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Recent Submissions

Red Cell Alloimmunization Among Transfused Chronic Kidney Disease Patients: A Hospital-Based Study in Southwestern Uganda
(Journal of Blood Medicine, 2025) Elizabeth A John; Enoch Muwanguzi; Robert Wagubi; Simon Peter Rugera; Charles Nkubi Bagenda; Rose Muhindo; Benson Okongo
Purpose: This study determined the prevalence, types of red cell alloantibodies and factors associated with red cell alloimmunization among transfused patients with CKD at Mbarara Regional Referral Hospital. Patients and Methods: A cross-sectional study was conducted among 141 consented, transfused patients with CKD from March to May 2025. Sociodemographic characteristics and clinical data were collected using a structured questionnaire. Four millilitres of EDTA anticoagulated blood were collected and tested for ABO/Rh blood group, direct antihuman globulin test, and red cell alloantibodies screening and identification by using the Echo Lumena machine (Immucor USA). Data were analyzed using STATA version 17. Logistic regression was used to determine factors associated with alloimmunization, and a p-value of ≤0.05 was considered statistically significant. Results: Out of 141 patients with CKD, 97 (67.8%) were male, and the mean age was 54.4 ± 17.12. The overall prevalence of red cell alloimmunization was 10 (7.1%). A total of 4 study patients were alloimmunized with a single type of antibody; 2 had multiple antibodies, while 4 had undetermined types. Anti-K was the commonest identified alloantibody. Blood group A had significantly lower odd of alloimmunization (aOR 0.01, 95% CI: 0.0005–0.229, p = 0.004), similar to blood group O (aOR 0.01, 95% CI: 0.0007–0.163, p = 0.001). Conclusion: The study reveals a slightly higher prevalence of red cell alloimmunization compared to global prevalence, with Anti-K being the most frequent antibody. Only ABO blood group was significantly associated with red cell alloimmunization. Therefore, more studies are needed to evaluate the complex nature of this phenomenon.
Depression among pregnant teenagers receiving antenatal care from primary healthcare facilities in Mbarara city, Southwestern Uganda
(BMC Pregnancy and Childbirth, 2025) Moses Muwanguzi; Sarah Oworinawe; Derrick Mwahuzi; Pavey Lila; Scholastic Ashaba
Background: Depression is a serious mental health condition whose risk is highest among women during pregnancy. The risk is high among pregnant teenagers due to intertwined developmental, hormone-mediated physical and psychosocial changes of pregnancy, with significant negative impacts on the unborn baby and the mother. This study aimed to determine the prevalence of depression and associated factors among pregnant teenagers in Mbarara city, southwestern Uganda. Methods: This was a cross-sectional study where we enrolled pregnant teenagers (13–19 years) attending antenatal care at 4 selected lower healthcare facilities in Mbarara City southwestern Uganda. We collected information on depression, resilience, social support and household food insecurity. Depression was defined as a score>10on the Edinburgh Postnatal Depression Scale (EPDS). Resilience was assessed using the 14-item Wagnild and Young Resilience Scale, Multi-dimensional Scale of perceived social support (MDSPSS) assessed perceived social support, and Household Food Insecurity Access Scale (HFIAS) assessed food insecurity in addition to sociodemographic variables. We run logistic regression analysis to determine factors associated with depression. Results: A total of 373 participants were recruited; median age was 19 (IQR: 18–19) years, 59% attained primary level education. The prevalence of depression was 35.9% (95% CI: 31.1% to 41.0%). Factors significantly associated with depression were current alcohol use (aOR=1.98, 95% CI: 1.18 – 3.32, p=0.010), and food insecurity (aOR=2.24, 95% CI: 1.25 – 4.01, p=0.006). Factors that reduced the odds of depression included resilience (aOR=0.93, 95% CI: 0.91 – 0.97, p=0.001) and family social support (aOR=0.94, 95% CI: 0.88 – 0.99, p=0.031). Conclusions and recommendations: In this study the prevalence of depression among pregnant teenagers was significantly high. Mental health services should be integrated in the antenatal care clinics to address the mental health needs of pregnant teenagers. We recommend further studies to explore the lived experiences focusing on the challenges and further understanding of their coping strategies and other possible confounders of depression. In addition, longitudinal studies should be conducted to establish the temporal relationships between the different factors related to depression to support intervention studies that promote the mental health of young mothers.
