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

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Central Administration 133
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Faculty of Agriculture, Enviroment and Veterinary Sciences 2
Faculty of Applied Sciences and Technology 67
Faculty of Business and Management Sciences 124
Faculty of Computing and Informatics 150
Faculty of Interdisciplinary Studies 224
Faculty of Medicine 2437
Faculty of Science 574
Institute of Tropical Forest Conservation 124
Maternal Newborn and Child Health Institute 18
MUST Research Institute 3

Recent Submissions

Diagnosis and Management of Pheochromocytoma in Pregnancy: A Multidisciplinary Approach to Treatment and Outcomes at Mbarara Regional Referral Hospital: A Case Report
(International Medical Case Reports Journal, 2026) Bashir, Mohamed; Begumana, Daniel; Anyit, Moses; Byamukama, Onesmus; Ngonzi, Joseph; Kayondo, Musa; Kyoyagala, Stella; Muhindo, Rose; Ttendo, Stephen; Fajardo, Yarine Tornes; Tibaijuka, Leevan
Introduction: Pheochromocytoma in pregnancy is extremely rare but can be life-threatening for both mother and fetus. Its clinical manifestations often mimic common obstetric complications, such as preeclampsia, resulting in delayed or missed diagnosis with potentially catastrophic consequences. Prompt recognition and careful management are critical to improving maternal and neonatal outcomes. Case Presentation: We report a 27-year-old Black African multiparous refugee woman at 26 weeks of gestation who presented with palpitations, shortness of breath, headaches, and markedly fluctuating blood pressure. Ultrasonography revealed a large right adrenal mass, and 24-hour urinary metanephrines confirmed catecholamine excess. Despite antihypertensive therapy, she continued to experience alternating hypertensive and hypotensive crises, necessitating an emergency cesarean delivery at 31 weeks of gestation. A live preterm neonate weighing 1.8 kg was delivered in good condition. Ten weeks postpartum, she underwent laparoscopic adrenalectomy. Histopathological examination and immunohistochemistry evaluation confirmed the diagnosis of pheochromocytoma. Conclusion: This case highlights the diagnostic challenge of pheochromocytoma in pregnancy, which can masquerade as preeclampsia and other hypertensive disorders. It underscores the importance of considering pheochromocytoma in the differential diagnosis of labile blood pressure during pregnancy. Multidisciplinary coordination, vigilant hemodynamic stabilization, and timely postpartum surgery can achieve excellent maternal and neonatal outcomes
Müllerian adenosarcoma in a young adult: A case report and literature review of diagnostic and management challenges
(Gynecologic Oncology Reports, 2026) Malisaba, Charles Posite; Legesse, Biruk; Etienne, Ndungo; Musubao, Justine; Tumwesigire, Samuel; Birungi, Abraham; Batista, Mirna Santos; Essa, Suleman Ahmed; Wabinga, Henry; Atwine, Raymond
Background: Müllerian adenosarcoma is a rare biphasic uterine malignancy typically affecting postmenopausal women. Its occurrence in young, nulliparous women is extremely uncommon, presenting diagnostic challenges, especially in cases of presumed recurrences. Case Presentation: A 22-year-old nulliparous woman presented with a presumed recurrent, enlarging prolapsing uterine mass and post-coital bleeding. Her history was notable for two prior excisions of a similar mass without histopathological review. Examination revealed a 6 cm friable mass protruding through the cervical os. Given the recurrence and risk of hemorrhage in a resource-limited setting, a total abdominal hysterectomy was performed. Gross examination identified a 9x6x4 cm polypoid mass confined to the fundus. Histopathology confirmed high- grade endometrial adenosarcoma, characterized by classic biphasic features, significant spindle-cell atypia, and a brisk mitotic rate (>10 mitoses/10 HPFs). Immunohistochemistry showed stromal positivity for CD10 and PR. No myometrial invasion or lymphovascular space invasion was observed. The patient remains asymptomatic under a rigorous three-month surveillance protocol. Conclusion: This case highlights a rare high-grade presentation in a young adult. Despite aggressive histological features, the absence of myometrial invasion supports definitive surgery followed by intensive long-term sur veillance. This report underscores the necessity of a high index of suspicion for malignancy in recurrent polypoid masses within the reproductive age group and addresses critical gaps regarding fertility preservation and age- specific management protocols.
