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Recent Submissions

Incidence of neonatal sepsis among HIV exposed neonates of mothers on integrase strand transfer inhibitors in sub-Saharan Africa: a systematic review and meta-analysis
(BMC Infectious Diseases, 2026-08-12) Pebalo, Francis; Bongomin, Felix; Morgan,Bethan; Pitua,Ivaan; Nantale,Ritah; Omona,Venice; Ngonzi,Joseph; Hamer, Davidson H.
Introduction Human immunodeficiency virus (HIV)-exposed infants face elevated risks of neonatal sepsis, influenced by maternal antiretroviral therapy (ART) regimens. Dolutegravir (DTG), a widely used integrase transfer inhibitor (INSTI), and the preferred first line drugs for management of HIV in pregnancy, has shown potential adverse effects such as hyperglycaemia, which may impact neonatal outcomes including risk of neonatal sepsis. We estimated the pooled incidence of neonatal sepsis among neonates exposed to INSTIs in utero compared to non-INSTIs-based ART regimens. Methods and analysis A systematic review and meta-analysis were conducted following written as per the PRISMA guidelines. Databases including PubMed/MEDLINE, Embase, Cochrane Library, CINAHL, Global Health and Global Index Medicus were searched for studies published between January 2013 and September 2025. Eligible studies included clinical trials and cohort studies comparing INSTI-based ART regimens with non-INSTI regimens among pregnant women living with HIV. Data were extracted using Covidence software, Cochrane risk of bias (RoB) and Newcastle-Ottawa Scale (NOS) were used to assessed for quality of randomised clinical trials and observational studies, respectively. The certainty of the evidence was assessed using the Grading, Recommendation, