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Recent Submissions

Bacterial Profile and Antibiotic Susceptibility Patterns of Urogenital Isolates Among Women With Preterm Labor at a Tertiary Hospital in Southwestern Uganda
(Cureus, 2026) Birungi,Wilson; Turanzomwe,Stuart; Byamukama,Onesmus; Bawakanya,Stephen; Orishaba,Francis; Kabanda,Taseera; Kayondo,Musa; Ngonzi,Joseph; Kajabwangu,Rogers
Background: Pathogenic bacterial colonization of the urogenital tract during pregnancy may lead to infection and inflammation, contributing to adverse obstetric and neonatal outcomes such as preterm labor, preterm premature rupture of membranes, chorioamnionitis, neonatal sepsis, and perinatal mortality. Early identification of bacterial isolates and their antibiotic susceptibility patterns is essential for guiding appropriate antimicrobial therapy, reducing maternal and neonatal morbidity, and informing local treatment guidelines. This study aimed to determine the bacterial isolates colonizing the urogenital tract and their antibiotic susceptibility patterns among women presenting with preterm labor at Mbarara Regional Referral Hospital. Methods: This cross-sectional study consecutively enrolled 156 women with preterm labor between November 2022 and April 2023. Midstream urine samples, endocervical swabs, and high vaginal swabs were collected for bacterial culture, identification, and antibiotic susceptibility testing. Data were analyzed descriptively, and bacterial isolates and antibiotic susceptibility patterns were summarized as frequencies and percentages. Results: Bacteria were isolated from urine samples in 43/156 (27.6%) participants and from genital tract specimens in 75/156 (48.1%). The predominant urinary isolates were Klebsiella spp. (20/43, 46.5%) and Staphylococcus aureus (16/43, 37.2%), while Escherichia coli accounted for 4/43 (9.3%) of urinary isolates. In the genital tract, S. aureus was the most frequently isolated organism (43/75, 57.3%), whereas Proteus spp. (1/75, 1.3%) and Pseudomonas spp. (1/75, 1.3%) were the least common. The predominant urinary and genital tract isolates demonstrated high resistance to ampicillin and azithromycin but were generally susceptible to ceftriaxone, gentamicin, and ciprofloxacin. Conclusion: Staphylococcus aureus and Klebsiella spp. were the predominant urogenital bacterial isolates among women with preterm labor. Most bacterial isolates were susceptible to gentamicin, ciprofloxacin, ceftriaxone, and ceftazidime but demonstrated high resistance to ampicillin and azithromycin. These findings highlight the need for routine culture and antibiotic susceptibility testing and may inform future updates of empirical antibiotic treatment guidelines in Uganda.
Association Between Advanced Age and Perioperative Complications Among Women Operated for Pelvic Organ Prolapse in Urogynecology Camps in Uganda
(Cureus, 2026) Kalyebara, Paul Kato; Ngonzi,Joseph; Byamukama,Onesmus; Ainomugisha,Brenda; Birungi,Wilson; Kajabwangu,Rogers; Geissbuehler,Verena; Kayondo,Musa
Background: The burden of pelvic organ prolapse (POP) is the highest among elderly women compared to their young and middle-aged counterparts. These women are also faced with various medical comorbidities. Surgery in these women presents a challenge due to the increased risk of perioperative complications, especially in low-resource settings. Therefore, this study aimed to determine the association between advanced age and perioperative complications among women undergoing POP surgery in a resource-limited setting. Methods: This was a retrospective review of records for women who had surgery for POP during urogynecology camps conducted over a four-year period from January 2022 to December 2025 at eight centers in Uganda. A woman was considered elderly if she was aged 70 years and above. Perioperative complications assessed included intraoperative injury to pelvic viscera, duration of hospital stay, and in hospital adverse events. We compared the proportions of perioperative complications in the elderly and nonelderly using a chi-square test. Cramér's V coefficient was used to assess effect size. Bivariate and multivariate modified Poisson regression analyses were done to determine the association between advanced age and perioperative complications. The level of statistical significance was set at < 0.005). The overall prevalence of perioperative complications was 14.26% (n = 78, CI: 11.57-17.46). There was no significant difference in the proportion of perioperative complications between the two groups (10/63, 15.9% vs. 68/484, 14.1%) (p = 0.697). At the multivariate analysis, advanced age was not associated with perioperative complications (aPR 1.07; CI: 0.57- 2.03; p = 0.828). Conclusions: Advanced age was not associated with perioperative complications. We recommend that surgery be offered as a viable option to elderly women with POP in urogynecological surgical camps and enhanced recovery after surgery measures be implemented by POP surgeons
Assessment of Immediate Postpartum Contraception Uptake Among Women Delivering by Cesarean Section in Southwestern Uganda
(Cureus, 2026) Ainomugisha,Brenda; Kayondo,Musa; Owaraganise,Asiphas; Ngonzi,Joseph
