Mbarara University of Science and Technology Institutional Repository (MUST-IR)

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Annual Research Dissemination Conference 3
Central Administration 124
This community will contain collections from the general Administrative staff
Faculty of Applied Sciences and Technology 54
Faculty of Business and Management Sciences 106
Faculty of Computing and Informatics 136
Faculty of Interdisciplinary Studies 210
Faculty of Medicine 2224
Faculty of Science 535
Institute of Tropical Forest Conservation 126
Maternal Newborn and Child Health Institute 18

Recent Submissions

The Uganda Aging Cohort Study: Current Lessons and Future Opportunities
(Alzheimer's & Dementia, 2025) Stephen Asiimwe; Moses Acan; Samuel Maling; Noeline Nakasujja; Flavia Atwine; Edna Tindimwebwa; Edna Tindimwebwa; Deanna Saylor; Alexander C Tsai; Robert Paul; Jeremy A. Tanner; Mark J Siedner
Background: Over 25 million people with HIV (PWH) in sub-Saharan Africa (sSA) are reaching older age in light of the success of antiretroviral therapy (ART). Older PWH are hypothesised to experience a greater burden of Alzheimer’s disease and related dementias (ADRDs) due to chronic inflammatory, increased prevalence of modifiable risk factors, and increased amyloid/tau pathology. However, there are few data on the prevalence, trajectories or predictors of ADRDs in sSA, particularly among PWH. The Uganda Dementia Cohort Study (UDCS) is a prospective cohort study designed to respond to these gaps in the field. Method: The UDCS is a continuation of a 10-year cohort study of quality of life among older adults in Uganda. PWH on suppressive ART are enrolled from the HIV clinic, while population-based sample of age- and sex-similar controls without HIV are enrolled from the same region. Each participant has had phenotyping of all 15 reported modifiable risk factors for ADRD and annual cognitive testing (Table 1) Result: This cohort has followed approximately 600 older persons with and without HIV with a mean age of 62 years. There is a higher frequency of married participants without HIV, otherwise demographics are similar by HIV serostatus (Table 2). Established risk factors for ADRDs are common in the cohort, including high prevalence rates of hypertension (20%), current or former smoking (41%), frailty (60%), and depression (40%). Rates are similar by HIV serostatus. Conclusion: The Uganda Dementia Cohort Study will enhance our understanding of ADRDs including risk/protective factors, clinical phenotypes, diagnostic tools, societal impacts, and mechanisms among older persons with and without HIV in Uganda. The cohort is expanding to include deep-phenotyping through annual cognitive assessments, clinical examinations, plasma ADRD biomarkers, and brain imaging (Table 1). Household visits and interviews will be conducted to assess social and economic wellbeing and caretaker burden. The protocol is harmonised with other regional initiatives to facilitate future cross-national studies. Clinical and imaging datasets and a biobank will be created to promote harmonised/cross-national studies to better understand ADRDs in Africa. In summary, the UDCS aims to provide a rich source of data and specimens for dementia researchers in Africa and globally.
Protractedness? A Driver to Sexual and Gender-Based Violence (SGBV) among Refugees in Nakivale Refugee Settlement, Southwestern Uganda
(Afriche e Orienti, 2022) Cleophas Karooma; Clementia Murembe Neema; Eria Serwajja; Veronica Nakijoba; Sophie Withaeckx; Gily Coene
This qualitative study investigates the linkage between protractedness and Sexual and Gender-Based Violence (SGBV) in Nakivale Refugee settlement. Uganda’s refugee settlements are characterized by protracted refugees due to prolonged conflicts among its neighbors and the inability to find a lasting solution for the refugees. In these settlements, SGBV is widespread yet remains a silent affliction, among women and girls, as well as men and boys, who are at an increased risk of multiple forms of SGBV as a result protractedness. The paper argues that protractedness has aggravated the challenge of SGBV, as it has created new forms of violence and exacerbated existing ones. The findings indicate that protractedness has become a big driver to SGBV, as it increases the vulnerability of women and men to the challenge of SGBV. Men as well as women perpetrate SGBV. Some refugees are reluctant to report for fear of social exclusion and some survivors and their families still conceal their SGBV experiences. While, several interventions including health, legal, psycho-social counselling, safety and security, and economic empowerment were reported to have reduced a challenge of SGBV, SGBV still exists due to frustration from long stay
Occurrence of Multidrug-Resistant Candidiasis Among Pregnant Women at a Peri-Urban Hospital, Uganda
(Cureus, 2025) Lucas Ampaire; Deogratious Mukasa; Marvin Bikamatte; Winston Katatanzi; Emmanuel Mukula; Agnes P. Akello; Aggrey Byaruhanga; Enoch Muwanguzi; Moses Ocan; Benson Okongo; Jazira Tumusiime; Charles Nkubi Bagenda
Introduction: Vulvovaginal candidiasis (VVC) is one of the most common non-bacterial infections in women worldwide. The common causative yeasts are Candida albicans and Candida krusei. Limited studies on antifungal resistance have been conducted in low-resource settings like Uganda. In this study, we aimed to establish the prevalence and drug susceptibility patterns of VVC among pregnant women at a peri-urban private not-for-profit referral hospital in Uganda. Methods: A total of 352 vaginal discharge swabs were collected from consenting pregnant women attending the antenatal clinic of Kisubi Hospital, Uganda. Microscopy and culture on Sabouraud dextrose agar were used for primary screening. Candida species identification and differentiation were achieved using the germ tube tests and Candida Chromogenic Agar (Oxoid Ltd, Hampshire, United Kingdom). Antifungal susceptibility testing was performed using the standard Kirby-Bauer diffusion method as previously described. We included voriconazole (1 μg), fluconazole (100 μg), itraconazole (1 μg), nystatin (100 μg), caspofungin (5 μg), and interpreted as per the guidelines of Clinical Laboratory Standard Institute 2022. We used SPSS Statistics for Windows, version 15 (SPSS Inc., Chicago, Illinois, United States) for descriptive analysis of the data. Results: Candida species were isolated in 93 (26.4%) pregnant women studied. These included C. albicans (n=51, 43.2%), C. krusei (n=46, 39.0%), Candida tropicalis (n=9, 7.6%), and unidentified Candida species (n=12, 10.2%). All Candida species showed resistance to at least one class of drug, with a total resistance of 86.9% and a multidrug resistance of 56.3%. C. albicans and C. krusei exhibited the most resistance up to 100% to azoles and caspofungin. All species exhibited the least resistance to nystatin at 76.3%. Conclusion: C. albicans and C. krusei remain significant causes of candidiasis among pregnant women in our setting. The observed multidrug resistance in C. albicans poses a great threat to the management of candidiasis.
