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

MUST-IR preserves research output from the MUST Community

Communities in MUST-IR

Select a community to browse its collections.

Now showing 1 - 10 of 10

Annual Research Dissemination Conference 3
Central Administration 124
This community will contain collections from the general Administrative staff
Faculty of Applied Sciences and Technology 59
Faculty of Business and Management Sciences 113
Faculty of Computing and Informatics 142
Faculty of Interdisciplinary Studies 215
Faculty of Medicine 2327
Faculty of Science 551
Institute of Tropical Forest Conservation 127
Maternal Newborn and Child Health Institute 18

Recent Submissions

Aetiology, outcomes, and in-hospital mortality predictors of suspected paediatric central nervous system infections in southwestern Uganda: a prospective cohort study
(The Lancet Regional Health–Africa, 2026) Phuthumani Mlotshwa; Elias Kumbakumba; Dan Nyehangane; Reza Rast; Richard Migisha; Milly Nassejje; Deborah Nanjebe; Yap Boum II; Juliet Mwanga-Amumpaire; Tobias Alfvén; Giulia Gaudenzi
Background: Central nervous system (CNS) infections remain a major cause of paediatric morbidity and mortality in sub-Saharan Africa. We aimed to describe the aetiology and outcomes of paediatric CNS infections in southwestern Uganda and identify predictors of in-hospital mortality. Methods: Children aged 0–12 years with suspected CNS infections were recruited upon admission and followed until discharge, transfer, or death between January 2019 and September 2020 at two major hospitals in southwestern Uganda. Blood and cerebrospinal fluid (CSF) underwent routine diagnostics and BioFire FilmArray ME Panel testing. We used modified Poisson regression with robust variance to identify predictors of in-hospital mortality. Findings: Among the 212 children enrolled, in-hospital mortality was 15% (95% CI: 11–20%), while 18% (95% CI:13–23%) were discharged with neurological sequelae. At admission, delayed capillary refill (adjusted risk ratio[aRR] = 5.9; 95% CI: 1.8–20), symptomatic anaemia (aRR = 2.7; 95% CI: 1.1–7.0), and elevated peripheral white blood cell count (aRR = 3.3; 95% CI: 1.8–6.1) were independently predictive of fatal outcomes. Plasmodium species were detected in 20% (n = 42) of cases, and HHV-6 in 9% (n = 19), including instances of co-infection. Among bacterial pathogens in CSF, Streptococcus pneumoniae (11/24) was the most frequently identified, followed by Haemophilus influenzae (4/24) and Neisseria meningitidis (4/24). Interpretation: Despite advances in infectious disease control, children with suspected CNS infections in south western Uganda continue to experience high mortality and neurological sequelae. Strengthened prevention, rapid diagnostics, and simple bedside markers such as delayed capillary refill, symptomatic anaemia, and elevated WBC count could enable earlier risk stratification and improved outcomes in low-resource settings.
Heat Stress and Occupational Health in a Changing Climate: A Brief Report on Brick Kiln Workers in Uganda
(African Journal of Public Health and Health Systems, 2026) Nakato Nalwoga; Okello Otieno; Musa Kato
This brief report addresses the critical occupational health challenge of heat stress among outdoor workers in Africa, exacerbated by climate change. Focusing on Uganda's brick kiln industry, it investigates the physiological impacts and health perceptions of workers within this heat-intensive informal sector. A cross-sectional study was conducted in 2024 across multiple kiln sites in Central Uganda. Data were collected through structured interviews assessing self-reported health symptoms and environmental heat exposure, complemented by direct wet-bulb globe temperature (WBGT) measurements. Findings indicate that over 87% of workers experienced heat-related illnesses, including excessive fatigue, dizziness, and muscle cramps, during the 2023-2024 working year. WBGT readings consistently exceeded internationally recommended exposure limits for heavy labour. Crucially, despite high morbidity, awareness of heatstroke as a medical emergency was low, and adaptive practices were largely informal and inadequate. The study underscores that climate change constitutes a direct occupational health hazard, disproportionately impacting vulnerable informal labour forces. It argues for the urgent integration of evidence-based heat health protection such as revised work-rest schedules and targeted health education into national occupational safety and climate adaptation policies. This report provides essential evidence for policymakers to develop interventions that safeguard this critical workforce on a warming continent
A Mediation Analysis of Sex Motives in the Locus of Control-Risky Sexual Behaviour Nexus among Students in Ugandan Universities
(THE UGANDA HIGHER EDUCATION REVIEW, 2025) Winfred Biribonwa Kyosaba; David Kani Olema; Aloysius Rukundo