Introduction The immediate postpartum period represents a critical opportunity to initiate contraception to prevent short interpregnancy intervals and associated adverse maternal and neonatal outcomes. However, uptake of postpartum contraception remains low in many low-resource settings despite increasing rates of caesarean delivery. This study assessed the uptake and determinants of immediate postpartum contraception (IPPC) following cesarean delivery in Uganda. Objectives To determine the prevalence of IPPC uptake and factors associated with IPPC among women delivering by cesarean section (CS) at Mbarara Regional Referral Hospital, Mbarara, Uganda. Methods Between November 2024 and February 2025, we conducted a cross-sectional study and systematically sampled mothers who delivered by CS. Data were collected through structured electronic surveys and medical records abstraction. IPPC uptake was defined as a mother who took on a contraceptive method within the first 72 hours following a CS. We estimated the prevalence of IPPC and used logistic regression to identify sociodemographic, medical, obstetric, and contraceptive factors associated with IPPC. Results A total of 429 women were enrolled, with a mean age of 27 years. The prevalence of IPPC uptake was 6.8% (95% CI: 4.7-9.6). The commonest contraceptive method taken up was bilateral tubal ligation (75.8%, 22/29). The reasons for IPPC non-uptake were preference to first heal (238/400, 59.5%), chose natural methods (92/400, 23%), lack of awareness (42/4000, 10.5%), needed partner consent (14/400, 3.5%), and unavailability of the methods (7/400, 1.75%). Factors associated with immediate postpartum uptake were no formal education (adjusted odds ratio (aOR) = 8.52, 95% CI: 1.88-38.5; p < 0.005) and having ever used postpartum contraception (aOR = 5.08, 95% CI: 1.32-19.44; p < 0.018). Conclusion and recommendation Uptake of immediate postpartum contraception remains suboptimal among women undergoing cesarean delivery. Having no formal education and prior postpartum contraception use were independently associated with IPPC uptake. Strengthening the integration of contraceptive counseling and method provision during the antenatal, intrapartum, and postpartum periods may substantially improve uptake and improve maternal and neonatal outcomes.
A Comparative Analysis for Inhospital and Postdischarge Puerperal Sepsis (Readmissions) Among Mothers Admitted in Mbarara Regional Referral Hospital
(Cureus, 2026) Luwaga,Rachel; Shindell,Deborah; Bajunirwe,Francis; Ngonzi,Joseph
Introduction: Puerperal sepsis is defined as an infection of the genital tract occurring within 42 days after delivery. It is characterized by symptoms such as chills, fever, foul-smelling vaginal discharge, pelvic pain, and delayed uterine involution. The condition is more prevalent in low-income countries, with Uganda among those reporting higher rates. Puerperal sepsis can be acquired either during the initial birth hospital admission or after discharge, resulting in readmission. Although the risk of infection exists during the antenatal period, it increases significantly during delivery and remains elevated throughout the postnatal period. Knowledge of self-care and use of postnatal care services are often limited in low-resource settings, increasing the risk of infection. Understanding the differences between mothers readmitted and those who acquire puerperal sepsis while hospitalized provides information for designing targeted interventions in its prevention. Therefore, we compared the magnitude, maternal characteristics, and associated factors among mothers who developed puerperal sepsis during their initial admission and those readmitted with post discharge puerperal sepsis at Mbarara Regional Referral Hospital. Methods: A retrospective chart review was conducted on a total of 316 files from 2017 to 2024 of mothers diagnosed with puerperal sepsis who had been admitted to the maternity and gynecology wards of Mbarara Regional Referral Hospital. Information was extracted using a predesigned checklist. The data were then cleaned, entered into MS Excel (Microsoft Corporation, Redmond, Washington, United States), and imported into IBM SPSS Statistics for Windows, Version 20 (Released 2011; IBM Corp., Armonk, New York, United States) for analysis. Readmissions were summarized as proportions, and binary logistic regression was performed for both bivariate and multivariate analyses. Additionally, the Mann-Whitney U test was used to assess differences in length of hospital stay. Results: The proportion of readmissions (66.8%, n = 211) was higher than that of mothers who acquired puerperal sepsis while still hospitalized. Most readmitted mothers had delivered by cesarean section (86.5%, n = 186) and were from rural areas (67.3%, n = 142). Factors significantly associated with readmission included age 15-19 years (adjusted odds ratio (AOR): 6.815; 95% CI: 1.786-26.018) and being prim parous (AOR: 0.424; 95% CI: 0.186-0.968). There was also a significant difference in length of hospital stay between readmitted and non-readmitted mothers (Mann-Whitney U: 7974; Z: −4.085; p < 0.001). Conclusion and recommendation: Despite the observed reduction in admissions due to puerperal sepsis, the predominance of post discharge cases, particularly among mothers who underwent cesarean section and younger mothers, remains a significant challenge to achieving Sustainable Development Goal 3. Targeted interventions focusing on the prevention of puerperal sepsis, with emphasis on post discharge self-care, are therefore essential.