Decision to delivery interval and predictors for delayed decision to delivery interval among women delivering by emergency caesarean section at a tertiary hospital, Southwestern Uganda: a prospective cohort study
(BMC Pregnancy and Childbirth, 2025) Julius Businge; Stuart Turanzomwe; Mathiang Agany Akol; Caxton Kakama; Rogers Kajabwangu; Michael Kanyesigye; Henry Mark Lugobe; Musa Kayondo; Joseph Ngonzi; Onesmus Byamukama
Background: Emergency caesarean section (EMCS) is a life-saving procedure carried out with urgency appropriate to the risk posed to the safety of baby and/or the mother. A decision to delivery interval (DDI) is the time from making the decision for cesarean section to delivery of the neonate. Delayed DDI can result in adverse obstetric outcomes and is thus an indicator of poor quality obstetric care. This study aimed to determine the decision to delivery interval and predictors for delayed decision to delivery interval among women delivering by emergency caesarean section at Mbarara Regional Referral Hospital in South western Uganda. Methods: We conducted a prospective cohort study on women delivering by emergency caesarean section. Women with category I or II indications as per the World Health Organization (WHO) guidelines were consecutively enrolled from December 2023 to March 2024. Delayed DDI was defined as DDI interval>75 min. We performed a modified Poisson regression analysis to determine predictors for delayed DDI. Results: A total of 504 participants were enrolled. The mean age of the respondents was 26.4 (±5.25) years. Majority 453 (89.9%) were married, 282 (56.0%) unemployed and 271 (53.8%) had been referred in. Overall median decision to delivery interval was 167.5 min. The proportion of women with delayed DDI was 77.2% (95% CI: 73.3–80.8). Predictors for delayed DDI were prior caesarean delivery (aRR 1.15, 95%CI:1.02–1.28), need for stabilisation before surgery (aRR 1.15, 95%CI: 1.01–1.39), need to buy sundries (aRR 1.76, 95%CI: 1.20–2.57), Lack of prior communication to the theatre team (aRR 1.14, 95%CI: 1.03–1.25), unavailability of theatre operating room (aRR 1.23, 95%CI: 1.14–1.32), unavailability of sterile linen (aRR 1.18, 95%CI: 1.03–1.35) and unavailability of anaesthesia provider (aRR 1.40, 95%CI: 1.26–1.55). Conclusion: Majority of the women at MRRH experience delayed DDI and it takes about 3 h to have an EMCS. Women with a prior caesarean section, those who require stabilization before surgery, the need to buy sundries, the lack of operating room, and lack of prior communication to the theatre team, sterile linen and anaesthesia provider are predictors for delayed DDI. We recommend mobilization of resources to address these health system gaps.
Leveraging digital technologies to reduce cancer disparities in low-income and middle-income countries
(The Lancet Digital Health, 2025) Judy W Gichoya; Rogers Mwavu; Frank Minja; Nadi Kaonga; Saptarshi Purkayastha; Janice Newsome
In a rural clinic in southwestern Uganda, Dr Sarah examines cervical images on her smartphone, receiving real-time artificial intelligence-powered guidance from a gynaecologic oncologist located hundreds of miles away. Once imaginary, this scenario now represents a highly probable future of digital health innovation transforming cancer care globally. With over 35 million new cases of cancer estimated by 2050, and up to 70% of deaths anticipated to disproportionately occur in low-income and middle-income countries (LMICs), digital solutions can be leveraged to accelerate the closure of these cancer care gaps. The global oncology community has responded to this imminent crisis by proposing several interventions, including promoting workforce education, mentorship, and task shifting; supporting early diagnosis and referrals through integrated diagnostics; prioritising and implementing prevention strategies such as tobacco cessation, cervical cancer screening, and vaccination; standardising and personalising treatment through increased participation in clinical trials and provision of essential cancer medications; and strengthening health-care systems. Across all these strategic pillars, digital health tools are crucial for advancing cancer care and narrowing existing global and geographical disparities in LMICs. In this Series paper, we evaluate the current status of these digital innovations in the context of cancer care.
Chemical Profiling and Geographic Differentiation of Ugandan Propolis by GC-MS Through Chemometric Modelling
(Molecules, 2025-11-16) Ivan Kahwa; Leonard Kaysser; Rapheal Wangalwa; Susan Billig; Jonans Tusiimire; Claudia Wiesner
Propolis is a resinous substance collected by honeybees, and its long-known bioactivity urged research on its exact composition on active ingredients. It was suggested that chemical composition reflects the botanical sources and environmental conditions of its origin; however, information on differences related to geographical origin is still incomplete. Therefore, this study aimed to characterise the volatile and semi-volatile chemical constituents of Ugandan propolis from nine agro-ecological zones using headspace gas chromatography–mass spectrometry (HS-GC-MS) and derivatisation-based GC-MS, coupled with multivariate statistical analysis. In total, 213 volatile and 169 non-volatile compounds were tentatively identified, including monoterpenes (α-pinene), sesquiterpenes (α-copaene), triterpenoids (β-amyrin acetate), diterpene resin acids (abietic acid), phenolic acids (caffeic acid), alkylresorcinols (bilobol) and many others. Multivariate chemometric modelling using partial least-squares discriminant analysis (PLS-DA), orthogonal PLSDA (oPLS-DA) showed strong geographic discrimination of samples (Q2 > 0.90) for several district comparisons. Heatmap clustering and variable importance in projection (VIP) analysis identified chemical markers. Notably, oPLS-DA revealed excellent discrimination between Nakasongola and Bushenyi, and between Adjumani and Bushenyi, in both volatile and non-volatile datasets. The findings provide the first comprehensive chemical profiling of Ugandan propolis, demonstrating the utility of combined GC-MS approaches and multivariate analysis for regional differentiation. This work lays the groundwork for standardising propolis preparations and establishing appropriate quality control in pharmacological applications.
Missed Appointments and Associated Factors Among Children Accessing Anti-Retroviral Therapy During the COVID-19 Pandemic in South Western Uganda
(HIV/AIDS-Research and Palliative Care, 2025) Timothy Nduhukire; Ismail Abiola Adebayo; Rachel Luwaga; Immaculate Mandela; Agnes Napyo; Herbert Ainamani; Victor Musiime
Background: Disruptions to the health sector in Uganda during the COVID 19 pandemic affected health services in the early phases of the pandemic. Not much data exists on their effect on these same services during the later stages of the pandemic especially for children. To fill this gap, we set out to study missed appointments and their associated factors during the lockdown for children receiving Anti-Retroviral Therapy (ART). Methods: This was a retrospective cohort study from January 2022 to May 2022. We included all children aged 0–15 and adolescents aged 15–19 years who were on ART. Electronic Medical Records (EMR) for the participants in the last 12 months were extracted. Descriptive statistics are presented. Binary logistic regression was performed, and odds ratios were reported. Results: Out of the 382 participants, 26 (6.8%) missed appointments during the study period. The likelihood of missing appointments was increased when drugs were given to last 4 months than when they were given to last one month (COR 3.207, P value 0.026, 95% CI 1.150–8.943). Patients were also more likely to miss appointments if their mode of receiving drugs was Facility based group (COR 3.174, P = 0.043, 95% CI 1.037–9.713). Not having a viral load in the last 12 months increased the likelihood of missing an appointment (COR 2.309, P = 0.049, CI 1.004–5.306). Conclusion: A drug refill of 4 months and being scheduled to receive drugs by Facility-based group model predisposed the participants to missing the next appointment. Home- or community-based ART delivery to clients as well as drug prescriptions for a longer period could reduce missed appointments. Timely viral load testing should be encouraged as it correlates with adherence to appointments. More research is needed on the safety, storage practices and efficacy of ART given to last more than 2 months.
Teachers’ Preparedness for Effective Implementation of the Lower Secondary Competence-Based Curriculum in Rukungiri District, Southwestern Uganda
(Journal of Research Innovation and Implications in Education, 2025) Gladyce Kachope; Viola N. Nyakato; Adrian Mwesigye
The Competence-Based Curriculum (CBC) at Uganda's lower secondary school level depends significantly on teachers' preparedness. This study explored the relationship between teachers’ preparedness and the practical implementation of the CBC in Rukungiri District. Adopting a convergent parallel mixed methods design, the research engaged 235 in-service teachers through structured questionnaires and conducted key informant interviews with 13 head teachers. Quantitative data were analysed using descriptive statistics in Stata 17, while thematic analysis of qualitative data was conducted using NVivo 14. Findings revealed that while teachers reported high levels of perceived preparedness, particularly in classroom management, inclusivity, and learner-centred instruction, substantial gaps were evident in training adequacy, assessment practices, and ICT integration. Qualitative insights reinforced the importance of administrative support, peer collaboration, and resource provision as critical enablers of effective CBC delivery. The study underscores the need for continuous professional development and targeted resource allocation to bridge the preparedness gap. These findings contribute to curriculum implementation theory by affirming that teacher readiness, when holistically supported, is pivotal to transformative educational reform.
Prevalence and factors associated with adverse drug reactions among patients on highly active antiretroviral therapy at a tertiary hospital in south western Uganda: A cross-sectional study
(PloS one, 2025) Nangosya Moses; Sarad Pawar Naik Bukke; Narayana Goruntla; Daniel Chans Mwandah; Bontu Aschale Abebe; Fredrick Atwiine; Muyindike Rhoda Winnie; Tadele MekuriyaYadesa
Background: HIV/AIDS remains a global health challenge, with significant prevalence in sub-Saharan Africa. Highly active antiretroviral therapy (HAART) is the mainstay treatment for HIV, and the number of people living with HIV (PLWHIV) on HAART has considerably increased worldwide. The use of HAART has led to improved patient outcomes; however, it is associated with adverse drug reactions (ADRs) and drug-drug interactions (DDIs), which pose serious concerns in the management of patients with HIV. The aim of the study was to determine the prevalence and factors associated with ADRs among patients on HAART. Methodology: This was a hospital-based cross-sectional study carried out among 312 HIV patients on HAART attending HIV clinics at Mbarara Regional Hospital. Data was collected using an interviewer-administered, semi-structured questionnaire and a review of patient charts. ADRs were assessed for causality and categorized using Naranjo ADR assessment scale into probable, possible and definite, for severity using the modified Hartwig and Siegel criteria into mild, moderate and Severe, and for preventability using Schumock and Thornton criteria into definite, probable and non-preventable. Lexicomp® Drug Interaction Checker software was used to identify and rate clinically significant drug-drug interactions The prevalence of ADRs and potential DDI was analyzed using descriptive statistics while logistic regression analysis was used to establish the association of variables. Results: 312 patients were interviewed and their records reviewed. The prevalence of ADRs during this study was 76.0%. On assessment, 78.3% of the ADRs were mild and 76.6% of ADRs were definitely preventable. CD4 count below 200 cells/mm3 (AOR = 1.00, 95% CI: 1.00– 1.02; p value = 0.04), primary education level (AOR = 3.27, 95% CI: 1.34–7.95; p value = 0.009), and secondary education level (AOR = 3.64, 95% CI: 1.39–9.52; p value = 0.009) were identified as independent risk factors. Patients who experienced a significant DDI were 5.66 times more likely to experience an ADR (p value = 0.02, 95% CI: 1.32–24.18). Conclusion: There is a high prevalence of adverse drug reactions among patients with HIV on HAART. Low CD4 count and lower education levels are risk factors for ADRs in this population; therefore, tailored interventions to these subgroups should be implemented for early ADR identification and management. Significant drug-drug interactions are highly associated with the occurrence of ADRs among HIV patients on HAART, which calls for intensified pharmacovigilance and pharmaceutical care in this population.