This study investigates the psychological and behavioural dynamics influencing risky sexual behaviours (RSBs) among young adults in Ugandan universities during their critical transition to adulthood. A quantitative research design was employed using a self-administered questionnaire to examine the interplay between locus of control (LOC), sex motives (SMs), and risky sexual behaviours (RSBs) among 527 randomly selected students (250 males, 277 females) from four universities in Uganda. Results indicated that 78.2% of participants exhibited a strong external LOC, correlating with heightened RSB engagement (65.7%), including unprotected sex (38.3%), multiple partners (26.4%), early sexual debut (12.1%), and homosexual practices (7.8%). While sexual motives were generally moderate (e.g., intimacy, coping), peer approval emerged as notably low (M = 9.08, SD = 4.26). Mediation analysis revealed that SMs – particularly self-affirmation and partner approval – significantly mediated the LOC-RSB relationship (R² = 20%, p < 0.02), suggesting that students with external LOC often engage in RSBs to fulfil psychological needs. These findings align with the Theory of Planned Behaviour (TPB), emphasising how perceived behavioural control and intrinsic motivations shape sexual decision making. The study highlights the need for targeted interventions, including (1) empowerment programmes to cultivate internal LOC and self-efficacy, (2) peer-led education addressing normative beliefs about sex motives, and (3) youth-friendly health services to improve access to contraceptives and counselling. By integrating psychological and social determinants, universities can mitigate RSB risks and promote sexual health
Family Functioning and its Association with Alcohol Use Disorder among Adolescents in Southwestern Uganda: A Cross-Sectional Study
(Adolescence, 2026) Novatus Nyemara; Aloysius Rukundo; Richard Merkel; Elialilia S. Okello
This study investigates the association between family functioning and the severity of alcohol use disorders (AUD) among adolescents in Southwestern Uganda. Focusing on dimensions such as family cohesion, adaptability, communication, and satisfaction, the research explores how familial relationships and sociodemographic factors influence adolescent alcohol use. A cross-sectional study was conducted from September to December 2019 in Ibanda District, involving 308 adolescents aged 10 to 19 years. Participants were selected through multistage sampling, and data were collected using the Alcohol Use Disorders Identification Test (AUDIT) and the Family Adaptability and Cohesion Evaluation Scale IV (FACES IV). Ordered logistic regression was used to assess predictors of AUD severity. The findings revealed that 21.1% of participants were classified as hazardous drinkers, 9.1% as harmful drinkers, and 9.7% as dependent drinkers. Higher levels of family cohesion were associated with increased odds of more severe AUD classification (OR = 1.14, p<0.001), suggesting possible enabling or permissive dynamics in certain family contexts. In contrast, higher levels of adaptability (OR = 0.79, p<0.001) and satisfaction (OR = 0.82, p= 0.003) were protective against severe alcohol use. Additionally, lower household income, non-nuclear living arrangements, and unstable family structures were significantly associated with greater AUD severity. These findings underscore the critical role of family dynamics and socioeconomic conditions in shaping adolescent alcohol use behaviours. The study highlights the need for family-centred and context sensitive interventions that strengthen adaptability and satisfaction within the family unit, while also addressing underlying structural vulnerabilities.
Alcohol Use Disorder in Southwestern and Northern Uganda: Prevalence and associated factors
(PLOS Global Public Health, 2026) Abraham Muhwezi; Tom Murungi; Pius Musinguzi; Davis Akampumuza; Mary Samantha; Moses Ocan; Henry Ochola; Godfrey Zari Rukundo; Samuel Maling; Edith K. Wakida; Celestino Obua
Alcohol use disorder (AUD) among adults is a major public health concern globally. Alcohol use disorder affects livelihood and contributes to adverse health outcomes. We investigated the prevalence of AUD and associated factors among adults (≥ 18years) in Lira and Isingiro districts in Uganda. This was a cross-sectional study conducted among adults (≥18 years) in households, selected using multistage sampling. Data were collected using an interviewer-administered questionnaire and the Alcohol Use Disorder Identification Test (AUDIT) tool. Data were downloaded from the Kobo Toolbox interface into Microsoft Excel and then exported to STATA version 17 for cleaning and analysis. A total AUDIT score of eight or more was used to define AUD. Binary Logistic regression was used to analyze factors independently associated with AUD at a 95% confidence level. A total of 577 participants were recruited in the study, with a median age of 35 years (IQR: 26–46). Half, 50.8% (293/577) of the participants were male. Over a third, 39.9% (230/577) of the participants had AUD. Factors significantly associated with AUD were; being male (aOR = 8.01; 95% CI: 5.02–12.76), age group of 31–50 years (aOR = 2.00; 95% CI: 1.21–3.33), secondary level education (aOR = 0.63; 95% CI: 0.21–0.78), having family members who use alcohol (aOR = 4.09; 95% CI: 2.54–6.59), use of other substances (aOR = 1.79; 95% CI: 1.10–2.92), and presence of major stressors (aOR = 3.58; 95% CI: 2.22–5.78). Alcohol use disorder was highly prevalent among adults in Uganda. Being male, age, use of other substances of abuse, and alcohol use among family members were significantly associated with AUD. The Ministry of Health and other key stakeholders should prioritize AUD, strengthen the regulation of alcohol use in the country, and provide rehabilitation for individuals with AUD.