User perceptions of a point-of-use water filtration device: Qualitative, focus group study
(PLoS, 2026) Fuller,Martha Grant; Najjuma,Josephine N.; Jacobitz,Frank G.; Macdonald,Keith; Ruzaaza Ndaruhutse,Gad
Universal access to clean water is sixth of the United Nations sustainable development goals. It has not yet been achieved. Boiling water, for water purification, is cost prohibitive and polluting. Diarrheal diseases linked to unsafe water cause morbidity and mortality in young children in Uganda, where most if the rural population lacks access to treated water. Bacterial water contaminants include Escherichia coli and Salmonella Typhi. Community perceptions of water quality and mitigation efforts in rural Uganda is unknown. In the absence of safe drinking water, a low-cost method of water purification is needed. In vitro studies of plant xylem filtration found this technique successful in removing coliform bacteria and other pollutants. The purpose of this study was to explore perceptions of water quality impact on the lives and health of residents in a rural community in Southwestern Uganda and obtain reactions to a prototype point-of-use water filtration device to determine the possibility of implementing its use in this community. Qualitative descriptive analysis of translated transcripts of purposefully designed focus groups was conducted. Participants included 36 adult residents of a rural community in Uganda. Groups led by experienced Ugandan facilitators in the local language, no researchers from the USA were present. No participants had access to treated water, past efforts to improve water failed due to lack of follow-up. Community members were aware of the poor quality of their water and described water associated illnesses in family members. Obtaining and boiling water required time, money, and resources with households using an average of 142 liters of water/day. Response to the device was mixed, with some excited at the possibility of using it and others expressing concerns regarding durability and cost. Future efforts must address concerns about costs and durability of any point-of-use device and will require extensive planning for sustainability
Use of artificial neural network optimization for MHD and non-Newtonian peritoneal Jeffery nanofluid dynamics on female reproductive health
(Journal of Biological Engineering, 2026-05-12) Anuradha,Keerthi Devarajan; Dhinakaran,Vedhesh; Viharika,J. U.; Sreesai, V; Khan, Umair; Khashi’ie,Najiyah Safwa; Nakintu,Justine
The dynamics of peritoneal fluid has vital applications in various physiological functions, particularly in female reproductive physiology, which modulates the transport of gametes within the fallopian tubes. This research aims to study the interactive operating factors of peritoneal fluid flow, heat transfer, and mass transport under various physiological and pathological conditions. In this regard, the Jeffrey fluid model is applied to examine the non-Newtonian behavior of peritoneal fluid and its responses to thermal and magnetic influences. The study extends to consider thermophoresis and Brownian motion of nanoparticles in Nano fluids with the purpose of enhancing thermal conductivity and optimizing fluid properties toward better reproductive health. Magnetic field effects on fluid dynamics, using magneto hydrodynamics, are also explored in relation to possible therapeutic interventions for endometriosis and tubal factor infertility. Numerical solutions and graphical interpretations are used to illustrate the impact of salient parameters such as Grashof numbers, Brownian motion, and shear-dependent viscosity on the fluid behavior. The results deepen the current understanding of the mechanics of peritoneal fluids and provide potential improvements in fertility treatments and biomedical applications. The proposed model can be applied to develop a non-invasive diagnostic technique for detection of endometriosis, to optimize infertility treatments and to design biomedical devices for peritoneal fluid manipulation in female reproductive therapy
Twelve Years of Managing Female Urogenital Fistula in Uganda: Characteristics, Repair Outcomes, and Predictors for Success in a Multicentre Cohort Study
(International Urogynecology Journal, 2026-07-08) Kayondo,Musa; Margolis,Thomas; Byamukama,Onesmus; Ainomugisha,Brenda; Kajabwangu,Rogers; Kalyebara,Paul Kato; Tabaijuka,Leevan; Ochola,Henry; Lugobe,Henry Mark; Geissbühler,Verena
Abstract Introduction and Hypothesis to describe the characteristics and aetiology of urogenital fistula, and to determine the predictors for successful repair. Methods We conducted a multicentre retrospective cohort study using prospectively collected data of women who underwent urogenital fistula repair at four regional repair centres between 2010 and 2021. The fistulae were classified as ischaemic (urethrovaginal and vesicovaginal), iatrogenic (vesico-cervical, vesico-uterine, vaginal vault fistula, and ureteric fistula) and congenital. The patients were followed up at 3 months postoperatively to assess surgical outcomes. Successful repair was defined as fistula closure with urinary continence, while unsuccessful repair included failed fistula closure or residual urethral incontinence. Modified Poisson regression was used to estimate adjusted risk ratios (aRR) for predictors of successful repair. Results A total of 510 women were included. The mean age was 32.7±12.5 years. The most common fistula type was urethrovaginal (34.9%). Successful repair was achieved in 80.8% (95% CI 77–84). Women with urethrovaginal fistula (aRR 0.18; 95% CI 0.1–0.4; p =0.009) were less likely to have successful repair. In contrast, grand multiparity was associated with a higher likelihood of success (aRR 2.4; 95% CI 1.08–5.2; p=0.03). Conclusion Fistula repair outcomes were favourable, with a high success rate. Urethrovaginal fistula, previous repair, and divorce were associated with lower likelihood of success. These findings highlight the need for careful patient selection and specialised expertise in the management of complex fistulae
Death after discharge among children living with HIV admitted with suspected sepsis in Uganda: A secondary analysis of two prospective observational studies
(HIV medicine, 2026) Mackenzie,O.; Zhang,C.; Kissoon,N.; Ford,N.; Sugandhi,N.; Kumbakumba,E.; Kabakyenga, J.; Komugisha,C.; Mugisha,N. K.; Wiens,M. O.
Background: Children living with HIV in low-income countries contribute disproportionately to death after hospital discharge. This study investigates the effect of HIV on post-discharge mortality and readmission by exploring a wide range of clinical, maternal and socioeconomic variables. Methods: A secondary analysis of children under 5 years old admitted with suspected sepsis. Participants were enrolled from two multisite observational studies conducted from 2012 to 2013 and 2017 to 2020 across six hospitals in Uganda. Participants were excluded if admitted outside the catchment area, for trauma, short-term observation or if admitted immediately after birth without prior discharge. We used a robust Poisson regression to identify risk factors of post-discharge mortality for three separate HIV groups: children living with HIV (CLHIV), children HIV-exposed uninfected (CHEU) and children HIV-unexposed uninfected (CHUU). We implemented Kaplan Meier curves to compare rates of post-discharge mortality and readmission between the three groups. In addition, we compared the risk ratio of the two outcomes. Results: Of the 7658 children who were discharged alive and completed the 6-month follow-up, 266 (3.5%) were CLHIV, 458 (6.0%) were CHEU and 6934 (90.6%) were CHUU. Post-discharge mortality was statistically significantly higher in CLHIV compared to the CHUU, with rates of 12.8% (34/266) and 5.8% (402/6934), respectively. Contrastingly, readmission was higher in CHUU (17.7% (1227/6934)) compared to CLHIV (11.3% (30/266)). Severe malnutrition, indicated by a weight-for-age z-score of less than 3, was associated with post-discharge mortality among all three groups with aRRs of 4.32 (95% CI: 1.89– 9.81), 3.96 (95% CI: 1.75–8.95) and 4.84 (95% CI: 3.94–5.96) for CLHIV, CHEU and CHUU, respectively, compounded by the fact that severe malnutrition is disproportionately higher in those living with HIV. Variables associated with post-discharge mortality in this group were prior antimalarial use (aRR = 2.27 [95% CI: 1.16–4.47]) and moderate anaemia (aRR = 2.33 [95% CI: 1.12–4.89]). Conclusions: Children living with HIV represent an exceptionally vulnerable group following hospital discharge. Very low readmission rates alongside high mortality suggest that strategies to improve care transitions and follow-up in these children are essential to improving recovery and survival
Second-order variational analysis of PV–battery energy management using jacobi equations
(Scientific Reports, 2026-05-16) Mundu,M. M.; Basajja,Mariam; Kweyu,Emmanuel; Ssempewo,J. I.; Nnamchi,S. N.; Uti,Daniel Ejim
The increasing penetration of photovoltaic (PV) generation requires energy management strategies for PV–battery systems that are not only optimal but also stable and robust under variable solar generation and load demand. Classical optimal control approaches based on first-order optimality conditions ensure stationarity of solutions but provide limited observation into local stability and sensitivity to operational perturbations. This paper introduces a second-order variational framework based on Jacobi equations to analyze and design optimal PV–battery energy management trajectories. The proposed methodology quantifies state-of-charge (SOC) trajectory stability, explicitly identifies conjugate points that signal loss of local optimality, and characterizes time-dependent sensitivity to PV and load fluctuations through Jacobi fields. Numerical experiments on a representative 24-hour PV–battery system demonstrate the practical effectiveness of the approach, revealing critical periods of vulnerability and providing quantitative guidance for battery sizing, control-weight selection, and predictive operational planning. Results show that incorporating second-order optimality conditions enables rigorous stability verification and enhanced robustness compared with classical first-order methods. By extending conventional optimal control frameworks with stability-aware analysis, this work provides a mathematically grounded and practically relevant foundation for resilient energy management in renewable microgrids and residential PV–battery systems
Prevalence and genotypic distribution of high-risk human papillomavirus in primary breast tumors in Western Uganda: a case control study
(Scientific Reports, 2026-05-08) Birungi,Abraham; Kalyetsi,Rogers; Nalumaga,Pauline Petra; Tumwesigye,Habert; Ssedyabane,Frank; Tumwesigire,Samuel; Simeon,Eloba; Yekosani,Mitala; Atwine,Raymond; DiazAnaya,Amnia; Aisagbonhi,Omonigho
Although in vitro studies have demonstrated that HPV can immortalize mammary epithelial cells, its contribution to breast carcinoma development in living organisms remains debatable. Reports on HPV detection in breast tumors vary widely across regions, and data from East Africa are limited. This study investigated the prevalence and genotypic distribution of high-risk HPV in breast tumors in Western Uganda. This retrospective case-control study was conducted using archived formalin-fixed paraffin embedded tissue specimens from 66 breast carcinomas (cases) and 42 fibroadenomas (controls) diagnosed between 2012 and 2018 at Mbarara Regional Referral Hospital. High-risk HPV DNA was detected using real-time polymerase chain reaction (rRT-PCR), and genotyping was performed using the AmpliSens HPV HCR genotype-titre-FRT PCR kit. To validate the assay, cervical squamous cell carcinoma samples served as technical controls. Associations between HPV prevalence and breast carcinoma were assessed using chi-square tests and odds ratios. High-risk HPV DNA was detected in 25 of 108 breast tumor specimens (23.1%). The prevalence of HPV was 24.2% (16/66) in breast carcinomas and 21.4% (9/42) in fibroadenomas, with no statistically significant difference between cases and controls (p=0.735; OR=1.17, 95% CI: 0.46–2.97). Detected HPV genotypes included 16, 18, 33, 39, 45, 51, 56, and 58. HPV genotype 39 was the most frequently detected genotype in both breast carcinomas (50% of HPV-positive cases) and fibroadenomas (44.4% of HPV-positive cases). High-risk HPV was detected in all cervical cancer control specimens, confirming assay validity. These findings indicate that although high-risk HPV DNA was detected in breast tissue in this population, its presence alone does not support a primary causal role in breast carcinogenesis. Further studies incorporating viral load and transcriptional activity are needed to clarify the biological relevance of HPV in breast tissue.