Menstrual disorder and associated factors among medical students in Uganda: a cross sectional study
(Discover Medicine, 2025) Jimmy Odongo Ogwal; Edward Ojuka; Richard Migisha; Rosemary Namayanja; Samuel Okello; Ronald Ouma Omolo; Victor Muyambi; Jolly Joe Enyang; Abel Obeny; Ronald Ogwang; Caleb Angulo; Jesse Steward Opwoya; Didan Jacob Opii; David Collins Agaba
Background: Menstrual disorders (MD) affect 75% of women worldwide and account for the majority of morbidity in women of childbearing age. Heavy and prolonged menstruation are linked to severe anemia and its sequelae, irregular menstruation predisposes females to unwanted pregnancies, which can result in unsafe abortion with associated maternal injuries and even death. Furthermore, students suffering from PMS, dysmenorrhea, or heavy menstruation are more likely to miss lectures and exams. Objectives: We determined the prevalence and factors associated with menstrual disorders among undergraduate medical students at Mbarara University of Science and Technology (MUST) in southwestern Uganda. Methods: We conducted a cross-sectional study in the Faculty of Medicine (FOM) at MUST from 2nd October, 2023 to 1st November, 2023 using consecutive sampling among the female undergraduate students, we included students from 19 to 45 years and excluded those who were either pregnant or breastfeeding. Sociodemographic, gynecological, lifestyle and clinical data were obtained through self-administered questionnaires. The prevalence of menstrual disorders was the proportion of participants with any of dysmenorrhea, Premenstrual Syndrome (PMS), infrequent, frequent, prolonged, heavy or irregular Menstruation. Modified Poisson regression analysis was used to evaluate associations between menstrual disorders and independent variables. Results: A total of 290 students were enrolled with mean age 23.93 (±4.40) years. The prevalence of menstrual disorders was 85.6% (249/290) (95%CI 81.83–89.90), indicates that these issues may be a common concern for young women, especially those in academic environments. Having stress [aPR 1.13, 95% CI (1.03–1.24), p=0.007], being below 24 years [aPR 1.12, 95% CI (1.01–1.25), p=0.034] and being underweight [aPR 1.15, 95% CI (1.08–1.22), p<0.001] were independently associated with Menstrual disorders. Conclusion: More than three-quarters of medical students at MUST experience menstrual disorders, highlighting a significant health concern in this population. These findings emphasize the need for integrating menstrual health education and stress management programs into medical curricula. Health policies should prioritize screening and management of menstrual disorders, with recommendations for wellness programs such as yoga, sports, and creative activities to support student well-being.