Integrating ESG Accounting in Higher Education: A Longitudinal Case Study at Mbarara University of Science and Technology, Uganda
(THE UGANDA HIGHER EDUCATION REVIEW, 2025) Charles Tushabomwe-Kazooba; Imelda Kemeza; Robinah Florah Nakakeeto; Prinari Behangana; Winfred Aliguma; Robert Stalone Buwule; Achilles Byabashaija
Despite increasing recognition of environmental, social, and governance (ESG) considerations among Uganda’s government ministries, departments, and agencies (MDAs), public universities in the country still lack a systematic and transparent framework for managing ESG-related issues. This gap weakens institutions’ capacity for sustainability engagement and undermines accountability mechanisms. The study asks: To what extent do national regulations and global standards shape ESG implementation in higher education (HE) institutions? This study employed a longitudinal case study design of Mbarara University of Science and Technology (MUST), a public university in Uganda, to examine financial reports, institutional records, and policy documents covering the 2020/2021 to 2024/2025 financial years (FYs). Five ESG-related themes and their corresponding sub-themes emerged from the analysis and were subsequently examined in greater depth. The study also included insights from 172 students and 18 faculty members, gathered through interviews and a questionnaire. Overall, the findings indicate that ESG accounting at MUST is still in its early stages, marked by weak categorisation and limited institutional integration. The study addresses a critical gap in research on ESG accounting. Aligned with the National Development Plan IV (NDP IV) and Sustainable Development Goal 4, it promotes inclusive and equitable quality education while advocating for ESG issues to be embedded in university governance, strategic planning, management, and accountability frameworks. This study concludes by advancing an ESG accounting framework that operationalises sustainability reporting within the HE sector.
Malaria attributable to one-third of anemia cases among febrile children in Eastern Uganda: A cross-sectional study
(Journal of Hematology and Allied Sciences, 2026) Benson Okongo; Enoch Muwanguzi; Daisy Asiimwe; Robert Wagubi; Elizabeth Alfred John; Clinton Olong
Objectives: The study aims to determine the Prevalence of anemia and its association with malaria infection among febrile children under 15 years at Bududa General Hospital, Eastern Uganda. Material and Methods: A hospital-based cross-sectional study was conducted among 347 febrile children between April and June 2023. Venous blood samples were collected for complete blood count and malaria microscopy. Stool samples were examined for intestinal helminths. A structured questionnaire was used to collect sociodemographic data. Multivariate logistic regression was used to identify factors associated with anemia. A P ≤ 0.05 was considered statistically significant. Results: The overall Prevalence of anemia was 225 (64.8%). The Prevalence of malaria parasitemia was 162 (46.7%), with Plasmodium falciparum as the dominant species (83.3%). Multivariate analysis revealed that malaria infection (adjusted odds ratio [aOR] = 8.24; 95% confidence interval [CI]: 3.63–18.70; P < 0.001), children aged 1–5 years (aOR = 0.24; 95% CI: 0.08–0.72; P = 0.011) and 6–10 years (aOR = 0.19; 95% CI: 0.05–0.66; P = 0.009) and a parent/guardian with secondary education (aOR = 0.40; 95% CI: 0.20–0.82; P = 0.012) were associated with anemia. The Prevalence of intestinal helminths was low (2.9%) and not associated with anemia. Conclusion: This study links a high anemia rate in febrile children to malaria, particularly affecting infants and those with less-educated caregivers, necessitating combined malaria and nutrition interventions.
Association Between Neutrophil-to-Lymphocyte Ratio and Vitamin D Deficiency in Patients With Sickle Cell Disease: A Cross-Sectional Study in Central Uganda
(Cureus, 2026) Enoch Muwanguzi; Jazira Tumusiime; Geofrey Salamu; Charles Nkubi Bagenda; Benson Okongo
Background: Vitamin D deficiency and chronic inflammation are prevalent in individuals with sickle cell disease (SCD), contributing to disease severity. Hematological ratios are simple inflammatory markers that can have various clinical outcomes. The main aim of our study was to assess the association between hematological ratios and vitamin D deficiency among patients with SCD in Central Uganda. Methods: We conducted a cross-sectional study among patients with SCD attending Mengo Hospital, Central Uganda. Data were collected using a researcher-administered questionnaire supplemented with information from participants’ medical records. Anthropometric measurements were taken, and a blood sample was drawn for laboratory measurement of hematological parameters and serum vitamin D levels. Results: Out of the 213 participants, 101 (47.4%) had serum 25-hydroxyvitamin D (25(OH)D) concentrations <20 ng/mL, indicating vitamin D deficiency, while 68 (31.9 %) had levels between 20-30 ng/mL, consistent with vitamin D insufficiency. Participants with vitamin D deficiency had a higher neutrophil-to-lymphocyte ratio (NLR) (0.27, IQR: 0.13-0.88) compared to those without vitamin D deficiency (0.22, IQR: 0.10-0.63), although the difference was not statistically significant (p=0.45). However, after adjusting for potential confounders, both the second (adjusted prevalence ratio (aPR)=1.83; 95% CI: 1.25-2.68; p=0.002) and third tertiles (aPR=1.74; 95% CI: 1.04-2.91; p=0.033) of the neutrophil-to-lymphocyte ratio were significantly associated with increased prevalence of vitamin D deficiency. Conclusions: Vitamin D deficiency is prevalent among patients with SCD in Central Uganda. High NLR is potentially associated with vitamin D deficiency among patients with SCD.