Prevalence and associated factors of non-communicable diseases among men: A cross-sectional analysis of Kenya Demographic and Health Survey 2022 data
(PLoS One, 2026-07-20) Asiimwe,John Baptist; Nuwabaine,Lilian; Namulema,Angella; Sserwanja,Quraish; Kawuki,Joseph; Nambozi,Grace
Background Non-communicable diseases (NCDs) are the leading cause of morbidity and mortality worldwide, with low- and middle-income countries (LMICs) increasingly being disproportionately affected. Although anecdotal evidence or reports indicate an increasing number of Kenyan men having NCDs, the prevalence and associated factors are not well understood. Therefore, this study aimed to determine the prevalence and associated factors of non-communicable diseases among men in Kenya. Methods Secondary data comprising 14,439 men aged 15–54 years from the 2022 cross sectional Demographic and Health Survey (KDHS) in Kenya were analyzed using univariable and multivariable logistic regression analyses in SPSS, version 29. Results Overall, the percentage of men with at least one NCD was 9.4% (95% confidence interval [CI]: 8.7–10.2%). Whereas the proportion of participants with multiple NCDs was 1.9 (95% CI: 1.6–2.3). Across NCDs, the highest prevalent NCD was hypertension (3.5% 95%CI:3.1–3.9) followed by depression (2.2% (95%CI:1.9– 2.5), anxiety (1.6% (95%CI:1.3–1.9), arthritis (1.4% (95%CI:1.1–1.6), heart dis ease (1.2% (95%CI:0.9–1.5), diabetes (1% (95%CI:0.8–1.3), lung disease (1% (95%CI:0.7–1.3), and cancer (0.1% (95%CI:0–0.1). In terms of multiple chronic conditions (multimorbidity), the majority of the participants had diabetes and hypertension (0.5% (95%CI:0.3–0.7) followed by hypertension and depression (0.3% (95%CI:0.2–0.4), hypertension and anxiety (0.3% (95%CI:0.2–0.4), and arthritis and depression (0.2% (95%CI:0.1–0.2). Several factors, such as age, region, residence, ethnicity, education level, health status, wealth index, religion, media access, and living a sedentary lifestyle, were found to be significantly associated with the prevalence of NCDs. Conclusion The overall prevalence of NCDs among men is relatively low based on available national data. We found that sociodemographic and lifestyle factors were significantly associated with the prevalence of NCDs. Although causal relationships cannot be inferred from this study, the findings suggest that initiatives such as tailored health education, regular medical checkups, and the promotion of physical activity may be relevant components of broader efforts to support men’s health in relation to non-communicable diseases (NCDs). Region-specific policies and culturally sensitive approaches may help address variations in risk factors and observed ethnic disparities. Encouraging healthier lifestyle practices among men of all backgrounds and improving access to integrated healthcare in rural areas may also be important considerations. Further research is needed to explore how media exposure, media content, health messaging, and religious contexts may influence men’s exposure to NCDs in Kenya and other sub-Saharan countries
Predictors of extinction risk in large tropical forest mammals: From global to local
(Science Advances, 2026) Schowanek,Simon D.; Sheil,Douglas; Beaudrot,Lydia; Dupont,Pierre; Espinosa,Santiago; Estienne,Vittoria; Julia, E. Fa; Geldmann,Jonas; Jansen,Patrick A.; Johnson,Steig E.; Rovero,Francesco; Santos,Fernanda; Semper-Pascual,Asunción; Vargas,Andrea Fernanda Vallejo; Ahumada,Jorge A.; Akampurira,Emmanuel; Amin,Rajan; Bitariho,Robert; Fayolle,Adeline; Fonteyn,Davy; Greco,Ilaria; Lima,Marcela Guimarães Moreira; Luskin,Matthew Scott; Kenfack,David; Martin,Emanuel H.; Uzabaho,Eustrate; Vermeulen,Cédric; Bischof,Richard
Studies can only guide conservation if their findings are informative at the scales at which practitioners and policy-makers operate. Yet, it is rarely tested whether large-scale studies reach similar conclusions to the smaller scale studies on which conservation traditionally relies. We examine whether predictors of extinction risk are consistent across global, regional, and local scales, for 210 tropical forest mammal species (≥1 kg) that existed during the last 130,000 years, in 64 tropical forests, across three biogeographical realms. We found consistent predictors of extinction risk (body mass, generation length, diet, brain volume, and scansoriality) when analyses differed only in their spatial resolution. However, predictors differed when analyses also varied in their temporal extent. Macroecological findings about extinction risk can, thus, inform conservation at smaller scales, but they risk misidentifying threatened species if differences in temporal extent are not recognized.