Knowledge and practices of intensive care unit nurses on the prevention of nosocomial pressure ulcers using a bundle protocol: an educational intervention study in Uganda
(BMC nursing, 2025) Kalanzi Phiona Katasi; Nyakuri Emma; Imujasi Martha; Ssemogerere Lameck; Atuhaire Catherine
Introduction: Nosocomial pressure ulcers are wounds acquired within the hospital setting, pausing a burden to the patient families and the care teams due to patient discomfort and increased costs to treat and hospital resources. Globally, patients in intensive care units (ICUs) are most impacted, and the incidents go up to 33%, while a study done in Mbarara Regional Referral Hospital stated it at 19.3%. These incidents are preventable with the use of pressure ulcer prevention guidelines. This study aimed to investigate the effect of an educational intervention with a care bundle protocol on the knowledge and practices of intensive care unit nurses of Mulago National Referral Hospital in the prevention of nosocomial pressure ulcers. Methods: This was a single-group quasi-experimental pre-test and post-test study that purposively selected 26 ICU nurses of Mulago National Referral Hospital. Their baseline knowledge andpractice were assessed with a knowledge assessment questionnaire and an observation checklist, respectively. The nurses were then trained on the pressure ulcer prevention bundle protocol, and the training lasted two weeks. ICU nurses’ knowledge and practices were assessed two weeks after the training. Data was collected between May and July 2024 and was analyzed using STATA version 17. Independent sample t-test, Wilcoxon-rank sum test and ANOVA were used to compare variables. Results: The median (IQR) age of the study participants was 37.5 (32, 49). A biggest number of the participants were females [18] 69.2% and just above a third had attained a diploma [10] 38.5% or a Bachelor’s degree [10] 38.5%. About two thirds of the participants [17] 65.4% had never received refresher training on prevention of pressure ulcers and just above a third of them had practiced for 3–5 years in critical care. The participants reported to care for about the median (IQR) of 3 [2, 4] pressure ulcers weekly. The critical care nurses’ knowledge of pressure ulcer prevention increased to (SD) 63.2% (11.8) from (SD) 40.5 (10.6), yet practice increased to 62.6% from 37.6% with a P value of 0.001, which was statistically significant. Conclusion: An educational intervention with a pressure ulcer prevention protocol brought about a significant change in participants’ knowledge and practice. More in-service training sessions on pressure ulcer prevention protocols and their availability to staff are recommended.
Investigation of Code Smells in Eclipse Framework Using SonarQube: An Empirical Analysis
(International Journal of Software Engineering and Computer Systems, 2025) Au Simon Kawuma; David Sabiiti Bamutura; Enock Mabberi; Moreen Kabarungi; Dickson Kalungi; Aggrey Obbo; Evarist Nabaasa
The Eclipse Framework provides both public and internal Application Programming Interfaces (APIs). Public APIs are widely supported and encouraged for use, while internal APIs are considered immature and subject to frequent changes. However, the quality of these APIs is not guaranteed, with many users reporting code smells, which could lead to application failures if unresolved. While some studies indicate that not all code smells can be easily fixed, users often face the challenge of either addressing these issues themselves or abandoning problematic APIs. To address this, we conducted an empirical investigation using the SonarQube static code analysis tool on 28 major Eclipse releases, aiming to identify code-smell-free APIs. Our study provides a dataset of 218K code-smell-free public APIs and 321K internal APIs. We found that 87.3% of public APIs and 91.5% of internal APIs in the analyzed releases are free from code smells, highlighting the importance of using these cleaner alternatives for application stability and long-term usability. Furthermore, we have discovered that the number of code smells proportionately increases as the Eclipse framework evolves. The average number of code smells and technical debt is 147K and 2,744 days respectively in all the studied Eclipse releases. Results from this study can be used by both interface providers and users as a starting point to recognize code smell-free interfaces and estimate efforts needed to fix code smells in each version of Eclipse.
Integrating baseline field surveys with local ecological knowledge to assess the diversity patterns and conservation needs of herpetofauna in highly disturbed areas of Uganda
(The Herpetological Bulletin, 2025) Mwijukye Brian; Jane Yatuha; John Bosco Nkurunungi; Julius Tumusiime; Mathias Behangana; Luca Luiselli
Uganda hosts a rich diversity of amphibians and reptiles, although many species remain Data Deficient, highlighting the need for comprehensive field studies. We report on the species richness, diversity patterns and local distribution of amphibians and reptiles in the Kagera riverine landscape of Uganda. A multidisciplinary approach was used, combining visual surveys, acoustic monitoring and Local Ecological Knowledge gathered through interviews. The study identified 21 amphibian and 12 reptile species, with distribution patterns influenced by both environmental conditions and human activities. Quantitative analysis demonstrated varying species richness across different sites, with mining activities showing the most pronounced negative effects on amphibian diversity. Ethno-herpetological surveys, based on a semi-structured questionnaire, revealed that local perceptions, particularly associating herpetofauna with misfortune and fear, could impact conservation efforts. This study emphasises the need for continued research to inform conservation strategies, particularly in unprotected and vulnerable habitats such as the Kagera basin.
Great minds map alike: Citizen and expert distribution models of schistosome snail hosts in rural west Uganda
(Ecological Solutions and Evidence, 2025) Noelia Valderrama-Bhraunxs; Tine Huyse; Emiel van Loon; Anton Van Rompaey; Ronald Twongyirwe; Liesbet Jacobs
1. Schistosomiasis is a parasitic disease that affects over 250 million people worldwide, with the majority living in rural areas of sub-Saharan Africa. The parasite relies on freshwater snails of the genus Biomphalaria as intermediate hosts. Mapping snail distribution is vital for identifying disease transmission hotspots. However, expert-led monitoring is often constrained by limited resources and restricted access to remote areas, highlighting the need for scalable and costeffective alternatives. 2. This study evaluates the effectiveness of citizen science in predicting Biomphalaria spp. presence by comparing models built from expert - and citizen-collected data. We tested two scenarios: the first one assumed perfect detection and focused on environmental and geomorphological predictors, while the second accounted for imperfect detection to explore discrepancies between citizen observations and expert-derived detection probabilities. 3. In the perfect detection scenario, the expert and citizen models identified site type and NDVI as significant environmental predictors of snail presence. Although both models demonstrated low marginal R2 values (~16%–17%), indicating limited explanatory power of broad-scale environmental predictors, conditional R2 values exceeded 65%, suggesting that fine-scale, site-specific habitat characteristics are critical determinants of Biomphalaria spp. presence. For the imperfect detection scenario, the expert model and the citizen observations showed minimal discrepancies, primarily explained by individual observer variability and differences in sampling effort. Increased sampling effort consistently reduced false negatives and led to unexpected observations of snail presence by the citizens (i.e. observed presence in sites predicted unsuitable by the expert model). 4. Practical implication. Our findings demonstrate that citizen science data, when properly structured and statistically accounted for bias and errors, can generate ecological modelling outputs comparable to those based on expert-led surveys. We highlight the importance of accounting for observer variability, providing calibrated training and optimizing sampling strategies to enhance data quality. This study presents a transferable and cost-efficient framework for participatory ecological monitoring in resource-limited and undersampled regions.