Haemodynamic changes from prepregnancy to very early pregnancy among women planning to conceive in Southwestern Uganda
(Journal of Hypertension, 2025) Henry M. Lugobe; Carmel M. Mceniery; Musa Kayondo; Janet M. Catov; Joseph Ngonzi; Charles Batte; Bonnie Wandera; Bruce Kirenga; Blair J. Wylie; Adeline A. Boatin; Kwame Adu-Bonsaffoh; David C. Agaba; Ian B. Wilkinson
Introduction: Normal pregnancy is associated with cardiovascular changes that enable adaptation to the pregnancy state. We sought to describe the haemodynamic changes from prepregnancy to very early pregnancy in women planning to conceive in southwestern Uganda. Methods: In this prospective cohort study, we enrolled women in southwestern Uganda planning to conceive. Brachial and central blood pressure, heart rate, cardiac output, stroke volume, and peripheral vascular resistance were assessed prepregnancy and repeated in very early pregnancy. Results: We studied 86 women with a mean age of 27.8 years (SD 4.4). The mean gestational age was 7 ( 2) weeks at the time of repeat blood pressure measurement. Brachial systolic and diastolic blood pressure decreased in very early pregnancy (116 11 to 114 8 mmHg and 68 6 to 65 5 mmHg, respectively; P < 0.001). Central systolic and diastolic blood pressure also decreased (112 10 to 109 8 mmHg, P ¼ 0.003 and 68 6 to 65 5 mmHg, P < 0.001, respectively), as did peripheral vascular resistance (1450 581 to 1311 276 dyn/s/cm5 P ¼ 0.038). There was no significant difference in cardiac output (5.3 1.2 vs 5.5 1.1 l/min P ¼ 0.146) or stroke volume (64 13 to 66 12 ml, P ¼ 0.172). Conclusion: Significant haemodynamic changes occur in very early pregnancy. Using late first trimester measurements as a baseline for pregnancy induced changes may not be suitable for understanding the full extent of pregnancy induced haemodynamic changes, or provide a reliable substitute for prepregnancy states.
Effectiveness of low-dose aspirin in reducing the risk of preeclampsia in women with chronic hypertension: an integrative literature review
(BMC Cardiovascular Disorders, 2025) Prisca Asiimwe; Grace Nambozi; Laura Brennaman; Joseph Ngonzi; Gad Ruzaaza
Background: Evidence on the use of aspirin in women with chronic hypertension has indicated low effectiveness in preventing superimposed preeclampsia. The possible cause has not been well explored. Many researchers have attributed it to inadequacies in dosages, timing of therapy initiation, timing of intake and adherence. Investigations into these aspects have yielded conflicting results. Previous research has mainly focused on the dosage and gestational timing, yet the timing the drug is taken and adherence are also important aspects in evaluating drug efficacy. Therefore, an appraisal of the combination of these parameters was necessary. Aim: This review aimed to explore the theoretical explanations for aspirin's low effectiveness in reducing the incidence of superimposed preeclampsia among women with chronic hypertension and propose therapy modifications to boost aspirin. We also aimed to synthesize evidence on the effectiveness of aspirin at different doses, gestation timing, timing of ingestion, and adherence in this population. Methods: The review followed the Whittemore and Knafl procedure which involves problem identification, literature search, data extraction/evaluation, data analysis and presentation of findings. 17 studies were evaluated in the integrative literature review obtained from international databases including PubMed, Hinari and Google Scholar. We searched for articles that pertained to the effectiveness of aspirin regarding dosage, gestational age at initiation, timing of ingestion and adherence. Results: On exploration of the possible explanation for the low effectiveness of aspirin on superimposed preeclampsia, it was noted that the pathogenesis of this condition in chronic hypertension has various pathways. However, aspirin targets only one of them, thereby leaving a gap for the other pathways to advance. After synthesizing the studies included in this review, it was noted that aspirin doses≥150 mg were safer and more effective in the majority of the populations. Overall, there was an optimistic trend between higher doses (≥150 mg), initiated before 12 weeks of gestation, taken over 90% of the time at night/bedtime. Conclusion: Owing to the variety of pathways through which preeclampsia develops in women with preexisting hypertension, this review recommends weight-adjusted multi-component pharmacological combinations such as aspirin and L-arginine, or aspirin and S-nitroglutathione to enhance aspirin’s effectiveness in this population. We also noted that the effectiveness of aspirin largely depends on early identification and control of hypertension,doses≥150 mg, initiation of the therapy before the 12th week of gestation and taking the drug more than 90% of the time at night/bedtime. We recommend further research in this area, consistent follow-up of women prescribed aspirin and use of combined methods to measure adherence.