Modeling of solar photovoltaic generation and power conditioning systems using maxwell’s equations of electromagnetics
(Discover Applied Sciences, 2026-05-22) Mundu,M. M.; Basajja,Mariam; Kweyu,Emmanuel; Ssempewo,J. I.; Nnamch,S. N.; Daniel Ejim Uti
Accurate modeling of photovoltaic (PV) systems coupled with power conditioning inverters is critical for optimizing efficiency, reliability, and thermal performance, especially in high-frequency and high-penetration applications. This study presents a Maxwell-based electromagnetic simulation framework that integrates PV module field distributions with inverter electromagnetic behavior, enabling a physically consistent evaluation of electric and magnetic stresses, losses, and thermal effects. Spatially resolved simulations reveal localized electric field hotspots, magnetic flux concentrations, and parasitic loss mechanisms that are not captured by conventional lumped-parameter models. Sensitivity analysis confirms the numerical stability and robustness of the coupled field–circuit model under variations in mesh, time-step, and material properties. Results demonstrate enhanced prediction of efficiency, component stress, and thermal behavior, offering actionable insights for inverter and PV design optimization. The proposed methodology supports reliable deployment of mini-grid and high-penetration PV systems, contributing to Sustainable Development Goals (SDG 7 and SDG 13) and advancing renewable energy strategies in African and emerging energy markets.
Knowledge, attitudes, and practices of obstetrics residents towards cesarean delivery–sparing procedures
(International Journal of Gynecology & Obstetrics, 2026) Roa,Lina; Kaitlyn, E. James; Abdel-Rahim,Hossam Fahem; Abonie,Maclean; Kwame ,Adu-Bonsaffoh; Byamukama,Onesmus; DeAndrade, Samantha; Rossana, Pulcineli Vieira Francisco; Lugobe,Henry Mark; Ladfors,Lars; Manotaya,Saknan; Ramos,Jania A.; Shahawy,Sarrah; Srisupundit,Kasemsri; Svensson,Emma; Boatin,Adeline A.
Objectives: Obstetrics and gynecology (ObGyn) trainees will impact future practice patterns and their cesarean rates. The knowledge, attitudes, and practices (KAP) of ObGyn residents have not been extensively studied. We aimed to assess KAP towards mode of delivery and cesarean-sparing procedures among ObGyn trainees. Methods: This is a multicountry study that was conducted in Brazil, Egypt, Ghana, Sweden, Thailand, Uganda, and the United States. A questionnaire was developed, piloted, translated, and adapted for ObGyn trainees in seven countries. The questionnaire was administered to assess knowledge regarding safety of cesarean and vaginal delivery (VD), attitudes towards mode of delivery, and perceived competency in performing cesarean-sparing procedures (forceps and vacuum-assisted VD, external cephalic version [ECV], and breech VD). The outcomes included the KAP of a group of global trainees, including number of procedures towards cesarean sections and cesarean-sparing procedures. Results: Of 744 complete responses, most residents perceive VD as safer than cesarean delivery for the mother (67%) and baby (55%). More trainees in Sweden (92%) and the United States (73%) agree that patients with breech presentation should be offered an ECV, compared with Ghana (8%), Egypt (8%), and Uganda (10%), and only in Sweden do most trainees feel competent with ECV (62%). Trainees in Ghana (86%) and Uganda (78%) report perceived competency with singleton breech VD while few do in Sweden (7%), Thailand (5%), and the United States (2%). Conclusion: Most trainees agreed on the comparative risks of CD versus VD but there is marked variation in self-perceived competency around cesarean-sparing procedures, particularly ECV and breech delivery. These findings can provide useful insights into focus areas for ObGyn training.
Invaders taking over—Mollusc faunal change in volcanic barrier lakes of the Albertine Rift biodiversity hotspot
(PLoS One, 2026-06-30) Ssenkuba,Francis; Rwibutso,Marcellin; Dusabe,Marie Claire; Tumusiime,Julius; Albrech,Christian
East African freshwater are renowned biodiversity hotspots, particularly within the Rift Valley lakes, which exhibit exceptional species richness and endemism. However, research in this region has predominantly focused on large Rift lakes, with smaller volcanic barrier lakes remaining underexplored. This study integrated morphological, DNA barcoding, and ecological analyses to assess mollusc diversity, biogeographical affinities, environmental correlates of distribution, and community differences in lakes Bunyonyi, Mutanda, and Mulehe in Uganda, and Lakes Ruhondo and Burera in Rwanda. Results revealed a relatively high malacofaunal diversity in these lakes compared to some Great Lakes in the region, although these comparisons should be interpreted cautiously because sampling scope differs among studies. Assemblages largely exhibited Nilotic affinities and were dominated by widespread mollusc species. Our findings suggest ongoing homogenisation of mollusc communities, as indicated by reduced dispersion among invaded lakes. While this pattern is consistent with potential influences of anthropogenic activities and invasive species such as the North American crayfish (Procambarus clarkii), Physella acuta, and the Asian lineage of Melanoides tuberculata, our analyses do not allow us to disentangle invasion effects from other confounding factors, including lake-specific characteristics and environmental gradients. Therefore, invasion-driven homogenisation should be interpreted with caution. Nevertheless, this trend, coupled with habitat degradation from agriculture, pollution, and infrastructure development, may pose significant threats to the mollusc diversity in these lakes. This research underscores the importance of prioritising these overlooked, fragile ecosystems in the regional biodiversity conservation strategies to safeguard habitats for molluscs and other faunal elements. A comprehensive regional freshwater survey, including metabarcoding, is needed to document molluscan diversity patterns under ongoing environmental change and increasing anthropogenic pressure.