Gender Variations and Entrepreneurial Intentions: A Cross-Sectional Analysis of Finalist Undergraduate Students at Mbarara University of Science and Technology, Uganda
(F1000Research, 2025-01-27) Aloysius Rukundo; Naster Tumwebembire; Wilbroad Aryatwijuka; Miriam Tugiramasiko; Specioza Twinamasiko
Background: Recently, the dynamics of gender and entrepreneurship have received more attention; however, the subtleties of how gender affects entrepreneurial intentions remain a challenge, despite empowerment through skills and formal training. This study seeks to establish gender differences in entrepreneurial intentions in educational settings as well as the broader context of gender equity in achieving financial independence among finalist undergraduate students. The results of this study contribute to a better understanding of gender related factors that influence entrepreneurial intentions among undergraduate students. Methodology: This was a cross-sectional and quantitative study. The study site was the town campus of Mbarara University of Science and Technology. The study population consisted of finalist businesses and students. The data were managed and analyzed using STATA version 17. T-tests of independent samples and means were used for data analysis. Results: Of the 404 respondents, the majority were males (56.2%). Entrepreneurial Intentions were higher among females with a history of business ownership (M = 22.7, SD = 5.1) than among those without a history of business ownership (M = 19.5, SD = 6.9), at t = 2.25, p <0.05. Further, entrepreneurial intentions were lower among male students whose male caretakers or parents had business as an occupation (M = 19.5, SD = 6.9) than their counterparts whose male parents were not in business (M = 21.5, SD = 5.6) at t = 2.31, p <0.05. No other gender differences were found across other socio-demographic variables (p <0.05). Conclusion: Entrepreneurial Intentions differed among females with a history of business ownership. We argue that the complex interplay of gender demographic gaps in shaping undergraduate students ‘entrepreneurial aspirations cannot be significantly improved based on family background without conclusive equal opportunity training approaches. Designing a hands-on and role-modeling entrepreneurship curriculum can shape gender-mainstream intentions.
African Food Systems Transformation Brief 06: The Status of Food Storage, Transport and Logistics Infrastructure in Africa
(African Food Systems Transformation Collective. Cape Town, South Africa, 2025) George Mark Onyango; Robert Bitariho; Naomi Kandawini
Food systems are critical to many African economies but face significant challenges due to underdeveloped or non-existent food storage, transport and trade infrastructures. This results in high post-harvest losses, inefficient supply chains, health hazards and limited market access for farmers – problems worsened by climate change. Integrating storage, transport and trade practices through agroecological transitions can enhance food security, reduce waste and support sustainable food systems, which would align them with sustainable development goals (SDGs). Smallholder farmers in rural areas rely on efficient local storage, intermediate transport and simple logistics systems to access markets, generate income, and improve livelihoods. Agroecological transitions empower farmers, boost productivity and promote economic growth. Climate-resilient practices, such as agroforestry and crop diversification, enhance resilience to climate shocks. These transitions also emphasise social equity by empowering local communities, preserving indigenous knowledge systems, and resolving poverty, inequality and land-tenure issues. Agroecological transitions in Sub-Saharan Africa – particularly in Uganda, Kenya and Ghana – should focus on food-storage improvements, efficient transportation networks and sustainable trade infrastructures. Food storage improvements aim to increase food security and reduce food waste. Food transportation focuses on efficient distribution networks based on intermediate transport that reduces emissions and connects local producers with markets. Stakeholders all play vital roles in the supply chain; they include government bodies, private-sector companies, non-governmental organisations (NGOs), farmers, transporters, academics, researchers, and traders. Efficient local infrastructure enhances productivity, food security and public health. Investments in modernising storage facilities respond to challenges such as outdated technology and climate impacts. Collaborations among governments, the private sector, and local communities reduce post-harvest losses and strengthen local food security. Philanthropic support for local infrastructure aligns wellwith the goals of alleviating hunger, reducing poverty, improving health, promoting sustainability and advancing social equity. Investments in intermediate transport facilities (motorbikes, ‘tuk-tuks’ and bicycle taxis) and community storage infrastructure such as granaries and warehouses can lead to transformative changes, which improve lives and set a model for sustainable development.
