitol MacConkey agar. Biochemical tests, minimum inhibitory concentration, and polymerase chain reaction were utilized. Data was analyzed by descriptive statistics, and Chi-square (χ²) Test statistical significance of quantitative data. Results: A total of 40 (18.5%) Salmonella and 120 (55.6%) pathogenic E. coli were isolated while extended beta-lactamase (ESBL) production was detected in 18 Salmonella and 57 pathogenic E. coli isolates. Prevalence of blaTEM gene was expressed in 7/18 (39%) Salmonella isolates and 42/57 (73.8%) Pathogenic E. coli isolates The significant associated factors that predisposed these farms to Salmonella spp was source of poultry feeds (p-value=0.066) while factors associated with pathogenic E. coli included contact of poultry with other birds and livestock (p-value=0.020), movement from one pen to the other by farm-handlers (p-value=0.017), use of untreated water (p-value=0.018) and food contamination of commercial poultry feeds (p-value=0.0021). Conclusion: The findings of this study highlight the significant presence of Salmonella and pathogenic E. coli in poultry farms, underscoring the potential risks to public health. The high prevalence of antimicrobial resistance observed among these isolates calls for urgent interventions to curb the misuse of antibiotics in poultry farming.
‘We would look at the chickens as a source of security’: microenterprise and health in rural Uganda
(Journal of Global Health, 2025) Justus Kananura; Bridget FO Burns; Charles Baguma; Rumbidzai C Mushavi; Emily N Satinsky; Allen Kiconco; Elizabeth B Namara; Clare Kamagara; Elijah Musinguzi; Owen Alleluya; David R Bangsberg; Alexander C Tsai; Bernard Kakuhikire
Background: Development interventions may promote sustainable livelihoods among participants via improved income generation, health, education, and quality of life. Within the development literature, microfinance institutions (MFIs) provide individuals with funds and/or startup capital to develop small businesses. However, the evidence on whether MFIs are successful in ensuring sustainable livelihoods is mixed. In this study, we assessed participants’ perceptions of the barriers and facilitators to a poultry microenterprise intervention, and the impact of the intervention on enabling sustainable livelihoods for the participants, their families, and their community. Methods: During exit interviews, 30 women who had participated in a poultry microenterprise demonstration project in rural Uganda nine months prior described their experiences in the intervention, including perceived benefits and challenges, and discussed specific factors that impacted their continuity in the project. We analysed the interviews using a content analysis approach. Results: The participants noted instrumental and interpersonal benefits of the intervention: greater financial security, increased trust from community members, social support, empowerment, and skills-building. Despite these facilitators, challenges precluded some of them from establishing sustainable livelihoods. Pervasive poverty, poultry disease outbreaks, poor spousal/familial support, and challenges in effectively communicating the goal of the intervention stood as barriers to the establishment of sustained poultry businesses. While most participants (n/N=20/30) reached the final phase of the intervention, only six continued rearing chickens beyond the project. Conclusions: Barriers and facilitators described by the participants and identified in our analysis bear implications for the design, implementation, and evaluation of microenterprise interventions aimed at providing participants with sustainable livelihoods. Our findings highlight the importance of qualitative research in identifying concerns and informing intervention adaptations.
An Optimized In-House Protocol for Cryptococcus neoformans DNA Extraction from Whole Blood: “Comparison of Lysis Buffer and Ox-Bile Methods”
(Journal of Fungi, 2025) Fredrickson B Wasswa; Kennedy Kassaza; Kirsten Nielsen; Joel Bazira
Cryptococcus neoformans (C. neoformans) is a capsulated yeast that enters the body through inhalation and migrates via the bloodstream to the central nervous system, causing cryptococcal meningitis. Diagnosis methods are culture, serology, and India ink staining, which require cerebrospinal fluid (CSF) or whole blood. Molecular methods are used for epidemiological studies and require expensive commercial DNA extraction kits. This study aimed to develop an economical in-house method for extracting C. neoformans DNA from whole blood. C. neoformans cells of varying McFarland standards were spiked into expired blood, then lysed using laboratory-prepared lysis buffer and ox-bile solution, followed by organic DNA extraction. Ordinary PCR targeting the CNAG 04922 gene was performed. To determine the limit of detection, serial dilutions of C. neoformans were made, and DNA extraction was performed on other parts cultured on yeast extract peptone dextrose agar to determine colony-forming units (CFU). The lysis buffer method successfully extracted DNA from as low as the average of 62 CFU in 0.9 mL of expired blood with superior quality and high yield compared to ox-bile. The lysis buffer method yielded higher DNA quality and quantity than ox-bile and detected low concentrations of C. neoformans in expired blood. This method presents a cost-effective alternative for molecular diagnosis in resource-limited settings.