Ex Vivo Cytokine Profiling of Cryptococcus neoformans Strains Suggests Strain-Specific Immune Modulation: A Cross-Sectional Study
(Cureus, 2025) Kennedy Kassaza; Fredrickson B. Wasswa; Kirsten Nielsen; Joel Bazira
Cryptococcal meningitis (CM) remains a major cause of mortality among people living with human immunodeficiency virus (HIV), especially in sub-Saharan Africa. The interplay between fungal genotype and host immune response is critical in determining disease outcome. We conducted ex vivo cytokine profiling using peripheral blood from HIV-positive and HIV-negative adults stimulated with heat-inactivated whole cell antigens from two Cryptococcus neoformans strains: the reference strain H99 and the genetically distinct UgCl377 clinical strain. These strains differ at multiple loci, including the CNAG_04922 gene. Luminex based quantification revealed that H99 induced significantly higher levels of CD40-ligand, IL-10, IL-12p70, IL-13, IL-15, and IL-33. These cytokines reflect pro-inflammatory, Th2, and regulatory responses, suggesting robust immune activation. In contrast, the UgCl377 strain elicited a dampened cytokine profile. While this study does not isolate the effect of CNAG_04922 alone, it demonstrates that whole-cell antigens from genetically distinct strains of C. neoformans elicit differential cytokine responses. These findings provide a foundation for future mechanistic studies using purified proteins or isogenic strains.
Impact of Transcutaneous Auricular Vagus Nerve Stimulation on Spatial Learning and Memory in Acrolein-Induced Alzheimer’s Disease-Like Hippocampal Neuronal Damage in Wistar Rats
(Cureus, 2025) Ronald Kamoga; Godfrey Z. Rukundo; Samuel Kalungi; Johnes Obungoloch; Celestino Obua; Amadi Ihunwo
Background: Data about the utility of vagus nerve stimulation (VNS) as a potential therapy for neurodegenerative disorders are still inconclusive. We used a rat model of acrolein-induced hippocampal neurodegeneration to investigate the effect of VNS on spatial learning and memory. Methods: A total of 24 Wistar rats were randomly allocated to one of the four groups: no acrolein exposure (n = 6), control (n = 6), sham (n = 6), and experimental (n = 6). The control, sham, and experimental groups were exposed to acrolein 2.5 mg/kg/day by gastric gavage for eight weeks. After acrolein exposure, the experimental and sham groups received transcutaneous auricular VNS and greater auricular nerve stimulation, respectively, under 2% isoflurane anesthesia for four weeks. Then, all animal groups were assessed for spatial learning and memory in a Morris water maze before being euthanized for hippocampus histological examination. Results: The mean time to find the hidden platform varied significantly between the no acrolein exposure group and each of the acrolein-exposed groups. The results of one-way ANOVA indicated a significant difference in the average swimming time between the four study groups (F = 14.64, p < 0.001). Results from the post-hoc analysis indicated that the mean difference was statistically significant between the “no “experimental” groups (p = 0.001), and between the “control” and “sham” groups (p < 0.001). There was no statistically significant difference in swimming time to find the hidden escape platform between the sham and experimental groups (p = 0.060). Conclusion: Transcutaneous auricular VNS has no significant effect on spatial learning or memory in Wistar rats with acrolein-induced hippocampus neuronal damage, indicating the need to review the long-standing notion that hippocampal neuronal loss causes spatial navigation deficits.