Kidney disease screening at ART initiation among adults with HIV in Uganda: A missed priority for a high-risk population
(PLOS Global Public Health, 2026) Grace Kansiime; Joseph Baruch Baluku; Edwin Nuwagira; Michael Kanyesigye; Paul Stephen Obwoya; Rose Muhindo; Winnie R. Muyindike; Pliers Denis Tusingwire; Henry Mugerwa; Matthew Odera; Monday Busuulwa; Matthew Ssemakadde; Esther C. Atukunda; Francis Bajunirwe; Robert Kalyesubula; Mark J. Siedner
Kidney disease affects 850 million people worldwide, with Sub-Saharan Africa bearing a significant burden. People living with HIV (PWH) are at increased risk due to nephrotoxicity of antiretroviral therapy (ART), in part due to widespread use of tenofovir disoproxil fumarate. In response, Uganda recommends routine kidney disease screening by doing a serum creatinine test at ART initiation. However, the extent of adherence to these guidelines remains poorly understood. We extracted clinical data for adults initiating ART between 2017 and 2024 at three large-volume HIV clinics in Uganda. To determine if kidney disease screening rates had increased appropriately over time, we divided the observation period into three eras as per national guidelines: (1) Test and Treat (2017–2019), that recommended screening only PWH and diabetes or hypertension; (2) DTG rollout/COVID-19 (2020–2022); and (3) creatinine-for-all (2023–2024), recommending screening everyone initiating ART. Logistic regression models were fit to identify correlates of renal screening. Of the 17,485 participants, only 22.4% (3,909/17,485) were screened for kidney disease at ART initiation. Screening was more common at the urban site (54.2%) compared to rural sites (10.0%). At rural sites, screening declined over time and individuals were 83% less likely to be screened in the creatinine-for-all era compared to the baseline era (aOR 0.17, 95% CI: 0.13–0.22) while itincreased at urban site (aOR 9.27, 95% CI: 7.37–11.66). Male sex (aOR 1.37, 95% CI: 1.20–1.57), older age (≥45 years), hypertension, and non–TDF-based ART regimens were associated with higher screening odds at rural sites. Diabetes, opportunistic infections, and TDF use were not significantly associated with screening likelihood at any site. Kidney disease screening for PWH at ART initiation remains poor in Uganda, even when using a single creatinine test, particularly in rural clinics, highlighting critical challenges in translating national guidelines into practice. Future research should focus on understanding multilevel barriers to screening and evaluating strategies to improve guide line uptake.
Prevalence of kidney disease and associated factors among adults with chronic hepatitis B virus in Southwestern Uganda
(Annals of Medicine and Surgery, 2026) Samuel Jjunju; Edwin Nuwagira; Mike Ssemusu; Grace Kansiime; Conrad Muzoora
Background: Hepatitis B virus (HBV) is a global health problem endemic in Sub-Saharan Africa, with 65% of global cases occurring in the WHO Western Pacific and African regions. HBV is a known primary cause of kidney disease that progresses throughout the illness. Early detection of kidney disease and antiviral initiation can slow its progression. Our study aimed to identify the prevalence of kidney disease and associated factors in adults with chronic HBV. Methods: We conducted a cross-sectional study from November 2023 to December 2024 in Mbarara, Uganda, recruiting adults with chronic hepatitis B. Data collected: socio-demographics, comorbidities, coinfections, and hepatitis B-related data. Spot urine and blood were collected for dipstick, urine neutrophil gelatinase–associated lipocalin (NGAL), and creatinine with estimated glomerular filtration rate (eGFR). We defined kidney disease as the presence of (1) urine NGAL >132 ng/mL, (2) eGFR <60 mL/min/ 1.73 m2 or (3) eGFR between 60 and <90 mL/min/1.73 m2 with proteinuria or hematuria. We utilized logistic regression to determine factors associated with kidney disease. Results: We enrolled 157 participants with a mean age of 35.8 (standard deviation, ±12.5) years, and 50% (79/156) were males. Overall kidney disease prevalence was 27% (43/157; 95% confidence interval (CI): 20.6–35.1%). Prevalence based on urine NGAL was 17.2% (27/157; 95% CI: 11.6–24.0), eGFR <60 mL/min/1.73 m2 was 5.7% (9/157; 95% CI: 2.7–10.6), and eGFR between 60 and <90 mL/min/1.73 m2 with either proteinuria or hematuria was 9.6% (15/157; 95% CI: 5.4–15.3). Being female was associated with higher odds of kidney disease (adjusted odds ratio, 2.49; 95% CI: 1.16–5.36; P = 0.019). Conclusion: Nearly one-third of adults with chronic Hepatitis B in Uganda had kidney disease, with NGAL increasing the detection by 12% over creatinine and urine dipstick alone. We recommend frequent monitoring of kidney function in adults with chronic HBV.