Impact of an Educational Intervention on Nurses’ Knowledge and Practice in Early Detection of Acute Kidney Injury at Mbarara Regional Referral Hospital, Western Uganda
(Advances in Medical Education and Practice, 2025) Were Phiona; Eric Baluku Murungi; Jannat Kasozi
Introduction: Acute Kidney Injury (AKI) is a common, often undocumented disorder causing significant morbidity and high mortality. It affects 20% of hospitalized patients, with over 50% incidence in ICUs. Nurses play a crucial role in AKI management, particularly in in-patient care. Early detection and management depend on nurses’ knowledge and practice, impacting outcomes. AKI is a global concern, with over 2.3 million projected annual deaths worldwide. Aim: To examine the impact of an educational intervention on nurses’ knowledge and practice in early detection of AKI at Mbarara Regional Referral Hospital. Methods: A quasi-experimental study was conducted at Mbarara Regional Referral Hospital in the Accident and Emergency and Intensive Care Units. It involved a pre-test, intervention, and post-test. Thirty nurses completed self-administered questionnaires to assess knowledge, while 25 medical charts were reviewed using a checklist to evaluate practice. Paired t-tests and Chi-square tests were used to analyse changes in knowledge and practice before and after an educational intervention. Results: The findings revealed that the knowledge and practices in early detection of AKI among the nurses was inadequate with only 3.3% of the nurses having excellent knowledge in the early identification of AKI while most of the medical charts had incorrectly performed practices. However, after the educational intervention the knowledge and practice in detection of AKI improved. The mean knowledge scores were 43.0333 (SD = 16.9) pre-test and 68.3 (12.8) post-test. There were significant differences in mean knowledge and practice scores before and after intervention, mean of (t (29) with 18.7018–31.96487 (95% confidence interval) and P-value of <0.0001. Conclusion: There is a need to organize regular sessions on AKI to improve the knowledge and practices of nurses in early detection of AKI.
Developing a Campus Blended Learning Framework to Improve Adoption in Higher Educational Institutions in Southwestern Uganda
(The Indonesian Journal of Computer Science, 2025) Kabarungi Moreen; Ntwari Richard; Annabella Habinka Ejiri; Kawuma Simon
Despite the potential benefits of blended learning in higher education, adoption rates in Ugandan universities remain critically low at 29.1%, with significant barriers including inadequate infrastructure, limited institutional support, and mental health challenges affecting both educators and students. This study aimed to develop a Campus Blended Learning Framework (CBLF) to improve blended learning adoption in higher educational institutions in southwestern Uganda. A Design Science Research methodology was employed, incorporating both quantitative and qualitative approaches. Data were collected from three universities: Mbarara University of Science and Technology (MUST), Bishop Stuart University (BSU), and Kabale University (KAB). A total of 1,495 participants (1,051 students and 444 staff members) were surveyed using structured questionnaires based on the Complex Adaptive Blended Learning Framework (CABLF). Ten experts participated in qualitative interviews to evaluate the framework's usability and acceptability. The study identified six critical components for effective blended learning adoption: pedagogy, infrastructure, content, assessment, support, and mental health. Mental health emerged as a significant factor influencing all other components. The proposed CBLF integrates these elements while addressing the unique contextual challenges of developing countries. The Campus Blended Learning Framework provides a comprehensive approach to addressing low adoption rates of blended learning in southwestern Uganda's higher educational institutions. The framework's emphasis on mental health support and contextual adaptation makes it
Treatment failure among children under 5 years hospitalized with pneumonia at the pediatric ward of Mbarara Regional Referral Hospital in Southwestern Uganda: a prospective observational study
(Therapeutic Advances in Infectious Disease, 2025) Laura Bacia; Stanslas Avaga; Simon Ngbape Ndrusini; Caroline Nakate; Abdu Damale; Julius Kyomya; Daniel Chans Mwandah; Stella Kyoyagala; Tadele Mekuriya Yadesa
Background: Pneumonia remains a significant global health concern, particularly for children in low- and middle-income countries. Despite advancements in medical care and the availability of effective medication, treatment failure still occurs. Objective: This study evaluated the incidence, associated factors, and outcomes of treatment failure among children under 5years with pneumonia. Design: A prospective observational study. Method: We conducted this study among children under 5years hospitalized with pneumonia at the pediatric ward of Mbarara Regional Referral Hospital over a period of 3months. We enrolled the participants in the study consecutively. Data was analyzed using SPSS software Version 27. Logistic regression was used to determine factors associated with treatment failure. Results: A total of 216 children aged between 0 and 59months were included in the study. The incidence of treatment failure after 48h was 53 (24.5%). A total of 32 (60.4%) cases of treatment failure occurred early (between 48 and 72h), while 21 (39.6%) occurred late (after 72h). Distance of >5km from the nearest health facility (adjusted odds ratio (AOR)=2.2, 95% CI: 1.1–4.4, p-value=0.029), severe acute malnutrition (AOR=6.2, 95% CI: 2.4–16.1, p value<0.001), and adverse drug reaction (AOR=6.9, 95% CI: 2.6–18.4, p-value<0.001) were independent predictors of treatment failure. The outcomes of treatment failure included prolonged hospitalization, death, referral to a higher-level facility, and complications of pneumonia. Conclusion: Our study identified a high incidence of treatment failure among children under 5years in this setting. There is a need for early and accurate diagnosis, which includes culture and sensitivity tests, timely initiation of effective antibiotic therapy, active pharmacovigilance, and close monitoring of patients with acute malnutrition to reduce the likelihood of treatment failure.