Voices and lived experiences of perinatal women recovering from mental illness and informal caregivers regarding quality of maternal mental health care in south western Uganda
(Discover Mental Health, 2026) Nakidde, Gladys; Kamoga, Ronald; Mugisha, John F.; Kumakech, Edward
Background Maternal mental illness (MMI) contributes significantly to maternal morbidity, particularly in low-resource settings. Although policies support integrating maternal mental health into routine maternity care, assessments of care quality have largely focused on health workers’ perspectives rather than women’s lived experiences. This study explored the quality of maternal mental health care as experienced by women recovering from MMI and family caregivers. Methods A phenomenological qualitative study was conducted between November 2022 and February 2023. Nineteen participants were purposively recruited from two regional referral hospitals in southwestern Uganda. We included women who had recovered from MMI and family caregivers. Following REC and hospital approvals, participants were contacted by telephone and after consent, appointments for the interviews were scheduled. Data were collected using in-depth interview guide until saturation was reached and manual thematic analysis done, guided by a hybrid coding approach. Results Most participants were female with male caregivers being husbands, rural residents, and self-employed. Women were aged 23–37 and caregivers 28–65 years. Five interrelated themes emerged: perceived causes of MMI; clinical presentation and healthcare experiences; challenges, recommendations, and future hopes; community perceptions and stigma; and social support and family dynamics. These inform that sociocultural beliefs, health-system responsiveness, and family support shape perceptions of care quality. Recovery and satisfaction were mainly attributed to hospital-based mental health services, often accessed through self-referral after maternity discharge. Despite some positive experiences, maternal mental health care quality remained limited by experienced challenges. Interventions should focus on community education, integrating mental health screening and management into maternity services, improving medicine availability and addressing stigma through culturally appropriate approaches.
Vitamin D Deficiency and Its Hematological Correlates in Patients with Sickle Cell Disease at a Ugandan Clinic
(Journal of Blood Medicine, 2026) Salamu, Geofrey; John, Elizabeth A; Wagubi, Robert; Muwanguzi, Enoch; Bagenda, Charles Nkubi; Okongo, Benson
Purpose: To determine the prevalence of vitamin D deficiency (VDD), evaluate its correlation with key hematological parameters, and identify associated factors among patients attending the Sickle Cell Clinic at Mengo Hospital (Kampala, Uganda). Patients and Methods: This cross-sectional study enrolled 213 patients with sickle cell disease (SCD) at Mengo Hospital, serum 25- hydroxyvitamin D levels were measured. Levels were classified as deficient (< 0.001) respectively. Additionally, folic acid and hydroxyurea were associated with a lower risk of VDD (aPR 0.69, p = 0.028). Conclusion: Nearly half of the patients with sickle cell disease had vitamin D deficiency. Older age increased the risk. VDD is weakly but significantly associated with lower Hb/RBC and higher RDW, suggesting a possible contributory role in the hematologic profile of Ugandan SCD patients
Post-discharge mortality, readmission and care seeking among postpartum women and their newborns following facility-based delivery in Uganda: a prospective observational study
(BMJ open, 2026) Pillay, Yashodani; Nguyen, Vuong; Komugisha, Clare; Lavoie, Pascal M; Bebell, Lisa M; Vidler, Marianne; Payne, Beth A; Trawin, Jessica; Christofferson-Deb, Astrid; Mwesigwa, Douglas; Twinomujuni, Happy Annet; Novakowski, Stefanie K; Dunsmuir, Dustin; Ansermino, Mark J.; Tagoola, Abner; Kissoon, Niranjan; Kenya-Mugisha, Nathan; Namala, Angella; Ngonzi, Joseph; Wiens, Matthew O
Introduction Maternal and newborn morbidity and mortality are a global concern. Understanding the epidemiology of post-discharge complications could identify opportunities for interventions. We aimed to quantify mortality, care-seeking events and readmission among mothers and newborns in Uganda following facility based delivery. Methods This prospective observational study (Apr 2022- Sep 2023) enrolled women presenting for delivery at two regional referral hospitals in Uganda. Data were collected during admission and 6weeks after delivery by phone. Results Overall, 7131women delivered 7359 newborns, of whom 7129 (99%) women and 6968 (94%) newborns were discharged alive. The newborn mortality rate was 2.7% and 32% of deaths occurred post-discharge. Following discharge, 230 (3%) women and 287 (4%) newborns were readmitted. Suspected sepsis and infections were the most common reasons for readmission among mothers (62.2%) and newborns (89.9%). Caesarean delivery (OR:2·26 (1·75-2·93)) and perinatal death (OR:3·18 (2·09-4·69)) were associated with post discharge maternal readmission. Both maternal and newborn readmission were associated with household food insecurity during pregnancy (maternal OR:1·56 (1·15-2·08); newborn OR: 1·73 (1·31-2·25)). Newborn resuscitation with oxygen was associated with maternal readmission (OR:2.24 (1.24–3·78)), newborn readmission (OR: 2·74 (1·54-4·56)) and newborn death (OR: 4·01 (1·73- 8·21)). Although >99% of women had ≥1 antenatal care visit, only 511 (7%) had ≥1 routine postnatal care visit. There were no routine postnatal care visits among 211 (91·7%) readmitted mothers, 276 (96·2%) newborns and 57 (91·9%) newborns who died. Conclusion Post-discharge complications occur in a context of low routine postnatal care use. Risk-informed discharge planning, postnatal care and health education strategies may improve outcomes in mothers, newborns and their families.