Primary Care Providers’ Perspectives of Knowledge and Skill Acquisition, and Benefits Following University Faculty-Led Continuing Medical Education Sessions: Results of a Qualitative Assessment in Southwest Uganda
(Cureus, 2026) Edgar Mulogo; Moses Ntaro; Eleanor Turyakira; Michael Matte; Andrew Wesuta; Fred Mwebembezi; Femus Agaba; Prudence Nabimanya; Angela Tushabe; Peter Kawungezi
Background and objective: Mbarara University of Science and Technology’s (MUST) First Mile Community Health Program (FMCH) has been at the forefront of providing continuing medical education (CME) to primary care providers working in health facilities in southwestern Uganda. However, little is known about how CME has influenced primary care providers' knowledge and skills. This qualitative assessment sought to describe participants' perspectives on knowledge and skill acquisition following these CME sessions. Methods: In 2024, a descriptive review was carried out using activity reports from CME sessions. The review included CME sessions conducted over two years (2018-2019). Forty primary care providers from 40 health facilities, ranging from health centers (HCs) to general hospitals, participated in each CME session offered by MUST faculty. CME sessions were provided in the following areas: basic emergency obstetric care (BEmOC), emergency triage, assessment, and treatment, admission care for the sick child and newborn (ETAT+), and infection prevention and control. Results: Primary care providers reported gains in knowledge and skills as well as other benefits after attending CME sessions, particularly in newborn care, the manual vacuum aspiration (MVA) procedure, management of preeclampsia, birth monitoring, and infection prevention and control. The average pre-test score was 58%, while the average post-test score was 80%. The percentage change in knowledge was 22%. The providers reported incorporating previously overlooked skills or procedures into their clinical practice. Conclusions: University-led CME sessions can be an effective method for primary care providers working in resource limited settings to acquire knowledge and enhance their skills. Fostering partnerships between universities and stakeholders in the local health system to support the sustainability of CMEs is likely to have a positive impact on healthcare delivery
Evaluating the “McMUST” global learning partnership: resident insights on knowledge exchange to enhance learning in postgraduate medical education
(BMC Medical Education, 2025) Sheila Harms; Godfrey Zari Rukundo; Samuel Maling; Anita Acai
Background: To critically evaluate a global learning partnership called “McMUST,” which was initiated collaboratively between Mbarara University of Science and Technology (MUST) in Uganda and McMaster University in Canada in 2014. Methods: A combination of quantitative and qualitative data collection methods was used. Evaluation forms were used to collect satisfaction and learning experience data from Canadian and Ugandan psychiatry residents during eight of 11 visits to Uganda by Canadian faculty and residents. The visits occurred between 2015 and 2023 and involved Canadian faculty and residents collaborating with local counterparts in psychiatry at MUST. Quantitative data were analyzed using means and standard deviations, while qualitative comments underwent conventional content analysis. Results: Satisfaction ratings from 56 evaluations out of a total possible of 62 were consistently high across all visits (Range=3.83-5.00 / 5.00, M=4.52, SD=0.41). Qualitative findings revealed five themes: (1) Enriched learning, highlighting the transformative experience for residents in challenging existing perspectives; (2) Effective pedagogy, emphasizing the value of diverse learning strategies; (3) Navigating cross-cultural and professional roles, focusing on Canadian residents’ transformative learning journeys; (4) Patient experiences—Humanizing psychiatric education, underscoring a shared focus on humanistic patient care; and (5) Enhancing future visits, addressing challenges and suggesting improvements, such as extending visit durations, supporting ongoing connections between residents, and advocating for bidirectional travel. Conclusions: The consistently high satisfaction ratings across multiple visits indicate that the global learning partnership between MUST and McMaster University has been successful in providing an enriching learning experience for residents participating in collaborative clinical work and learning of psychiatry in Uganda. Despite many positive findings, our partnership was not immune to some of the equity-related problems that have been documented in the literature. Going forward, advocacy efforts to gather resources that will allow for bidirectional travel for residents will be essential. Our findings also highlight opportunities to evaluate impact longitudinally, especially on participants’ clinical practice and patient outcomes.
Suicidality and associated factors among people living with mental illness attending an outpatient clinic at a tertiary hospital in Uganda
(BMC psychiatry, 2026) Emmanuel Alol; Alain Favina; Scholastic Ashaba; Godfrey Zari Rukundo
Background: Suicidality is one of the leading causes of mortality worldwide. Mental disorders are major predictors of suicidality. Individuals with severe symptoms of mental disorders face marked distress, significant restrictions in functioning across several life domains, and a higher risk of suicidality. The risk of suicidality is even higher among people with mental illness following discharge from hospital due to challenges of adjusting to life with a mental illness in the community, taking psychotropic medications which are life long, and acceptance of the diagnosis. Information on suicidality and associated factors among people with mental disorders especially in Uganda is sparse. This study aimed to determine the prevalence of suicidality and factors associated among people with mental illness attending an outpatient clinic at a tertiary hospital in Uganda. Methods: A cross sectional quantitative study design was adapted for this study. We used consecutive sampling to enroll 400 participants as determined by the Kish and Leslie formula. Recent suicidality (both ideation and attempts) was evaluated using the Columbia-Suicide Severity Rating Scale (C-SSRS). All the factors significant at bivariate analysis were entered into a multivariable regression model to determine the factors that were statistically significantly associated with suicidality. A p-value of ≤0.05 was considered statistically significant. Results: The study found that 8.50% of participants reported suicidal ideation out of whom 3.25% attempted suicide. Females exhibited higher prevalence of ideation (10.26%) and attempts (3.59%) compared to males. Rural residents had higher rates of ideation, while urban residents had more suicide attempts. The factors that remained statistically significantly associated with suicidality included being female (AOR=2.50, 95% CI 1.07–5.82; p=0.03), being separated or widowed (AOR=0.88, 95% CI 0.02–0.04; p=0.003)), having a family history of suicide (AOR=0.35, 95% CI 0.15–0.79; p=0.01) and being on two or more medications (AOR=0.22, 95% CI 0.08–0.62; p=0.004). Family social support (AOR=0.87, 95% CI 0.78–0.97; p=0.02) and Resilience (subscale of the internalized stigma of mental disorders) (AOR=1.54, 95% CI 1.18-2.00; p=0.001) also remained statistically significantly associated with suicidality Conclusions: The prevalence of suicidality is high among people with mental disorders accessing care as outpatients and it is associated with the female gender, being widowed or divorced, family history of suicide and resilience to stigma of mental illness. Routine screening and management of suicidality especially among females, those with positive family history of suicide and the widowed or divorced, taking into account stigma of mental disorders should be very crucial elements of the health care system targeting those accessing outpatient care.