Association between hyperuricemia and adverse perinatal outcomes among women with preeclampsia at a tertiary hospital in Southwestern Uganda: a prospective cohort study
(The Journal of Maternal-Fetal & Neonatal Medicine, 2025) Hani Omar Wehlie; Yarine Fajardo Tornesa; Julius Businge; Onesmus Byamukama; Musa Kayondo; Paul Kato Kalyebara; Joseph Ngonzi; Henry Mark Lugobe; Brenda Ainomugisha; Leevan Tibaijuk
Background: Pre-eclampsia is a major cause of adverse perinatal outcomes, such as preterm birth and perinatal deaths, at Mbarara Regional Referral Hospital (MRRH). While serum uric acid is a crucial marker for predicting adverse outcomes, it is not routinely assessed. This study aimed to compare the incidence of adverse perinatal outcomes between women with and without hyperuricemia and determine the association between hyperuricemia and adverse perinatal outcomes among women with preeclampsia at MRRH. Methods: We conducted a prospective cohort study from March 2024 to June 2024 at the maternity ward of MRRH. We consecutively enrolled women diagnosed with preeclampsia who were at least 26weeks gestational age and assessed their serum uric acid levels upon admission. The primary exposure was hyperuricemia (>6mg/dl) while the primary outcome was adverse perinatal outcomes. We compared the incidence of adverse perinatal outcomes among those with and without hyperuricemia using Chi-square and used multivariable modified Poisson regression analysis to determine the association between hyperuricemia and adverse perinatal outcomes among women with preeclampsia. Results: Among the 111 women enrolled (mean age 28.3±6.5years), 43 (38.7%) had hyperuricemia. Adverse perinatal outcomes occurred in 55.9% (62/111). Women with hyperuricemia had higher rates of adverse outcomes (88%, n=38/43) than those without (35%, n=24/68). Specific outcomes were significantly more frequent among hyperuricemic women: fresh stillbirth (21% vs. 0%), low birth weight (49% vs. 26%), Apgar score <7 at 5min (26% vs. 1%), NICU admission (76% vs. 26%), and early neonatal death (32% vs. 0%), p<0.05. Hyperuricemia was linked to a two-fold increased risk of one or more adverse outcomes (aRR 2.42, 95% CI: 1.54-3.80), fresh stillbirth (aRR 3.14, 95% CI: 1.79-5.48), low Apgar score (aRR 31.5, 95% CI: 3.8-260.9), NICU admission (aRR 2.44, 95% CI: 1.86-4.49), and early neonatal death (aRR 12.1, 95% CI: 4.22-33.98). Conclusion: Hyperuricemia is common in preeclamptic women at MRRH and is associated with significantly higher rates of complications. Routine serum uric acid testing is recommended for early detection and timely intervention to improve maternal and neonatal health outcomes.