Prevalence and factors associated with experiencing occupational biological hazards among clinical university students in South Western Uganda
(Discover Public Health, 2026) Ayesiga, Innocent; Wekha, Godfrey; Kihumuro, Raymond Bernard; Nakandi, Racheal Mukisa; Tenywa, David; Muwanga, David; Ediamu, Tom Didimus; Nabaweera, Rebbecca; Musoke, Phillip; Kiyimba, Blaise; Ebiju, Isaac
Background Clinical students face hazards, such as needlestick injuries and blood spills. While healthcare workers’ exposure to such hazards is well-documented, there is limited data on medical students, particularly in Uganda. We explored the prevalence and factors associated with biological occupational hazards among clinical university students. Methods This cross-sectional study examined biological occupational hazards among 384 randomly selected undergraduate clinical medical students at a university in Southwestern Uganda. Data were collected using a structured self-administered questionnaire. Categorical and numerical data were summarised descriptively using frequencies and means. Multivariable logistic regression identified factors independently associated with hazard exposure. Adjusted odds ratios with 95% confidence intervals were reported, and was considered statistically significant Results A total of 384 participants, with a mean age of 25.1 years and a male predominance of 208 (54.2%), were included; 223 (58.1%) pursued careers in medicine and surgery. 316 (82.3%) reported experiencing a hazard, with 107 (33.9%) reporting experiencing it more than three times. 155 (49.1%) and 102 (32.3%) of the participants had experienced blood spills and needle stick injuries, respectively. Gender (aOR 0.448, CI: 0.24–0.84) and the current ward where the students were placed (aOR 2.94, CI: 1.39–6.22) were significantly associated with exposure to hazards Conclusion Clinical students are significantly exposed to occupational hazards, with blood spills and needle stick injuries being the most common. Most students experience multiple exposures in high-risk wards such as Obstetrics. Targeted interventions, such as establishing injury response teams, pinning procedure charts on the ward walls, and providing procedure manuals, are needed to enhance safety and improve clinical training. Future research should also examine safety protocols and gendered risk perceptions to develop effective strategies to mitigate hazards.
The Impending Collapse of Modern Coast Bus Company: A Tale of Mismanagement and Turbulence in East Africa’s Transport Industry
(Emerging Economies Cases Journal, 2026) Nabachwa, Sarah
Modern Coast Express Limited, once a leading player in East Africa’s bus transport sector, faces imminent collapse, driven by family succession failures, internal conflicts, safety lapses and external pressures. Founded in 1985 by Shahid Pervez Butt, the company grew to over 200 luxury buses operating across Kenya, Uganda, Tanzania, Rwanda and beyond by 2010. Butt’s assassination in 2014 created a leadership vacuum that sparked protracted family ownership disputes, paralyzing strategic decision-making and eroding governance. In the ensuing years, Modern Coast’s safety record deteriorated, with multiple fatal accidents leading regulators to suspend its licence and prompting costly legal liabilities. Meanwhile, ageing infrastructure, new competitors (including Kenya’s Standard Gauge Railway) and informal transport alternatives chipped away at its market share. This case invites students to critically analyze how effective succession planning and governance strategies can either enhance stability or contribute to instability within large family-owned enterprises operating in high-risk service industries. It also highlights how socioemotional wealth considerations and family dynamics can influence business decisions, often at the expense of professional management. The case therefore examines crisis leadership in the transport industry and shows how socioemotional wealth considerations and family dynamics can influence business decisions, often at the expense of professional management.
Phenotypic and Molecular Characterization of Extended-Spectrum β Lactamase Producing Escherichia coli and Klebsiella pneumoniae isolates from Communities in South Western Uganda
(Scientific Reports., 2026-07-20) Sidi, Khalid Mohamud; Asiimwe, Moses; Bazira, Joel; Tuhamize, Barbra
Background: Escherichia coli and Klebsiella pneumoniae are common Extended-spectrum β-Lactamase (ESBL) producing bacteria that can potentially cause substantial challenges in both human and veterinary medicine. This study aimed to characterize the phenotypic and genotypic ESBL production in E. coli and K. pneumoniae isolates from community samples obtained from South Western Uganda. Methods: We conducted a cross-sectional study using laboratory methods among stored E. coli and K. pneumoniae isolates. Phenotypic detection of ESBL production was performed using double disk synergy test and the combination disk test, using the Kirby–Bauer disk diffusion method. DNA Polymerase Chain Reaction (PCR) was performed using a conventional PCR thermocycler to detect the ESBL genes. Descriptive statistics were used to summarize the resistance patterns between E. coli and K. pneumoniae. Results: Among the 136 isolates retrieved 96(70.59%) were E. coli. The prevalence of ESBL production among isolates was 37.50% (95% CI=29.58- 46.52). Among E. coli, majority carried blaCTX-M (61.46%) and blaTEM (56.25%) genes. Among K. pneumoniae isolates, there was a uniform distribution of the multiplex genes for blaCTX-M (37.5%), blaOXA (32.5%), blaTEM (30%) and SHV (30%). Conclusion: The blaCTX-M and blaTEM genes were identified as the predominant ESBL genes especially among E. coli isolates which aligns with global trends.