Appropriateness of Histopathology Specimen Containers and Completeness of Laboratory Request Forms in Uganda: A Case of Mbarara Regional Referral Hospital, South Western Uganda
(Sage Open Pathology, 2026) Yekosani Mitala; Raymond Atwine; Richard Dratu; Dianah Ishimwe; Francis Nsumba Kitenda; Joel Musayi; Isaac Keith Kasadha; Habert Tumwesigye; Vivian Naluzze; Simeon Eloba; Samuel Tumwesigire; Abraham Birungi; Brian Ssenkumba
Introduction: Laboratory request forms (LRFs) are pivotal to histopathologists as they are the only medium through which pathologists communicate with patients and clinicians. On many occasions, the LRFs are incompletely filled and do not paint the right picture of the patient. Methods: This was a cross-sectional study that audited 586 LRFs and specimen containers sent to the Mbarara University of Science and Technology (MUST) histopathology laboratory between July 2024 and September 2024 for their completeness and appropriateness. The main parameters considered were biodata, clinical history, clinician details, and hospital details. Results: Overall, only 3.6% (21/586) of LRFs were appropriately filled. Of the 4 main parameters, biodata was the most filled at 54.1%, hospital details at 18.1%, and clinical details at 7.5%, and the least completed was clinician details at 5.6%. Conclusion: The completion rate of the LRFs is unacceptably poor, and the used specimen containers are unbefitting. Patient age and name are the most completed parameters, while requesting the physician’s signature was the least completed variable. Clinicians need to be constantly reminded of their role in histopathology diagnosis through continuous medical education and the introduction of laboratory standard operating procedures (SOPs) on the wards and operating theaters.
Association Between High Serum Alanine Aminotransferase to High Density Lipoprotein Cholesterol Ratio and Metabolic Syndrome among People Living with HIV on Dolutegravir-Based ART in South-Western Uganda
(Journal of the International Association of Providers of AIDS Care (JIAPAC), 2026) Charles Nkubi Bagenda; Carol Nantongo; Michael Junior Mugisa; Blendar Ainebyoona; Amos Oyuru; Daniel Nzaramba; Jazira Tumusiime; Conrad Lubwama; Benson Musinguzi; Lawrence Obado Osuwat; Brian Ssenkumba; Ronald Ouma Omolo
Background: Serum Alanine aminotransferase to High density lipoprotein cholesterol ratio (ALT-to-HDL-C ratio) has been identified as a significant predictor of non-alcoholic fatty liver disease, a hepatic manifestation of metabolic syndrome. This study investigated the association between serum aminotransferases to high-density lipoprotein cholesterol ratios and metabolic syndrome (MetS) among people living with HIV (PLWH) on Dolutegravir (DTG)-based antiretroviral therapy (ART) in South Western Uganda. Methods: We conducted a secondary analysis study from June 15, 2025 to August 20, 2025 using a dataset generated from hospital-based cross-sectional study that investigated an association between aspartate aminotransferase to alanine aminotransferase ratio and MetS among 377 PLWH who were on DTG-based ART at Ruhoko Health Centre IV, South Western Uganda. Results: The prevalence of MetS was 44.6%(168/377); 95% CI: 39.6 - 49.6 and significantly increased from the lowest to the highest ALT-to-HDL-C ratio tertiles (30.2% vs 47.7% vs 56.1%, p < 0.001). In the adjusted model, higher ALTto-HDL-C ratio was significantly associated with MetS. Individuals in the second tertile had 2.35-fold higher odds (aOR 2.35, 95% CI: 1.26–4.41, p=0.008), and those in the third tertile had over fourfold higher odds (aOR 4.65, 95% CI: 2.25–9.61, p < 0.001) of MetS compared to the lowest tertile. ALT-to-HDL-C ratio at an optimal cutoff of 0.33 had a significant ability (AUC=0.820, 95%CI: 0.782 - 0.861) to differentiate between participants with MetS from those without MetS at a sensitivity of 92% and specificity of 54%. Conclusion: Higher ALT-to-HDL-C ratio is potentially associated with MetS. Since both ALT and HDL-C are routine measurements in HIV Care, this warrants further studies on the potential of ALT-to-HDL-C ratio as a biomarker for MetS.