Antimicrobial Resistance in Clinical Neisseria gonorrhoeae Isolates at Regional and National Referral Hospitals in Uganda
(PSM Microbiology, 2025-05-31) Were Jackson; Nalumaga Pauline Petra; Twinomugisha Phiona; Busingye Jude; Joel Bazira
Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a growing global health challenge, particularly in sub-Saharan Africa yet data in Uganda remain limited. This cross-sectional study analyzed 54 clinical isolates of N. gonorrhoeae collected between July 2019 and June 2021 from three referral hospitals in Uganda. Phenotypic resistance patterns were determined using the Kirby-Bauer disc diffusion method, while genotypic analysis employed PCR to detect resistance-associated mutations in the penA, gyrA, and parC genes. Resistance was highest to Penicillin (100%) and Tetracycline (98.15%), followed by Ciprofloxacin (87.04%). In contrast, lower resistance rates were observed for Cefixime (33.33%) and Cefoxitin (28.26%). Genotypic analysis revealed the penA gene in 66.7% of isolates, making it the predominant genetic determinant of resistance, while gyrA and parC were detected in 35.3% and 25.5% of isolates, respectively. Statistical analysis indicated that older adults (≥ 45 years) had the highest odds of infection (OR = 2.88, p = 0.045). These findings underscore the need for enhanced AMR surveillance and updates to treatment guidelines prioritizing Ceftriaxone and Cefixime for gonorrhea management.
Christianity and Health: A Glimpse into the Evolution of Delivery of Modern Health Services in Uganda
(Bishop Stuart University Journal of Development, Education & Technology, 2025) Gad Ruzaaza Ndaruhutse
The Bible emphasizes how Jesus came to preach to teach and to heal, that Christians would attain life in all its fullness (Mattwew 4: 23- 25). This message was internalized by the early Christian Missionaries, since they would preach the word of God, teach initially reading and writing and provide health services. This is likely why among the early missionaries were teachers, doctors, nurses and builders (Ssekamwa, 1997). It is well documented that the earliest schools and health facilities, such as Mbarara Junior School, Nsanji Primary School, Gayaza Girls School, Kings College, Budo, Kigezi high School, Mengo Hospital and Kisiizi Hospital to be built in Uganda were founded by Christian Missionaries, with most of them still thriving today (Ssekamwa, 1997). Both the schools and health facilities have since further expanded their mandate and scope; with some of the schools becoming universities, such as the Nomal School in Kabale and Bishop Stuart College and the hospitals further enriching their teaching and training aspect to become centers of excellence and schools of health sciences. Conceived partly from the lived experience, anchored in literature and testimonies of missionaries, this paper aims at tracing the evolution of Uganda’s health sector and health professions’ education from the foundations. The Christian Missionary Doctors and Nurses, resiliently pursued the establishment of modern healthcare and later health professions’ education that became the springboard for Uganda government to establish her health sector on firm ground. At Uganda’s independence in 1962, Uganda had one of the best healthcare systems in Africa. The paper proposes the deliberate need for continuing support of church – founded health initiatives for quality health service delivery to Uganda’s population.
“Too poor to migrate”: A narrative of labor migration and land fragmentation in Uganda
(Land Use Policy, 2026) Kashi Kafle; Naureen Fatema; Shahriar Kibriya; Yuanhang Wang; Ronald Twongyirwe
Land fragmentation is a growing concern among smallholders in developing countries. As families grow and split off, per-capita land size declines significantly. Fragmented land holdings can have ramifications on agricultural production and labor migration. We investigate the relationship between land fragmentation and short-term labor migration using longitudinal household data from Uganda. We collate data from four periods of the Living Standard Measurement Study – Integrated Survey in Agriculture (LSMS-ISA) between 2013 and 2020. We use the two-way fixed effects estimator to estimate the effects of land fragmentation on migration. We find that land fragmentation is negatively correlated with labor migration. The relationship is more pronounced among rural, poor, and male-headed households compared to urban, rich, and female-headed households, respectively. We also conducted Focus Group Discussions (FGDs) with members of smallholder families in Southwest Uganda to qualitatively confirm the empirical findings. Results show that the negative relationship between land fragmentation and labor migration is mediated by the negative impacts of fragmented holdings on agricultural productivity. Public policies and programs that focus on land redistribution or consolidation may want to pay close attention to the consequences of fragmented holdings on agricultural production and smallholders’ migration behavior
Resolution of signs and symptoms of illnesses among self-medicating undergraduate students of Mbarara University of Science and Technology: a cross-sectional study
(Journal of Pharmaceutical Health Care and Sciences, 2025) Ronald Mushemeza; Hannah Mwebaza; Patience Amutuhaire; Diana Nakwanyi; Silvano Samba Twinomujuni; Silas Ojuka
Introduction: Self-medication(SM) is highly prevalent among university students in Uganda, This poses various challenges to the local healthcare system and the nation at large. SM is notorious for its undesirable effects like adverse drug events, drug addiction, antimicrobial resistance, progression of disease to more complicated forms, prolonged morbidity and death. However, some studies have documented reports of resolution of signs and symptoms among self-medicating individuals. This study purposed to investigate the association between patterns of SM and resolution of signs and symptoms among undergraduate students enrolled at Mbarara University of Science and Technology (MUST). Methods: A descriptive cross-sectional study was conducted at Mbarara University of Science and Technology in Uganda from February 2024 to April 2024. A physical close-ended self-administered questionnaire was used to collect data from respondents. Analysis was done using SPSS version 25. The patterns of SM and the proportion of respondents who reported resolution of signs and symptoms were analysed and presented using descriptive statistics. Pearson’s Chi-square was performed to analyse the association between patterns of SM and resolution of signs and symptoms at the significance level of P<0.05. Results; Out of 387 respondents, the prevalence of self- medication was 71.1% (275/387). Majority of respondents who self-medicated, 85.1% (234/275), reported resolution of signs and symptoms of their illnesses. Most respondents who self-medicated were treating cough, 65.1% (179/275), and headache, 58.5% (161/275). Most of them used cough medications, 63.3% (174/275), and over-the-counter pain relievers, 51.3% (141/275). In the current study there was a statistically significant association between resolution of signs and symptoms and; having cough, (X2 (1, N=178) =3.851, p=0.050), having sore throat, (X2 (1, N=64)=4.983, p=0.026), and use of cough or cold remedies, (X2 (1, N=173)=5.668, p=0.017) Conclusion: The findings of the current study are suggestive of the popularity of SM among students attending university in sub-Saharan Africa. This study also brings to light the significance of SM to the health care of this population. However, the convenience of resolution of signs and symptoms could mask looming dangers of SM that should be seriously considered by all stakeholders of public health.