An Exploration of Locus of Control Levels among Young Adults in Ugandan Universities
(East African Journal of Education Studies, 2025) Winfred Biribonwa Kyosaba; David Kani Olema; Aloysius Rukundo
This study examines locus of control (LOC) orientations among Ugandan university students, investigating how control beliefs influence their behavioural patterns. Employing a concurrent mixed-methods design, we surveyed 527 students (250 males, 277 females) across four institutions and conducted focus group discussions with peer educators and student leaders. The results demonstrated a predominant external LOC orientation (78.2%), with only 21.0% exhibiting combined external-internal LOC. Significant variations emerged across demographic factors: female students and hostel residents showed stronger external LOC tendencies compared to their male and privately accommodated counterparts. Religious affiliation also influenced LOC patterns, though to a lesser degree. These findings substantiate key propositions of the Theory of Planned Behaviour, particularly regarding the relationship between external LOC and increased vulnerability to risky behaviours stemming from diminished perceptions of personal agency. The study reveals how socioeconomic constraints and institutional environments in Uganda's higher education system shape students' control beliefs. Notably, the near-absence of purely internal LOC contrasts with Western studies, suggesting cultural and contextual influences on control orientations. Based on these insights, we propose targeted interventions including university-based empowerment programs, peer mentorship initiatives, and life skills training to cultivate internal LOC attributes. Such measures could enhance students' self-efficacy and promote more adaptive decision-making. The findings contribute to both theoretical understanding of LOC in collectivist educational contexts and practical approaches to student development in resource-constrained settings.
Prevalence of Risky Sexual Behaviours among Young Adults attending Urban Universities in Uganda
(East African Journal of Education Studies, 2025) Winfred Biribonwa Kyosaba; David Kani Olema; Aloysius Rukundo
Risky sexual behaviours (RSBs) among young adults are a worry in Ugandan Universities. These are actions that heighten the likelihood of acquiring Human immunodeficiency virus (HIV), other Sexually Transmitted Infections (STIs), and unintended pregnancies among young adults. This study examined the prevalence and forms of RSBs among young adults in Ugandan universities. The research targeted students aged 18–25 years from 4 universities in Kampala. A mixed methods concurrent design was employed, involving 527 randomly selected students. Quantitative data were collected using a structured self-administered questionnaire, while qualitative insights were obtained through focus group discussions with peers and student leaders. Quantitative data were analysed using SPSS Version 23 to generate frequencies and percentages, whereas qualitative data were interpreted using Interpretative Phenomenological Analysis. Findings indicated that 346(65.7%) students had previously engaged in sexual activity, and 330(62.6%) were sexually active at the time of the study period. Male students were more likely to engage in RSBs 185(74.0%) compared to females 16(58.1%). With over 60% of participants actively involved in RSBs, the prevalence highlights significant exposure to STIs, including HIV, and unintended pregnancies. The study concluded that RSBs were highly prevalent among young adults in Ugandan universities. The study recommends urgent targeted interventions, including comprehensive peer-led sexual and reproductive health education and the establishment of youth-friendly health services like contraceptive clinics. These measures would empower students with the knowledge, skills and resources to reduce RSBs and improve their sexual health outcomes.
Unexpected detection of Mycobacterium tuberculosis DNA in US-born patients in putative association with clinical syndromes
(Nature Communications, 2026) Edward C. Jones-López; Nancy S. Miller; Beverley Orr; Laura F. White; Solange Vinhas; Moses Mpeirwe; Patrick Orikiriza; Juliet Mwanga-Amumpaire; Moises Palaci; Reynaldo Dietze; Yap Boum II; Guillermo Madico
Sequential inflammatory stages characterizing early tuberculosis (TB) disease and reports of differentially culturable M. tuberculosis have compounded existing gaps in the detection of paucibacillary TB disease, threatening global elimination goals. Here we report unanticipated results we encountered while conducting early development work for an ultrasensitive molecular TB assay that has been validated in various cohorts of patients with suspected TB disease. Detection of M. tuberculosis DNA (TB-DNA) was confirmed by an alternate molecular target and sequencing. Over a six-year period, we conducted three separate clinical studies (N = 297) that tested two sets of anonymized respiratory samples from patients hospitalized in two Boston hospitals, and a longitudinal observational study to determine clinical associations and outcomes. We found an unexpectedly high prevalence of TB-DNA in US-born patients and a potential association with acute chest syndrome in patients with sickle cell disease. These results are preliminary and will require further study in prospective studies that include clinical, radiological, immunological, and microbiological correlation.