HIV self-testing uptake and associated factors among students and staff in a public university in Uganda: evidence from an analytic cross-sectional study
(AIDS Research and Therapy, 2026-09-09) Bagenzi, Brenda; Mwebesa, Edson; Izudi, Jonathan; Musinguzi, Benson; Anyase, Ronald Amaza
Abstract Background Human Immunodeficiency Virus self-testing (HIVST) improves access to HIV testing services by enhancing privacy and convenience. However, evidence on HIVST uptake and its associated factors among university populations in Uganda remains limited. This study determined HIVST uptake and identified factors associated with HIVST uptake among students and staff at Muni University, Uganda. Methods This analytic cross-sectional study was conducted between 7 February 2026 and 20 March 2026. Data were collected using a structured self-administered questionnaire. HIVST uptake was defined as self-reported ever use of an HIV self-test kit to test one’s own HIV status. Descriptive statistics were used to summarize participant characteristics, and a multivariable Poisson regression model identified the factors independently associated with HIVST uptake. Adjusted prevalence ratios (aPRs) with 95% confidence intervals (CIs) were reported. Results Among 272 participants, HIVST uptake was 39.7% (108/272). In adjusted analyses, HIVST uptake was associated with having two or more sexual partners in the past six months (aPR=1.44, 95% CI: 1.03-2.00), alcohol or drug use (aPR=1.47, 95% CI: 1.28–1.68), and knowledge of a partner’s HIV status (aPR=1.58, 95% CI: 1.40–1.78). Conversely, daily income of ≥2 dollars was associated with a lower likelihood of HIVST uptake (aPR=0.68, 95% CI: 0.51–0.91). Conclusion HIVST uptake among Muni University students and staff is nearly 40%. The HIVST uptake is influenced by sexual behavior, substance use, economic status, and HIV-related risk awareness. These findings should be leveraged to support university-based HIVST uptake to ensure early HIV diagnosis and treatment.
High-precision K2/TESS photometry and HERMES spectroscopy of four bright field stars
(Monthly Notices of the Royal Astronomical Society, 2026) Trust, Otto; Joshi, Santosh; Nsamba, Benard; Aol, Sharon; Vermeulen, Owen; Ssembatya, Ronald; De Cat, Peter; Lampens, Patricia; Barnes, Sydney A.; Goswami, Partha P.; Dileep, Athul; Ghosh, Surath C.; Kumar, Pramod S.; Jurua, Edward; Sarkar, Mrinmoy; Bedi, Sarabjeet S.
Space-based photometry from K2 and TESS, coupled with high-resolution spectroscopy, provides a unique opportunity to re-examine the variability and chemical nature of four brightstars(HD 73135, BD +19◦ 2045, BD +19◦ 2046, and TYC 1395- 855-1), which were poorly characterized by the original ground-based campaign under the Nainital–Cape survey. We aim to establish the nature of the variability, chemical properties, and evolutionary status of these stars. We analysed ground-based Johnson BV photometry combined with K2 and TESS time-series data to establish the nature of their variability. Using high-resolution HERMES (High Efficiency and Resolution Mercator Echelle Spectrograph) spectroscopy, we determined their spectral classifications and chemical abundances. In addition, we used the inferred spectroscopic constraints with grid-based evolutionary modelling to derive their corresponding masses, radii, and ages. The frequency analysis reveals a diversity of low-amplitude variability across the sample. HD 73135 shows a persistent modulation near 1.5 d that is most consistent with rotation, although an ellipsoidal-binary interpretation cannot yet be excluded, while BD +19◦ 2045 exhibits multiple low-frequency signals and is identified as a new candidate γ Doradus g-mode pulsator. BD +19◦ 2046 and TYC 1395-855-1 are non-variable or only marginally variable in K2 but display coherent low-frequency modulation in TESS of uncertain origin. Spectroscopically, HD 73135 is the only chemically peculiar star in the sample and shows a clear Am abundance pattern, whereas the other three stars are chemically normal. These results demonstrate the value of combining legacy survey data with contemporary photometric and spectroscopic analysis.