Impact of a surgical sponsorship program on compliance with decision-to-delivery intervals in rural hospitals in Uganda
(BMC Pregnancy and Childbirth, 2026-05-13) Byamukama,Onesmus; Mwiindi,Jonathan; Wangigi,Beth; Tumwiine, Gilbert; Mungai, Phoebe; Osumo,Rodgers; Muguthu,Edward; Delgado,Rigoberto; Busingye, Priscilla
Background: An emergency caesarean section is a critical intervention to reduce maternal and fetal risks during labour complications. The decision-to-delivery interval, recommended internationally of seventy-five minutes or less, is a key indicator of quality in emergency obstetric care. In rural western Uganda, this interval is often prolonged due to financial and infrastructural barriers. This study evaluated the impact of a sponsorship program’s case management and documentation procedures on compliance with the decision-to-delivery interval in a rural hospital setting. Methods: A retrospective cross-sectional study was conducted from January 2020 to December 2023 across four comprehensive emergency obstetric care hospitals in southwestern Uganda: Ibanda, Nyakibale, Rushoroza, and Rwibaale. Data were extracted for all emergency caesarean section cases with indications in categories one and two. Documentation rates and compliance with the decision-to-delivery interval (defined as less than seventy-five minutes) were analyzed using descriptive statistics, trends, and stratified graphs. The study sample compared data from non-sponsored and sponsored patients covered by a financing program offered by African Mission Healthcare, a not-for-profit organization working in Africa. Results: Surgical Access for Everyone–sponsored patients consistently demonstrated higher documentation rates for the decision-to-delivery interval (70–80%) compared to non-sponsored patients, especially from 2021 onwards. By the fourth quarter of 2023, documentation in both groups exceeded 75%. All facilities showed a reduction in the median decision-to-delivery interval over time, with Rushoroza and Rwibaale achieving the most significant declines to below 60 min by 2023. Compliance with the decision-to-delivery interval of less than 75 min improved from 30% in 2020 to nearly 70% in 2023. Facility-specific trends revealed overall improvement, with Rushoroza and Rwibaale showing the most significant progress by 2023, while Ibanda exhibited the slowest progress. Conclusion: The Surgical Access for Everyone sponsorship program and its required case management and documentation procedures enhanced compliance with the decision-to-delivery interval in emergency obstetric care, demonstrating benefits for both sponsored and non-sponsored patients. Sustained improvements highlight the importance of structured funding and oversight. To maintain and expand these gains, targeted facility-level interventions, strengthened data systems, and continued investment in clinical training are recommended.
Hepatitis C virus seroprevalence among people with sickle cell disease in Uganda: a cross-sectional study
(Therapeutic Advances in Infectious Disease, 2026) Kibone,Winnie; Muzoora,Conrad; Bongomin,Felix; Namiiro,Amelia Margaret; Ssenkungu,Samuel; Gebeh,Sam J.; Paulo,Heavenlight A.; Kasirye, Philip; Hamer,Davidson H.
Background: Viral hepatitis is a major cause of chronic liver disease, including cirrhosis and hepatocellular carcinoma, with significant morbidity and mortality. Individuals with sickle cell disease (SCD) are at increased risk of hepatitis C virus (HCV) infection due to frequent transfusions. Despite the high burden of HCV in Uganda, recent data on HCV seroprevalence among individuals with SCD are limited. Objective: To determine HCV seroprevalence and describe characteristics among patients with SCD receiving care at Mulago National Referral Hospital (MNRH), Kampala, Uganda. Design: Hospital-based cross-sectional study Methods: Individuals with SCD attending the MNRH outpatient SCD clinic in Kampala, Uganda, were recruited between July and September 2025. Sociodemographic, clinical, and behavioral data were collected using a structured questionnaire. Anthropometric measurements were taken using standardized scales. HCV, hepatitis B surface antigen (HBsAg), and HIV rapid tests were performed. Data were analyzed using the SAS statistical package version 9.4. Results: There were 119 participants with SCD enrolled, with a mean age of 13.1years, and 55.5% (n=66) were male. Most participants had a SCD diagnosis for 6years or longer. HCV seroprevalence was 12.6% (n=15). All HCV-seropositive participants were less than 18years, with nearly two-thirds of those aged 9–17years (66.7%, n=10). Nearly all HCV-seropositive participants had a history of blood transfusion (n=14, 93.3%), with 53.3% (n=8) reporting three or more transfusions. Only one participant (0.84%) tested positive for HIV, and none tested positive for HBsAg. Conclusion: This study revealed a high seroprevalence of HCV among individuals with SCD in Uganda. Strengthening routine HCV screening, linkage to care, and infection prevention, including within blood transfusion services, is needed. Larger studies incorporating HCV RNA testing are recommended to assess the true burden of active infection and risk factors among patients with SCD to inform targeted prevention, screening, and treatment strategies.