The Incidence of Hemolytic and Serologic Transfusion Reactions Among Patients with Hematological Malignancies at Mbarara Regional Referral Hospital and the Uganda Cancer Institute, in Uganda
(Journal of Blood Medicine, 2026) Ivan Mugisha Taremwa; Nixon Niyonzima; Scholastic Ashaba; Deusdedit Tusubira; May Y Choi; Craig N Jenne; Guido van Marle; Bernard Natukunda
Background: Blood transfusions are essential in the supportive care of patients with hematological malignancies but carry a risk of adverse reactions. Data on the incidence of transfusion reactions remain scarce in Uganda. This study evaluated the incidence of hemolytic and serologic transfusion reactions among patients with hematological malignancies at Mbarara Regional Referral Hospital and the Uganda Cancer Institute in Uganda. Materials and Methods: This prospective cohort study enrolled hospitalized patients aged ≥2 years with hematological malignancies and a history of prior red blood cell (RBC) transfusions. Participants received additional transfusions and were monitored for up to 14 days. Blood samples were collected on day 0 (transfusion day), days 7, and 14 to assess hemoglobin (Hb) levels, lactate dehydrogenase (LDH), and perform direct and indirect antiglobulin tests. Participants’ medical records were also reviewed for transfusion and pregnancy histories. Repeated Measures-Analysis of Variance was used to compare mean Hb and LDH levels over time points. Results: Of the 467 participants enrolled (median age: 36.4 years, interquartile range: 27.3–46.9), 382 completed the follow-up period. A progressive increase in mean Hb levels (g/dL) was observed: 6.6 (95% confidence interval [CI]: 6.1–8.9) on day 0, 7.5 (7.3–10.1) on day 7, and 8.9 (8.4–10.6) on day 14. No acute or delayed hemolytic reactions occurred. The incidence of delayed serologic transfusion reactions (DSTRs) was 0.86 in 100 (95% CI: 0.02–1.69), while the overall RBC alloantibody prevalence was 2.4% (95% CI: 0.98–3.74). The identified alloantibodies were directed against antigens in the Rh, Kell, Lewis, and MNS group systems. Conclusion: Despite a low incidence of DSTRs, a notable prevalence of RBC alloimmunization was observed among patients with hematological malignancies. These findings underscore the need to strengthen pre-transfusion antibody testing to prevent hemolytic complications and improve transfusion outcomes in this population.
Prevalence and associated factors of chorioamnionitis among women with preterm premature rupture of membranes at Mbarara Regional Referral Hospital, Southwestern Uganda
(BMC Pregnancy and Childbirth, 2026) Ochuga Patrick Olanya; Richard Migisha; Yarine Fajardo; Onesmus Byamukama; Musa Kayondo; Godfrey R. Mugyenyi; Joseph Ngonzi; Hamson Kanyesigye; Anisa Salad; Begumana Daniel; Mohamed Bashir; Kasyeba Sowed; Byaruhanga Norbert Musisi; Anyit Moses; Adupa Emmanual; Etwop Patrick; Leevan Tibaijuka
Background: Chorioamnionitis is a frequent complication of preterm premature rupture of membranes (PPROM) and contributes substantially to adverse maternal and neonatal outcomes. However, data on the burden and determinants of chorioamnionitis among women with PPROM in resource-limited settings, including Uganda, are limited. This study determined the prevalence and factors associated with chorioamnionitis among women admitted with PPROM at a regional referral hospital in southwestern Uganda. Methods: This hospital-based cross-sectional study was conducted from December 2024 to April 2025 among pregnant women admitted at 26 weeks to 36 weeks and 6 days of gestation, with a diagnosis of PPROM. Consecutive sampling was used to enroll participants. Data were obtained through structured interviews, review of clinical records, and laboratory investigations, including microbiological culture, to capture sociodemographic, obstetric, medical, and clinical information. Chorioamnionitis was defined as maternal fever (≥38 °C) with at least one additional clinical or laboratory sign (uterine tenderness, foul-smelling amniotic fluid, maternal or fetal tachycardia, leukocytosis, or elevated C-reactive protein) and a positive cervical or posterior fornix culture used to detect intra-amniotic infection. Associations were assessed using modified Poisson regression to estimate adjusted prevalence ratios (aPRs) with 95% confidence intervals. Results: A total of 324 women were enrolled with a mean age of 26.56 (±5.86) years. Most of the women had primary or no education (69.8%), and were unemployed (65.7%). The prevalence of chorioamnionitis was 39.8% (n=129/324, 95% Confidence Interval [CI]: 34.6–45.3%). The factors independently associated with chorioamnionitis were duration of PPROM (≥4 days) (aPR=5.85, 95% CI: 2.68–12.78) and undergoing≥4 digital vaginal examinations (aPR=3.25, 95% CI: 1.51–6.70). Conclusion: Chorioamnionitis was common, affecting approximately four in ten women with PPROM at MRRH, which may be influenced by delayed presentation and initiation of prophylactic antibiotics. Prolonged duration of membrane rupture and multiple digital vaginal examinations were associated with increased prevalence of chorioamnionitis. These findings underscore the importance of preventive practices during expectant management of PPROM, including minimizing unnecessary digital vaginal examinations and maintaining clinical vigilance for signs of chorioamnionitis. Future studies could evaluate the maternal and perinatal outcomes of chorioamnionitis among women with PPROM in this setting.