Financial Literacy, Saving Practices, Loan Management, and Financial Performance of Youth-Led VSLAs in Nakivale Refugee Settlement
(East African Journal of Business and Economics, 2026-08-26) Turyahebwa, Julius; Musiita, Benjamin; Murangira, Martin
This study examined the relationship between financial literacy, saving practices, loan management, and the financial performance of youth-led Village Savings and Loan Associations (VSLAs) in Nakivale Refugee Settlement. The study was guided by three objectives: to determine the relationship between financial literacy and financial performance, to examine the relationship between saving practices and financial performance, and to assess the relationship between loan disbursement and recovery practices and the financial performance of youth-led VSLAs. A cross-sectional correlational research design using quantitative and qualitative approaches was adopted. The study involved 156 respondents, and data were collected using questionnaires and the interview method. Quantitative data were analysed using descriptive statistics, Pearson correlation, and regression analysis, while qualitative data were analysed thematically using NVivo software. The findings revealed that financial literacy had a positive and significant relationship with financial performance, indicating that financially knowledgeable members make better financial decisions and improve VSLA outcomes. Saving practices also positively influenced financial performance, demonstrating that consistent and effective saving behaviour enhances financial stability and sustainability. Similarly, loan disbursement and recovery practices significantly contributed to improved financial performance by strengthening loan management and reducing repayment challenges. The study concluded that financial literacy, saving practices, and effective loan management are key determinants of financial performance among youth-led VSLAs in Nakivale Refugee Settlement. The study recommends continuous financial literacy training, promotion of disciplined saving practices, and strengthening of loan management systems to enhance the sustainability and growth of youth-led VSLAs.
Distribution, architectural design and functionality of megalithic structures of the Lake Eyasi Basin in northern Tanzania
(Southern African Field Archaeology, 2026-05) Mjandwa, Albert Samwel; Kyazike, Elizabeth; Lejju, Julius Bunny
We examined megalithic structures in the Lake Eyasi Basin of northern Tanzania to establish the provenance of the construction materials, understand the reasons for the use of particular raw material options and means of transport, as well as to identify the group or groups of people associated with their creation. The findings suggest that the megalithic culture in the Lake Eyasi Basin reflects ancient cultural advancements, ingenuity, craftsmanship, and spiritual significance. These megaliths, which appear in the form of dolmens, stone circles, or burial cairns, serve as enduring markers of bygone eras. They leave an unforgettable imprint on the landscape and our understanding of human history by cultivating a sense of curiosity about the societies that erected them. Therefore, the megaliths in the basin serve as tangible evidence of the builders’ technical capabilities while also providing insight into their social organisation, daily practices, and belief systems. However, the precise purpose behind their construction, whether spiritual, astronomical, or commemorative, and the people who constructed them, continue to be a subject of scholarly debate and exploration.
Comparison of ionospheric irregularities observed by the COSMIC satellites with ground-based scintillation observations over the low latitude African Region
(Advances in Space Research, 2026) Mungufeni, Patrick; Migoya-Orue, Yenca; Aol, Sharon; Omondi, George
This study compared the ionospheric irregularities as observed using two different techniques, namely; the Constellation Observing System for Meteorology, Ionosphere, and Climate (COSMIC) satellites and the scintillation intensity index (S4) data measured by the Scintillation Network and Decision Aid (SCINDA) receiver which operated at Nairobi University (geog lon 36.8 E, geog lat 1.3 S, dip lat −24.1 , Kenya. The data compared were those of the years 2009 (low solar activity) and 2011 (ascending phase of solar cycle 24), for both quiet (Kp 3) and disturbed (Kp 5) geomagnetic conditions. For the cases of Global Positioning System (GPS) satellites with elevation angle 0 as observed by the COSMIC satellites, a geo-location of the COSMIC S4 data associated with the link between GPS and COSMIC satellites was proposed at the tangent point. The COSMIC S4 data whose geo-locations fall in the vicinity of Nairobi were compared with the S4 data measured by the SCINDA receiver. The coefficient of determination which represents the percentage of the variation in COSMIC S4 data associated with the variation in SCINDA S4 was 50 %. The two data sets depict that scintillation occurs mostly in the seasons of March and September equinoxes of high solar activity conditions. However, there was a moderate positive correlation (Pearson correlation coefficient, r = 0.52 on quiet days) between COSMIC and SCINDA S4 data. The results presented signify that the COSMIC S4 could be analyzed to study ionospheric irregularities (which cause scintillations) over locations such as deserts and oceans where it is usually difficult to deploy equipment. © 2026 COSPAR. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