Heat transfer optimization in MHD Casson ternary hybrid nanofluid flow using CPC fractional modeling
(Discover Nano, 2026-06-26) Saba,Maryam; Rubab, Huma; Khan,Umair; Shamshuddin,MD.; Syed, Modassir Hussain; Nakintu,Justine
Efficient thermal management in microchannel systems is essential for modern cooling devices, biomedical systems, energy units, and compact heat exchangers. In this study, the unsteady heat transfer and flow behavior of a Casson-type ternary hybrid nanofluid in a parallel-plate microchannel are investigated under generalized magnetohydrodynamic (MHD) effects. Water is used as the base fluid, while gold (Au), copper (Cu), and silver (Ag) nanoparticles are uniformly suspended to improve the thermal transport capacity of the fluid. The main motivation of this work is to examine how memory effects, magnetic field strength, and enhanced nanoparticle properties influence the velocity and temperature distributions in a non-Newtonian microchannel flow. To describe the memory and hereditary characteristics of the flow, the governing equations are modeled using the Constant Proportional Caputo (CPC) fractional derivative. An implicit finite-difference scheme is also developed to support thus study results numerically. The model is validated by comparing the present profiles with the previous study results, and a close agreement is observed. In addition, a magnitude-based sensitivity analysis is carried out to identify the most influential physical parameters. The results show that the thermal Grashof number has the strongest effect on the velocity response, while the effective Prandtl number is the dominant parameter controlling the temperature field. The CPC fractional model provides smoother and more flexible transient behavior compared with the classical integer-order model. Furthermore, the ternary hybrid nanofluid shows better heat transfer performance than simple nanofluid and hybrid nanofluid cases because of its improved effective thermal conductivity
Gabapentin to achieve HIV viral load suppression in people with risky drinking in Mbarara, Uganda: study protocol for a randomized, double-blinded, placebo-controlled trial (GRAIL)
(Trials, 2026) Truong,Ve; Kekibiina,Allen; Muyindike,Winnie R.; Gnatienko,Natalia; Tsui,Judith I.; Emenyonu,Nneka I.; Cheng,Debbie M.; Hahn,Judith A.; Allison,Olivia; Bullard,Matthew J.; Lunze,Karsten; Samet,Jefrey H.
Background Ending the HIV epidemic requires achieving HIV viral load (HVL) suppression for key populations including those with risky drinking. Gabapentin can decrease alcohol use and thus holds potential for improving medication adherence and HIV viral load suppression for individuals with HIV and risky drinking. Methods The aim of this paper is to describe the protocol for a randomized, double-blinded, placebo-controlled trial (GRAIL [Gabapentin to Reduce Alcohol and Improve Viral Load suppression]), to test the efficacy of gabapentin versus placebo on achieving undetectable HIV viral load among people with HIV with risky drinking. We will recruit and randomize 220 people with detectable HIV viral loads (≥200 copies/ml) and risky drinking. Participants will be randomized 1:1 to receive either gabapentin (1800 mg/day target dose) or placebo for 3 months in a double blind design. Both arms will receive a 5-min evidence-based counseling session aimed at reducing alcohol use. The primary outcome is undetectable viral load Other secondary outcomes include undetectable viral load at 6 and 12 months, biomarker-confirmed recent alcohol consumption, antiretroviral therapy (ART) adherence, engagement in HIV care and pain severity. This study will take place in Mbarara, Uganda, as the country ranks among the top five for alcohol consumption globally and has 1.4 million people living with HIV. Discussion GRAIL tests the efficacy of gabapentin, a medication to decrease alcohol use to achieve HIV viral load suppression. This trial may identify a treatment strategy to prevent the transmission of HIV and improve health outcomes among a high-risk HIV population, specifically those with risky drinking.
Extreme weather effects on health services and communities in low and lower-middle income countries: a thematic systematic review
(Transactions of the Royal Society of Tropical Medicine and Hygiene, 2026) Brainard,Julii; Sedekia,Yovitha; Natalia, R. Jones; Matte,Michael; Sunday,Patrick; Watson-Jones,Deborah; Kabakama,Severin A.; Mulogo,Edgar Mugema; Ntaro,Moses; Tuyet-Hanh,Tran Thi; Hunter,Paul R.; Geere,Jo-Anne
Most previous research about the dangers of extreme weather events was applicable to populations in high-income countries. Data summarising harms related to extreme weather events in low-income settings are lacking. A systematic review thematically summarising evidence about weather event-linked harms and responses in low- and lower-middle-income countries was conducted. Peer-reviewed and grey literature was systematically searched and selected. Data were extracted about harms, responses and outcomes relevant to six WHO building blocks of healthcare systems. Framework analysis was used to identify predominant themes related to harms, responses and the WHO building blocks. In total, 183 reports were included. Flooding and high winds were the most common types of extreme weather events documented. The main community experience themes identified were the displacement of populations and disruption. The main themes identified for health service delivery were vulnerability, disruption and resilience. Documented examples of resilience or recovery were far fewer for all six WHO healthcare system building blocks than descriptions of vulnerability and disruption. Extreme weather events can be highly disruptive and harmful to healthcare systems and communities in LMIC settings that are often already highly vulnerable.