Reducing Iatrogenic Female Genitourinary Fistula: Impact of Short-Term Obstetric Training for Lower Cadre Surgeons in Uganda
(International Journal of Women's Health, 2026) Musa Kayondo; Onesmus Byamukama; Brenda Ainomugisha; Wilson Birungi; Rogers Kajabwangu; Paul Kato Kalyebara; Christopher M Tarnay; Verena Geissbühler
Background: In Uganda, almost 50% of genitourinary fistulae are iatrogenic, primarily resulting from inadvertent urinary tract injuries during obstetric and gynecologic surgeries. Cesarean sections (CS), often performed by less experienced providers at lower level facilities, account for 70% of these cases. In 2022, the Essential Training in Operative Obstetrics (ETOO) program was introduced to improve surgical skills among lower cadre surgeons. This study evaluated the program’s impact on iatrogenic fistula incidence at a tertiary teaching hospital in southwestern Uganda. Methods: A retrospective review was conducted on women who underwent fistula repair at a tertiary teaching hospital in south western Uganda between January 2020 and December 2024. Data from the pre-training period (2020–2021) were compared with post training data (2022–2024). Fistulae were classified as iatrogenic if caused by surgical error rather than obstructed labor. Anatomical subtypes included ureteric injuries, vault fistulas, and vesico-[utero]/-cervico-vaginal fistulas. The primary outcome was the annual number and proportion of iatrogenic fistula cases. Results: Among 102 fistula cases post-training, 57 (55.9%) were iatrogenic. Most followed CS (66.7%) and involved ureteric injuries (54.3%). A significant portion (34.8%) originated from private facilities. Following ETOO implementation, annual iatrogenic cases declined from 39 in 2020 to 19 in 2024. A marked drop occurred in late 2022, aligning with program rollout. The trend slope of −5.4 suggests a steady annual decline. Conclusion: The ETOO program is associated with a notable reduction in iatrogenic fistula incidence. Expansion to private and lower-level facilities is recommended to enhance nationwide surgical safety
In Vivo Imaging With a Low-Cost MRI Scanner and Cloud Data Processing in Low-Resource Settings
(NMR in Biomedicine, 2026) Teresa Guallart-Naval; Robert Asiimwe; Patricia Tusiime; Mary A. Nassejje; Leo Kinyera; Lemi Robin; Maureen Nayebare; Luiz G. C. Santos; Marina Fernández-García; Lucas Swistunow; José M. Algarín; John Stairs; Michael Hansen; Ronald Amodoi; Andrew Webb; Joshua Harper; Steven J. Schiff; Johnes Obungoloch; Joseba Alonso
The goal of this work is to demonstrate in vivo imaging with a low-cost, low-field MRI scanner built and operated in Africa and to show how systematic hardware and software improvements can mitigate the main operational limitations encountered in low-resource environments. To this end, a 46-mT Halbach scanner located at the Mbarara University of Science and Technology (Uganda) was upgraded through a complete reorganization of grounding and shielding, installation of new control electronics, and open-source user-interface software. Noise performance was quantified using a standardized protocol and in vivo brain images were acquired with three-dimensional RARE sequences. Distortion correction was implemented using cloud-based re constructions incorporating magnetic field maps. The revamped system reached noise levels routinely below three times the thermal limit and demonstrated stable operation over multi-day measurements. Three-dimensional T1- and T2-weighted brain images were successfully acquired and distortion-corrected with remote GPU-based reconstructions and near real-time visualization through the user interface. The results show that low-cost MRI systems can achieve clinically relevant image quality when electromagnetic noise and power-grid instabilities are properly addressed. This work highlights the feasibility of sustainable MRI development in low-resource settings and identifies stable power delivery and local capacity building as the key next steps toward clinical translation.