Soil properties and phytochemical analysis of spleen amaranth (Amaranthus dubius Mart. Ex Thell.) from Ankole and Teso sub-regions of Uganda: Implications for management and prevention of hyperglycemia
(JSFA Reports, 2025) Caroline Asekenye; Paul E. Alele; Patrick E. Ogwang; Eunice A. Olet
Background: The current authors reported a remarkably higher prevalence of hyperglycemia in Ankole than in the Teso sub-region of Uganda, and Amaranthus dubius was documented among the frequently eaten leafy vegetables in both sub-regions. In an attempt to investigate this remarkable variance in the prevalence of hyperglycemia and find alternative therapies for hyperglycemia, we assessed the influence of soil properties on phytochemical quantity in spleen amaranth (A. dubius) from the two sub-regions. The soil properties and vegetable phytochemicals were quantified using spectrophotometric methods. Results: Soil pH, organic matter (OM), and nitrogen (N) were higher in soil samples from the Teso sub-region than those from the Ankole sub-region. The Teso sub-region had sandy loam soils that were relatively low in exchangeable cations, whereas Ankole had clay loam soils. Total tannin content (TTC) and total saponin content (TSC) were significantly higher in A. dubius samples from the Teso sub-region, and total alkaloid content (TAC) was higher in vegetable samples from Ankole. The Pearson’s correlation results showed a significant relationship between pH and TTC, N, and TAC. Total flavonoid con tent (TFC) was correlated with exchangeable cations. Conclusion: High soil pH, N, cations, and sand percentage found in soil samples from the Teso sub-region supported the biosynthesis of polyphenolic compounds in the vegetable samples. By implication, this consequently benefited its consumers by reducing blood glucose levels ultimately reducing the prevalence of hyperglycemia in the region.
A Cross-Sectional Study on the Frequency of Vital Signs Measurement and Missed Opportunities Among In-Patients in Medical and Surgical Wards at Mbarara Regional Referral Hospital in Uganda.
(Student’s Journal of Health Research Africa, 2025-03) Viola Nabiddo; Grace Nambozi
Background: Monitoring and recording vital signs is part of routine clinical care and a fundamental nursing procedure in hospitals. Repeated measurement provides early warning scores that assist in noticing a patient who is at risk of deterioration and hence prevent morbidity and mortality in hospitals. This study assessed the frequency of vital signs measurement and missed measurements among in-patients on medical and surgical wards at MRRH. Method: A quantitative retrospective study using files of patients who were admitted and discharged between May 2020 and October 2020 in the medical and surgical wards of MRRH was conducted. 243 patient files were used in this study. Information on vital signs (Temp, PR, RR, BP, and SpO2) in patient files was collected. Results: 131(53.9%) were files of male, 76(31.3%) had gastrointestinal conditions as their diagnosis on the ward, and 2573(66.2%) of the patients’ vital signs were not recorded from admission to discharge on both medical and surgical wards. Most patients 7(47%) died at night than during day or evening time. The majority of patients with prolonged hospital stays 13, 81.3%) and deaths 2, 50%) had respiratory conditions on a medical ward. In the surgical ward, the majority of patients with prolonged hospital stays 14, 87.5%) were patients with musculoskeletal conditions, and more deaths 5, 45.5%) occurred in patients with gastrointestinal conditions. Missed opportunities were seen in all conditions, and they were all more than >50%. Conclusion: Most of the patient files reviewed had missed vital signs from admission to discharge on both medical and surgical wards. Missed opportunities were seen in patients with life-threatening conditions. Recommendation: Nurse staffing levels should be paid attention to, and vital sign equipment should be availed to these wards to ensure that vital signs are monitored and the quality of care to patients is improved.
Affiliate stigma and associated factors among informal caregivers of people with mental illness in southwestern Uganda: A multi-center cross-sectional study
(PLOS Mental Health, 2025) Alain Favina; Nicholas Hobe; Moses Muwanguzi; Gideon Munaru; Abel Rubega; Dan Lutasingwa; Joseph Kirabira; Godfrey Zari Rukundo; Scholastic Ashaba
The stigma surrounding mental illnesses is widespread and informal caregivers of patients with mental illness face stigma because of their relationship with the patients they care for. Despite the key role played by these informal caregivers in the management of people with mental illness, few studies have assessed affiliate stigma and its factors associated among this population. This study aimed to investigate the prevalence of affiliate stigma and associated factors among caregivers of patients with mental illness in southwestern Uganda. We used a cross-sectional study design and enrolled 385 caregivers. We assessed affiliate stigma, depression, and social support using the affiliate stigma scale, patient health questionnaire-9 and social support using the social provision scale respectively. We ran multivariable logistic regression models to assess for the factors associated with affiliate stigma among caregivers. The prevalence of affiliate stigma and depression were 65.97% and 25.2% respectively. Factors associated with affiliate stigma included caregiving for one year or longer (AOR: 1.89; 95% CI: 01.07–03.35; p=0.03), having more than one patient to care for (AOR: 3.40; 95% CI: 01.39–08.36; p=0.01), being the only caregiver to the patient (AOR: 2.60; 95% CI: 1.27–5.33; p=0.01), being depressed (AOR: 75.76; 95% CI: 10.03–572.26; p<0.001), and social support (AOR: 0.14; 95% CI: 0.06– 0.29; p=0.04). This prevalence of affiliate stigma among caregivers of patients with mental illness is high in southwestern Uganda and depression is a key predictor. Considering the important role played by informal caregivers, more studies are necessary to inform interventions to address affiliate stigma, depression, and overall mental health of caregivers.