Climate variability perception and its influence on crop diversification as an adaptation strategy among smallholder farmers in south-western Uganda
(Discover Sustainability, 2026-09-06) Nabasumba, Dina; Vranken, Liesbet; Bukenya, Hakim; Nakintu, Justine; Wangalwa, Raphael; Nakazibwe, Immaculate; Mutyebere, Rodgers; Nkurikiye, Jean Bosco; Kagoro-Rugunda, Grace; Kervyn, Matthieu
Abstract Smallholder farmers in sub-Saharan Africa face climate-induced threats to food and income security. While crop diversification is recognised as a sustainable adaptation strategy, its relationship with smallholder farmers’ climate variability perception across seasons and agro-ecological zones (AEZs) remains underexplored. Using survey data from 583 smallholder farmers in south-western Uganda, this study examined how climate variability perception across seasons and AEZs influences crop diversification and cropland allocation. Climate variability perception differed significantly across seasons and AEZs. The long rains season was perceived as more erratic and shorter. The short rains season was perceived as prolonged. For the long rains season, climate variability perception was greatest in the water-stressed AEZ and lowest in the humid AEZ. For the short rains season, it was greatest in the water-stressed and humid AEZs and lowest in the moderately humid AEZ. Climate variability perception influenced crop diversification heterogeneously. Farmers in the water-stressed AEZ tended to diversify more during the long rains season (β = 0.039, p < 0.10). In the humid AEZ, farmers diversified less during the short rains season (β = −0.084, p < 0.01) but increased land allocation to tubers (β = 2.3, p < 0.05). In the moderately humid AEZ, climate variability perception was associated with crop specialization (β = −0.078, p < 0.05). The findings demonstrate that crop diversification is a context-dependent adaptation strategy, varying seasonally and spatially in response to differentiated climatic risks. Adaptation interventions should account for seasonal and agro-ecological differences for climate-resilient smallholder production systems in SSA.
Bacterial Contamination in Stored Blood for Transfusion and Associated Infectious Risks Among Patients with Cancer at Mbarara Regional Referral Hospital, in Uganda
(Journal of Blood Medicine, 2026-09-09) Taremwa, Ivan Mugisha; Ashaba, Scholastic; Tusubira, Deusdedit; Dhabangi, Aggrey; Bortolussi, Robert; MacDonald, Noni; Bebell, Lisa M; Niyonzima, Nixon; Natukunda, Bernard
Background: Patients with cancer often require supportive transfusion therapy. However, this approach is undermined by the risk of bacterial contamination. This study assessed the bacterial contamination rate, identified the bacterial contaminants and their antimicrobial susceptibility patterns; and the associated infectious risk to patients with cancer at Mbarara Regional Referral Hospital, in southwestern Uganda. Materials and Methods: This prospective cohort study used a pre-transfusion aliquot of donor blood or components for blood culture. Positive cultures were identified and their antibiotic susceptibility testing was performed using the bioMerieux VITEK 2 compact system. Recipients were assessed for bacterial infection at 48 hours’ post-transfusion. Data were analyzed using R software and presented as proportions. Results: We evaluated 376 blood units, with 275 (73.1%) of these being red cell concentrates (RCC). The median storage times for RCC and whole blood (WB) were 23 days (IQR, 18–29 days) and 3 days (IQR, 1–5 days) for platelets (PLT), respectively. Four units (3RCC, 1PLT) had bacterial growth, yielding a contamination rate of 1.1% (95% confidence interval, 0.4–1.8%). Staphylococcus hominis and Bacillus subtlis were isolated from RCC, while Staphylococcus capitis was isolated from PLT. The isolates exhibited variable resistance to erythromycin, clindamycin, teicoplanin, vancomycin, tetracycline, nitrofurantoin, rifampicin, and trimethoprim sulfamethoxazole. There were 211 recipients whose mean age was 34.1 years (standard deviation: 2.84 years). Of these, 62 (29.4%) had received ≥3 donor units, and 146 had been on antibiotics. None of the investigated recipients had a positive bacterial blood culture. Conclusion: The study found a low bacterial contamination rate of stored blood components underscoring the importance of stringent blood collection precautionary measures. The four bacterial isolates were resistant to common antibiotics, which poses a risk of transmission of antibiotic-resistant strains to immunocompromised recipients with cancer. Notably, there was no infectious risk posed post-transfusion presumably due to the concurrent antibiotic therapy.