Farmers’ social networks and adoption of disaster risk reduction measures: An experimental study in Uganda
(International Journal of Disaster Risk Reduction, 2026) Rodgers Mutyebere; Ronald Twongyirwe; John Sekajugo; Clovis Kabaseke; Mercy Gloria Ashepet; Grace Kagoro-Rugunda; Matthieu Kervyn; Liesbet Vranken
Action against the severe impacts of climate change requires strengthening the local community’s resilience to hazards such as landslides and flash floods. Therefore, improving farmers' knowledge to adopt farm-based Disaster Risk Reduction (DRR) measures is key. In addition, mountainous areas limit accessibility by external, less-facilitated government extension workers mandated for information transfer. Other informal, local social networks can play a role to promote DRR measures' adoption, but their effectiveness remains unclear. Using an experimental study involving 533 rural households, we investigated the effectiveness of different channels of information transfer: we tested whether a network of Citizen Scientists (CS) - an example of local social networks, can promote adoption of tree planting and diversion channels as DRR measures in the disaster-prone Western Uganda region. We also examined whether the CS network was more effective, than conventional outreach formal extension workers in influencing farmers' behaviour. Analyzing the treatment effect using the Analysis of Covariance, findings indicate that knowledge transfer through CS – either in one-on-one or group sessions - is more effective in enhancing tree adoption than transfer through external agents. For diversion channels, only group sessions facilitated by CS significantly increased their adoption but not the sessions by external agents or CS-facilitated one-on-one sessions. Therefore, social networks promise a bright future for knowledge transfer but may not be a ‘silver bullet’ to information access problems. Long-term impact of knowledge transfer, adoption by others in the farmers' networks, and integrating social networks like CS into the formal extension programs should be investigated.
Knowledge, attitudes, and practices of community health workers regarding Mpox in Mbarara City, Uganda, February 2025
(J. Interv. Epidemiol. Public Health, 2026) Patrick Kwizera; Richard Migisha; Hannington Katumba; Charity Mutesi; Emmanuel Mfitundinda; Owens Joyce Kobusingye; Loryndah Olive Namakula; Emmanuel Okiror Okello; Abraham Muhwezi; Dansan Atim; Ivan Lukabwe; Lilian Bulage; Benon Kwesiga; Alex Riolexus Ario
Introduction: Mpox is a re-emerging zoonotic viral disease with significant public health implications due to its potential for human-to-human transmission and outbreaks in urban areas. Community health workers (CHWs) play a critical role in surveillance, case detection, and health education; however, their preparedness for mpox control is not well documented. This study assessed the knowledge, attitudes, and practices (KAP) of CHWs regarding mpox transmission, detection, reporting, and referral in Mbarara City, February 2025. Methods: We conducted a cross-sectional study in Mbarara City, southwestern Uganda, from February 1–15, 2025. Eligible participants were CHWs aged ≥18 years with at least one year of experience. Those unavailable during data collection were excluded. Using simple random sampling, CHWs were selected from a list of all CHWs across city wards. A self-administered, researcher-developed questionnaire comprising 26 mpox-related KAP items was used. Knowledge was assessed using 11 items, attitude with 5 items, and practice with 7 items, each worth 1 point. Scores >60% were classified as good knowledge, positive attitude, or good practices. Multivariate logistic regression was used to identify KAP-associated factors. Results: Among 206 CHWs, 159 (77%) were female, and 127 (62%) had >10 years of experience. Four participants had not heard about mpox. In total, 64% (129/202) of participants had good knowledge, 90% (181/202) had positive attitudes, and seven (3%) demonstrated good practices. Regarding practices, 143 (73%) engaged in health education, 55 (28%) referred suspected cases, and 51 (26%) consistently reported to health authorities when a suspected case was identified. Having attended mpox-specific training (aOR=5.0; 95%CI: 2.2–11) and having good knowledge (aOR=9.0, 95%CI: 2.6–30) were significantly associated with a positive attitude. Conclusions: While most CHWs showed positive attitudes about mpox, just about two-thirds had good knowledge. Serious gaps remain in case referral and reporting. Targeted CHWs training and mentorship could improve outbreak response effectiveness.
Capacity for glaucoma screening and treatment at primary and secondary level health centers in Uganda: Situational analysis
(Journal of Ophthalmology of Eastern, Central and Southern Africa (JOECSA), 2024) Onyango J; Kwaga T; Namwase S; Tusingwire P; Arunga VN; Atwine D; Arunga S
Objective: To measure the capacity for glaucoma screening and treatment at primary and secondary level health centers in southwestern Uganda. Methods: In a cross-sectional study, we used quantitative methods to conduct a situation analysis at primary (health center IVs, district hospitals) and secondary level health facilities (referral hospitals) within southwestern Uganda. Survey questionnaires were administered to eye health workers at the health facilities to ascertain glaucoma awareness. An inventory checklist was used to establish equipment and consumables available to screen, diagnose and treat glaucoma in the primary and secondary level setting. Results: There were 86 primary and secondary level health facilities enrolled in this study. Out of the 86 facilities, 45 (52.3%) did not have any eye care worker. Majority lacked functioning basic eye equipment and consumables for the diagnosis of glaucoma. Only 28 (32.6%) facilities had a direct Ophthalmoscope. Timolol was the most common eye drop and was available in 12 (14%) of the health facilities. The lowest level of knowledge about glaucoma was observed at health center IVs (34.6%), while the highest level of knowledge was observed at regional referral hospitals (82.7%). Conclusion: There is need to improve the availability of equipment, diagnostic consumables and essential medicines for glaucoma at health facilities in southwestern Uganda. Additionally, training and deployment of more eye care workers at the primary and secondary health facilities is necessary for quality access to eye care services.