Counselling and depressive symptoms in older adults with HIV/AIDS in mbarara, Uganda
(BMC psycholog, 2025) Jordan Mutambi Amanyire; Irene Aheisibwe; Ronald Asiimwe; Godfrey Zari Rukundo
Background: Depression is a mood disorder characterized by persistent low mood, loss of interest, hopelessness, sleep disturbances, difficulty concentrating, and low self-esteem. Among people living with HIV (PLWH), depression is linked to poor psychological and medical outcomes, including lower quality of life, higher viral load, and increased mortality risk. Various psychotherapy methods, such as cognitive behavioral therapy (CBT), interpersonal psychotherapy, group counselling, and rational emotive behavior therapy (REBT), have been used to treat depression. Counselling, an interpersonal process between a client and a counselor, has been shown to reduce stress, anxiety, and hopelessness among PLWH. This study assessed the role of counselling on reducing depressive symptoms in older adults with HIV/AIDS in Mbarara, Uganda. Methods: We recruited 265 older adults (mean age 64.2±5.1 years; 150 women, 115 men) receiving HIV/ AIDS services at four care centers. The Patient Health Questionnaire assessed depression levels, while additional questionnaires evaluated the frequency and perceived benefits of counselling. Reported benefits included improved self-esteem, better illness management, reduced stigma, increased medication adherence, and financial empowerment. Logistic regression was used to analyze the relationship between counselling and depression, with a significance level set at 5%. We used stepwise logistic regression to select the final model, with a p-value threshold of 0.05 for variable inclusion and p-value of 0.10 for variable retention. Findings: Most participants (216; 83.4%) reported that counselling helped them cope with their illness, reducing their likelihood of depression. Factors associated with counselling and depression included lack of home visits (AOR=2.54, 95% CI 1.57–13.07, p=0.019) and infrequent counselor interactions (AOR=1.24, 95% CI 1.09–3.84, p=0.014). Conclusion: Regular home visits and counselling are associated with significant reductions in depressive symptoms among older adults living with HIV/AIDS. Incorporating home-based counselling services and regular home visits can enhance the well-being of this population.
Effects of educational intervention on knowledge of Full Outline of Un Responsiveness score among health workers in uganda: a quasi -experimental pilot study
(BMC Medical Education, 2025) Obongo Tom; Kinkuhaire Betty; Tibaijuka Leevan; Kaddumukasa Mark; Nantongo Hanifah
Background: The Full Outline of Un-Responsiveness (FOUR) score is a new and better coma grading scale in critically ill patients. However, there is a paucity of data on its knowledge among health workers in sub-Saharan Africa. This study assessed the effects of an educational intervention on knowledge of FOUR Score among health workers at a Regional Referral Hospital in Southwestern Uganda. Methods: This was a one-group quasi-experimental study among conveniently sampled health workers attending to critically ill patients. Using a pretested questionnaire, data was collected pre and post intervention. Participants with low and moderate pre-test knowledge attended a theory session of 45-minutes and hands on sessions using the FOUR Score reference chart for one week, on ward. The post-test data was collected for all trained participants seven days after training. Data was analysed using STATA-17. Results: Of the 146 health workers (HWs) recruited, 50.7% and 45.2% were nurses and doctors, respectively. Over 113 (77.0%) were degree holders and 114 (78.1%) had no prior FOUR Score training. The median knowledge score was 8 (34.8%) and 19 (82.6%) in the pre- and post-test, respectively. A Wilcoxon Signed-Rank test showed a significant knowledge score difference in the median pre- and post-test (Z=10.4; p<0.001). Higher level of education (X2 [1]=10.3, P=0.016), working in ICU (X2 [2]=13.8, P=0.001), and prior FOUR Score training (Z=6.3, P<0.001) were significantly associated with high pre-test knowledge score but were not significant in the post-test. Conclusion: This educational intervention was effective in increasing the knowledge of health workers regarding the FOUR score, indicating that it can be easily learned and mastered. When properly done, this intervention could potentially improve the management of critically ill patient in similar (low- and middle-income countries) settings.