Admission photoplethysmography-based mortality prediction in hospitalized Ugandan children with suspected or confirmed infection: A feasibility study
(PLOS Digital Health, 2026-08-06) Rahimi, Mahan; Wiens, Matthew O.; Kabakyenga, Jerome; Kumbakumba, Elias; Kenya-Mugisha, Nathan; Ansermino, John Mark
Sepsis remains a major cause of preventable pediatric hospital deaths in develop ing countries, with progress hindered by the lack of effective risk identification tools. Early detection of children at highest risk upon hospital admission is crucial for guiding clinical care and allocating resources, particularly in resource-limited set tings. Photoplethysmography, which measures blood oxygen levels, also provides objective insight into cardiovascular alterations associated with sepsis. We conducted a secondary analysis of prospectively collected data from the Smart Discharges project, involving children under five years hospitalized with suspected or confirmed infection at six Ugandan hospitals, and developed models to predict all-cause in-hospital mortality across two age groups (0–6 and 6–60 months). Mortality was 7% in younger and 4.1% in older children. Machine learning models were trained on features extracted from one-minute photoplethysmograms collected at the time of admission. The best-performing model achieved mean values for the area under the receiver operating characteristic curve of 0.70 (95% CI: 0.62–0.76) in the younger cohort and 0.67 (95% CI: 0.56–0.73) in the older cohort, with corresponding values for the area under the precision–recall curve of 0.18 (95% CI: 0.12–0.27) and 0.14 (95% CI: 0.06–0.22), respectively. Calibration within risk strata was satisfactory (Brier scores 0.06 and 0.04), and decision curve analysis showed clinical utility. Notably, the models’ predictive capacity, although moderate, was achieved with a rapid and readily available objective measurement at admission, without the need for extended monitoring. While less accurate than most existing risk scores and not a substitute for clinical judgment, these simple admission-based models may help identify high risk children and guide targeted interventions where sophisticated diagnostics are unavailable. External validation is needed before adoption.
Seasonal and landscape patterns of Fasciola infection in cryptically diverse Radix natalensis snails in the Lake Albert region, Uganda
(Parasitology Research, 2026) Ssenkuba, Francis; Huyse, Tine; Benjamin, Andre; Kagoro-Rugunda, Grace; Tolo, Casim Umba; Tumusiime, Julius
Fasciolosis is a zoonotic foodborne trematode infection involving freshwater lymnaeid snail intermediate hosts and is highly prevalent among livestock in Uganda’s Lake Albert region. However, xenomonitoring data remain limited, particularly regarding cryptic Radix diversity and ecological predictors of infection. This study investigated Radix molecular diversity and the spatial and seasonal patterns of Fasciola-trematode infection. A longitudinal survey of 18 freshwater habitats in Kagadi District was conducted during the dry (June–July 2020) and wet seasons (October–November 2020). Radix snails were morphologically identified and screened for fasciolid and other trematode infections using multiplex rapid diagnostic PCR (RD-PCR) and genotyped using Cytochrome c Oxidase subunit I (COI) and Internal Transcribed Spacer (ITS) markers. Logistic regression was used to evaluate the association of spatio-temporal factors with infection patterns. Among 220 Radix snails, overall trematode and FasciolaQ3 prevalence were 63.18% (139/220) and 8.64% (19/220), respectively, with sequence analysis confirming Fasciola gigantica (99.41–100% identity-PZ297442). Phylogenetic and haplotype analyses revealed two sympatric Radix natalensis sensu lato subspecies, R. n. debaizei and R. n. exsertus, harbouring infections. Fasciola (p=0.013) and overall trematode (p=0.005) prevalence were significantly higher during the dry-season, while overall trematode prevalence was also higher below the escarpment (p=0.003). Seasonal and spatial variation are strongly associated with Fasciola spp. and other trematode infections in snail populations, with higher prevalence during the dry-season and at sites below the escarpment. Targeted dry season snail control, particularly at infection hotspots, combined with water-trough use, may reduce livestock exposure
Suicidal ideation among adolescents and young adults with cancer in Uganda
(BMC Cancer, 2026) Mukiibi, Nicholas; Abaatyo, Joan; Nanziri, Angella; Ntukunda, Faith; Kaggwa, Mark Mohan; Rukundo, Godfrey Zari
Background Adolescents and young adults (AYAs) living with cancer face unique psychosocial challenges that may heighten vulnerability to suicidality and other mental health challenges. However, evidence from low- and middle-income countries, including Uganda, remains scarce. This study examined the prevalence and factors associated with suicidal ideation among AYAs with cancer in Uganda. Methods A cross-sectional analytical survey was conducted among 271 AYAs aged 10–24 years attending oncology clinics at the Uganda Cancer Institute and Mbarara Regional Referral Hospital, between March and May 2024. Sociodemographic and clinical characteristics were collected using a structured questionnaire. Suicidal ideation was assessed using four suicide-related items rated on a four-point Likert scale. Because depression and anxiety are established risk factors for suicidal ideation, depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and anxiety symptoms using the Generalized Anxiety Disorder-7 (GAD-7) scale as potential explanatory variables. Descriptive statistics summarized participant characteristics, while multivariable logistic regression identified factors independently associated with suicidal ideation. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were reported, and a sensitivity analysis using a stricter suicidal ideation threshold was performed. Results The overall prevalence of suicidal ideation was 63.5%. Probable anxiety showed the strongest association with suicidal ideation (aOR=15.37, 95% CI: 1.88–125.65), followed by a history of cancer recurrence (aOR=5.56, 95% CI: 1.84–16.77), duration of cancer diagnosis more than two years (aOR=4.17, 95% CI: 1.38–12.57), and probable depression (aOR=3.70, 95% CI: 1.03–13.29). Receiving a combination of treatment modalities was associated with reduced odds of suicidal ideation (aOR=0.27, 95% CI: ad. Conclusions Suicidal ideation is highly common among AYAs with cancer in Uganda, especially those with chronic, or recurrent disease, probable depression and anxiety symptoms, and those receiving a single modality of cancer treatment. Incorporating routine mental health screening and psychosocial support into oncology care can facilitate early identification, timely referral, and appropriate management of AYAs at risk, thereby potentially reducing suicide risk
Induction failure and early death in paediatric acute myeloid leukaemia in Uganda: a developing country experience
(BMC Cancer, 2026) Nyeko, Richard; Kruger, Mariana; Niyonzima, Nixon; Atwiine, Barnabas; Balagadde Kambugu, Joyce; Verhulst, Stijn; Heerden, Jaques van
Abstract Introduction Dose-intensive therapy for paediatric acute myeloid leukaemia (AML) has improved outcomes in high-income countries (HICs); however, outcomes remain poor in resource-limited settings, where induction failure and early death continue to pose significant challenges. This study aimed to determine the frequency of induction failure and early death and identify associated risk factors among children treated for AML in Uganda. Methods This retrospective study examined induction failure and early death among children with AML. Data collected included demographic information, clinical characteristics, and induction outcomes for children under 18 years who were diagnosed with AML between 2016 and 2022 at three Ugandan institutions. Induction failure was defined as failure to achieve microscopic remission after induction chemotherapy, including deaths during induction. Early death was defined as death before or within 42 days of initiating induction therapy. Variables included sex, age, initial white cell count, and nutritional status, among others. Nutritional status was assessed using the World Health Organization weight-for-height, body mass index (BMI)-for-age, and mid-upper-arm circumference (MUAC) z-scores. Descriptive statistics and logistic regression analyses were performed using IBM SPSS version 27 to investigate variables associated with induction failure and early death. Results There were 159 children with AML, of whom 87 (54.7%) were males, with a median age of 9.0 years (IQR 3.0–12.0). Nearly half (n=62; 39.0%) were malnourished, and over a third (n=59; 37.1%) had a peripheral white blood cell count (WBC) at diagnosis of ≥50,000/uL. Of the 149 (93.7%) patients who received induction chemotherapy, 39 (26.2%) experienced induction failure and 27.7% early death (44/159). The main causes of death were sepsis (35%), bleeding (25%), organ failure (15%), severe anaemia (13%), and severe pneumonia with respiratory failure (12%). Induction failure was significantly associated with malnutrition (p=0.031), presumed fungal infection (p=0.043), and absence of CNS involvement assessment at diagnosis (p=0.005). Early death was associated with malnutrition (p=0.007), suspected fungal infection (p=0.008), and pneumonia (p=0.024). Conclusion In this Ugandan cohort of children with AML, induction failure and early death rates remained high and were strongly associated with infections and treatment-related complications, underscoring the challenges in AML management. Malnutrition, suspected fungal infections, and pneumonia were significantly associated with poor outcomes, highlighting the need for improved supportive care and early management of complications in resource-limited settings.
Harnessing digital–relational synergies for sustainable SME performance: exploring the interplay between digital marketing and network capital in resource-constrained settings
(Journal of Sustainable Business, 2026) Bindeeba, Dedrix Stephenson; Bakashaba, Rennie; Tukamushaba, Eddy Kurobuza
This study examines how Digital Marketing (DM) and Network Capital (NC) jointly influence the economic and social performance of small and medium-sized enterprises (SMEs) in Uganda. Drawing on the Resource-Based View, the Technology–Organization–Environment framework, and Network Theory, an explanatory mixed-methods design was employed. In the quantitative phase, survey data from 272 SMEs were analyzed using Hayes’ PROCESS macro (Model 1) with mean-centered predictors and bootstrapped standard errors. The results show that DM and NC independently enhance both economic and social performance; however, NC negatively moderates the DM–performance relationship, indicating a substitution rather than a complementary effect. Conditional effects reveal that DM significantly improves performance at low and moderate levels of NC but becomes non-significant at high NC levels. The qualitative phase, based on 15 interviews, explains this pattern through managerial attention constraints, trust substitution, and digital cost frictions. Together, the findings advance a contextual threshold perspective, showing that digital strategies are most effective where relational capital is limited, while dense networks dampen the marginal returns to digital investment in resource-constrained settings. Practically, the results suggest that SMEs should calibrate digital marketing investments to their relational context, prioritizing digital tools where network resources are weak and avoiding overinvestment where strong relational ties