Anemia in HIV-Infected Children on ART in Uganda: High Risk Associations with Malaria, Opportunistic Infections, and Poor Adherence
(HIV/AIDS-Research and Palliative Care, 2026) Christopher Lyatinga Anyelwisye; Jimmy Kata Ogwal; Simon Evarist Kadogosa; Rauben Timuzigu; Cricent Anyetaba; Robert Wagubi; Clinton Olong; Elizabeth A John; Enoch Muwanguzi; Benson Okongo
Purpose: This study aimed to determine the prevalence and associated factors of anemia among HIV-positive children receiving antiretroviral therapy (ART) at two urban clinics in Mbarara City, Southwestern Uganda. Patients and Methods: We conducted a cross-sectional study among 293 HIV-positive children (<18 years) attending ART clinics at Mbarara Municipal Health Center IV and Holy Innocent Children’s Hospital between July and September 2025. A structured questionnaire captured sociodemographic and clinical data. Venous blood were collected for complete blood count (CBC) analysis, and stool samples were examined for intestinal parasites. Data on CD4 count and viral load were abstracted from medical records. Anemia was defined using age-specific WHO criteria. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with anemia, with statistical significance set at p ≤ 0.05. Results: The overall prevalence of anemia was 6.14% (95% CI: 3.4% – 8.9%). Normocytic normochromic anemia was the predominant morphological type (72.2%). In the multivariate analysis, a recent episode of malaria (AOR = 9.61; 95% CI: 3.26–28.34), the presence of an opportunistic infection (AOR = 6.78; 95% CI: 1.28–35.83), and poor adherence to ART (AOR = 14.75; 95% CI: 1.31–165.65) were independently and significantly correlated with anaemia. Conclusion: While the prevalence of anemia in this cohort of HIV-infected children on ART was lower than global averages, it remains a significant clinical concern. The strong associations with malaria, opportunistic infections, and suboptimal ART adherence highlight critical areas for intervention. Targeted strategies, including integrated malaria control, enhanced prevention and management of OIs, and reinforced adherence support, are required to decrease the anaemia burden and optimize health outcomes in this at-risk population.
Genomic Characterization of Selected ESKAPEEE Clinical Isolates From Mbarara Regional Referral Hospital, Southwestern Uganda: Resistome, Multilocus Sequence Typing, Mobilome, and Virulome
(Cureus, 2026) Judith Owokuhaisa; Joel Bazira; Moses Mpeirwe; Godwin Tusabe; Edgar Mulogo
Background: The global dissemination of Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus faecium, Enterococcus faecalis, and Enterobacter cloacae pathogens is increasingly driven by the convergence of multidrug resistance (MDR) and hypervirulence. These opportunistic pathogens are characterized by their ability to "escape" the bactericidal effects of conventional antibiotics through a refined repertoire of resistance mechanisms. Infections related to these pathogens are responsible for the majority of hospital-acquired infections (HAIs) globally, leading to increased morbidity, mortality, and healthcare costs. Methods: This study used whole-genome sequencing to identify the resistome, virulome, mobilome, and multilocus sequence types of selected clinical Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus faecalis, and Enterobacter cloacae pathogens. Results: Molecular profiling revealed a diverse virulome, with Pseudomonas aeruginosa (ST244) exhibiting the most expansive repertoire (>130 virulence factors (VFs)), including type III secretion system effectors (exoS, exoT) and complete alginate biosynthesis (alg) clusters. S. aureus (ST1) demonstrated a potent toxigenic profile characterized by the Panton-Valentine Leukocidin (lukF/S-PV) and toxic shock syndrome toxin-1 (tsst-1) genes. Among the Enterobacteriaceae, virulence was dominated by the yersiniabactin ( ybt) and enterobactin (ent/fep) iron-acquisition systems, which were notably conserved across Klebsiella pneumoniae (ST307) and E. coli (ST448). Furthermore, the presence of the Escherichia coli common pilus (ecp) and curli fimbriae (csg) across multiple species suggests that mobile genetic elements (MGEs) facilitate the horizontal transfer of "survival packages" that combine colonization and persistence traits. In addition, these isolates also revealed diverse plasmids varying significantly in size (1,570 bp to 235,562 bp) and GC content (0.28 to 0.65). Conjugative plasmids were exclusively large (>60 kb) and characterized by the presence of both a relaxase (primarily MOBH or MOBP) and a mate-pair formation (MPF) system (predominantly MPF_F and MPF_T). Conclusion: These findings identify a critical genetic variation where high-risk bacteria combine multidrug resistance with an enhanced ability to cause disease. The emergence of these multidrug-resistant bacteria highlights an urgent need for genomic tracking in clinical settings to monitor and prevent their spread.