Generalized anxiety disorder and major depressive disorder among healthcare professionals in Mbarara city, southwestern Uganda: the relationship with professional quality of life and resilience
(BMC Public Health, 2025) Joan Abaatyo; Alain Favina; Margaret Twine; Dan Lutasingwa; Rosemary Ricciardelli; Godfrey Zari Rukundo
Background: Marking the lives of healthcare professionals (HCPs) are tensions arising from the conflict between fulfilling their duty of care and the demands of the healthcare setting, creating concern for HCPs’ mental. In our study, we aim to determine the prevalence of major depressive disorder (MDD) and generalized anxiety disorder (GAD) among HCPs in Southwestern Uganda and to establish how the disorders’ prevalence affects professional quality of life and resilience. Method: In total, 200 HCPs from two health facilities (one private and one public) in Southwestern Uganda enrolled in an analytical cross-sectional study. We used the Patient Health Questionnaire-9 (PHQ-9) to determine MDD, the Generalized Anxiety Disorder-7 (GAD-7) to determine GAD, the Professional Quality of Life Scale-5 (ProQOL-5) to determine professional quality of life and the Nicholson McBride Resilience Questionnaire (NMRQ) to determine resilience. Results: The prevalence of MDD was 11.0% and of GAD was 14.5%. High compassion fatigue increased the likelihood of MDD [aPR=3.38, pvalue<0.001]. However, high compassion satisfaction and exceptional resilience reduced the likelihood of GAD i.e., [aPR=0.50, pvalue<0.001] and [aPR=0.50, pvalue<0.001] respectively. Being male [aPR=2.41, pvalue=0.005] and being married [aPR=1.79, pvalue=0.017] increased the likelihood of having MDD. The likelihood of GAD among HCPs decreased with age, [aPR=0.97, pvalue=0.022]. Conclusion: There is a significant occurrence of MDD and GAD among healthcare professionals (HCPs) in Southwestern Uganda. Compassion fatigue is linked to an elevated prevalence of MDD, while compassion satisfaction and high resilience scores are associated with a reduced prevalence of GAD. We recommend creation and execution of extensive mental health initiatives designed for HCPs.
Prevalence of, and Factors Associated with Hemodynamic Instability Among Women Presenting with Incomplete Abortion at a Tertiary Hospital in Southwestern Uganda
(International Journal of Women's Health, 2025) Caxton Kakama; David Collins Agaba; Onesmus Byamukama; Rogers Kajabwangu; Elizabeth Kengonzi; Mathiang Agany Akol; Amos Muhumuza; Julius Businge; Stuart Turanzomwe; Brenda Ainomugisha; Kato Paul Kalyebara; Musa Kayondo; Joseph Ngonzi; Wasswa George Muganwa; Henry Mark Lugobe
Background: Sub-Saharan Africa has a high abortion case-fatality rate, and most of these maternal deaths are due to hemodynamic instability which results from hemorrhage, especially in cases of incomplete abortion. Timely identification and management of hemodynamic instability is an important strategy for addressing the morbidity and mortality associated with incomplete abortion. This study, therefore, aimed at determining the prevalence and factors associated with hemodynamic instability among women presenting with incomplete abortion at Mbarara Regional Referral Hospital (MRRH). Methods: We conducted a cross-sectional study at the gynaecology ward of MRRH from January 2024 to April 2024. We consecutively enrolled women with incomplete abortion and collected data on socio-demographic, abortion- and medical-related factors, and measured their blood pressure and heart rate at admission. Obstetric shock index (OSI), the ratio of the heart rate to systolic blood pressure, was used as a measure of haemodynamic stability. A participant whose OSI was ≥0.9 was considered haemodynamically unstable. We performed a modified Poisson regression analysis to determine the factors associated with hemodynamic instability. Results: A total of 137 women with incomplete abortion were enrolled in this study with a mean age of 26.3 (±5.93) years. The majority of the participants had first-trimester abortions (65.7%), were married (70.8%), and were from rural areas (60.0%). The prevalence of hemodynamic instability was 41.6% (95% CI: 33.6–50.1). At multivariable regression analysis, gestation age ≥13 weeks (aPR 1.67, 95% CI: 1.12–2.49) and post-abortion infection (aPR 1.75, 95% CI: 1.18–2.60) were significantly associated with hemodynamic instability. Conclusion: Approximately two in every five women with incomplete abortion at MRRH were hemodynamically unstable at admission during the study period. Women with second trimester abortion and those with post-abortion infection are more likely to present with hemodynamic instability. We recommend strengthening routine assessment and management of hemodynamic instability among women with incomplete abortion