Detection of Filarial IgG and IgM Antibodies Among Individuals with Lymphedema in the Kamwenge District, Western Uganda
(Cureus, 2025) Vicent Mwesigye; Joanita Berytah Tebulwa; Benson Musinguzi; Bosco Bekita Agaba; Charlse Nkubi Bagenda; Francis Bajunirwe; Joel Bazira; Edgar Mulogo; Itabangi Herbert; Frederick Byarugaba
Filarial infections trigger a complex immune response characterized by the production of different antibodies, particularly immunoglobulin G (IgG) and immunoglobulin M (IgM). These immunoglobulins play a key role in diagnosing the disease, with IgM typically indicating recent infection and IgG reflecting past or ongoing exposure. Assessing their presence provides valuable insight into an individual's immune response and infection history. This study examined the levels of IgG and IgM in people living withlymphedema in the Kamwenge district, Western Uganda, to better understand their immunological status in relation to filarial infection. This cross-sectional study, conducted in the Kamwenge district, aimed to assess the presence of anti-filarial antibodies among lymphedema patients. A total of 154 participants, predominantly female (71.4%), with a mean age of 54.7 years, were selected through simple random sampling. Serological testing using the Abbexa Filariasis IgG/IgM Rapid Test revealed that 10.4% tested positive for IgG, and 1.9% for IgM antibodies. We enrolled a total of 154 participants, the majority of whom were female 110 (71.4%) while 44 (28.6%) were male. The participants had a mean age of 54.7 years, with a standard deviation of 15.6 years. Overall, 10.4% (n=16) tested positive for filarial antibodies. Specifically, 10.4% (n=16) were positive for filarial IgG, while 1.9% (n=3) tested positive for IgM antibodies. The serological findings demonstrated a low prevalence of recent filarial infections, with a higher occurrence of past or chronic exposure among participants. This suggests that while active transmission may be limited, lymphatic filariasis remains an ongoing public health concern in the Kamwenge district. These results emphasize the need for continued surveillance, early detection, and targeted interventions to effectively manage and mitigate the burden of filarial-related lymphedema in the region.
Enhancing HIV self-testing uptake among university students in Rwanda: the proportion, barriers, and opportunities
(BMC Public Health, 2025) Ritah Mukashyaka; Gerald Kaberuka; Alain Favina; Dan Lutasingwa; Fred Mulisa; Everest Turatsinze; Ann Karanja; Deborah Kansiime; Egide Niyotwagira; Basile Ikuzo; Mark Mohan Kaggwa; Aflodis Kagaba; Evans Mantiri Mathebula; Gallican N. Rwibasira
Introduction University students in Rwanda are at high risk for HIV, yet they have a low uptake of HIV self-testing, which is crucial for HIV diagnosis and prevention. This study investigated their knowledge, behaviors, and perceptions towards HIV self-testing, highlighting the barriers and opportunities whose consideration is necessary for the improvement of HIV self-testing uptake in this population. Method A concurrent mixed-method design was used, and it involved 424 students from five universities across Rwanda. Quantitative data was collected through surveys, and descriptive statistics were performed. Chi-square tests were performed, and sociodemographic variables were stratified against the awareness of HIV self-testing and HIV self-testing for the past 12 months’ variables. Qualitative data was collected through in-depth interviews and focus group discussions using interview guides developed based on the Health Belief Model (HBM) framework; data was then analyzed thematically. Results The mean age was 23 (IQR: 21; 24), with 51.2% (n=214/424) females. 64.7% (n=261/424) of students had never heard of HIV self-testing, yet 37.74% (160/424) were sexually active. Among sexually active students, 17.87% were aware of HIV self-testing, but 35.82% had never used it. The reported perceived HIV self-testing barriers include high cost, unavailability of testing kits, lack of awareness, misinformation, and absence of post-test counseling. However, some HIV self-testing opportunities, like the availability of testing kits and motivating factors for university students to test, were also reported. Conclusion Although university students reported the needs and benefits of HIV self-testing, uptake remains low due to misinformation, unawareness, unavailability, and the high cost of HIV self-testing kits. Increasing awareness, availing HIVST kits, and addressing the other reported barriers to HIV self-testing, is essential for the achievement of the universal goal of HIV status awareness among university students.