Social determinants of academic performance among undergraduate health professional students at Mbarara University of Science and Technology, Uganda
(Discover Education, 2026) Joyce Namwase; Samuel Maling; Ismail Opolot; Julius Kyomya; Ronald Omolo Ouma; Alain Favina; Safina Nakkazi; Rogers Turyamusiima; John Semuwemba; Lydia Nakirya; Edith K. Wakida
Background: Academic performance among health professional students is influenced by social determinants. This study assessed factors associated with academic performance among undergraduate health professional students at Mbarara University of Science and Technology (MUST), Uganda. Methods: We conducted a cross-sectional survey among 335 undergraduate students using a self-administered questionnaire. Academic performance was categorized as poor or good. Bivariable and multivariable logistic regression analyses were performed to identify factors independently associated with poor academic performance. Results: Of the 335 students (mean age 23.86 ± 6.4 years), 70.8% demonstrated good academic performance. In multivariable analysis, female students had significantly higher odds of poor academic performance compared with male students (AOR = 1.95; 95% CI: 1.01– 3.78). Third-year students were more likely to have poor academic performance than fifth-year students (AOR = 4.27; 95% CI: 1.06–17.20). In contrast, students with high online social media engagement had significantly lower odds of poor academic performance compared with those with low engagement (AOR = 0.30; 95% CI: 0.12–0.74). Conclusion: Female gender and being in the third year of study were associated with higher odds of poor academic performance, while high online social media engagement was associated with lower odds of poor academic performance. Targeted academic support for vulnerable student groups and structured approaches to online engagement may help improve academic outcomes.
Understanding the Drivers and Constraints to Participation in Citizen Science Programs in Uganda
(Citizen Science: Theory and Practice, 2025) Mercy Gloria Ashepet; Liesbet Jacobs; Caroline Michellier; Grace Kagoro-Rugunda; Casim Umba Tolo; Tine Huyse; Liesbet Vranken
Citizen science (CS) has gained recognition as a useful tool for monitoring and facilitating sustainable development transitions. However, CS initiatives are only emerging in the Global South, leaving many unknowns, like the factors influencing participation. This article contributes to the literature by examining the factors driving and limiting participation in two CS networks established in Uganda: Action Towards Reducing Aquatic Parasitic diseases (ATRAP), which monitored freshwater snails; and the Geo-observer (GO), which monitored natural hazards. Building on the theory of planned behaviour and the volunteer functions inventory, a questionnaire was administered to the participating individuals or citizen scientists and a control group that consisted of candidate citizen scientists, through group and individual interview settings. Motivations for participation were strikingly similar across the CS networks, respondent groups, and interview settings. The main drivers for participation were the desire to gain new skills and knowledge (understanding) and contribute to the community’s well-being (values), while the influence of others (social) and opinions or expectations of significant others (subjective norms) played lesser roles. Although the control group in both networks consistently expressed higher levels of positive responses, the importance of the motivational factors generally declined in both respondent groups over time. Financial compensation and favorable working conditions, like flexibility, contributed to sustained participation among the citizen scientists, while the major barriers to participation embodied external and internal factors, like bad weather and sickness. This study provides valuable insights to guide future CS recruitment initiatives toward alignment with the aspirations of individuals in similar contexts.
Perspectives of Primary Health Facility Leaders on the Contributions of Clinical Residents During Community Placement in Southwestern Uganda
(Advances in Medical Education and Practice, 2026-01-08) Peter Chris Kawungezi; Moses Ntaro; Eleanor Turyakira; Andrew Christopher Wesuta; Angela Tushabe; Michael Matte; Ronnie Ndizeye; Fred Mwebembezi; Brian Turigye; Joseph Ngonzi; Edgar Mugema Mulogo
Background: The Mbarara University of Science and Technology (MUST)’s First Mile Community Health Program (FMCH) has facilitated community placement of clinical residents at Primary Healthcare (PHC) facilities within the MUST catchment area in southwestern Uganda. While community-based training of medical residents is common in sub-Saharan Africa, little is known about how PHC facility leaders perceive its effect on service delivery in Uganda. This assessment aimed to describe the perspectives of PHC facility leaders on the impact of clinical residents’ community placements on PHC services in southwestern Uganda between 2018 and 2023. Methods: From July 2018 to December 2023, 152 clinical residents from ten specialties were placed at PHC facilities in southwestern Uganda. This was a cross-sectional study based on qualitative data-collection techniques. This study focused on MUST clinical residents and PHC facilities in the MUST catchment in southwestern Uganda. We conducted KIIs with 15 health facility leaders until no new ideas emerged. Data were deductively analyzed using WHO’s five strategic directions. Transcripts were transcribed verbatim, repeatedly reviewed, and coded into predefined categories. Interviewers bracketed their own experiences to ensure facility leaders’ perspectives were accurately captured. Results: Of the 15 facility leaders interviewed, most were male and from government HC IVs. Leaders reported that resident placements improved health service delivery through community engagement, enhancing care models through training, mentorship and low-cost innovations, and improving service coordination, including establishing specialized clinics and promoting better use of equipment. Residents also supported advocacy and resource mobilization. However, short placements, inconsistent outreach, staff shortages and lack of specialists limited continuity and sustainability. Conclusion: Facility leaders reported perceived improvement in strengthening PHC services by the clinical residents. Sustaining these gains will require institutionalized partnerships and evaluation of long-term impact. This could contribute to the advancement of primary healthcare services.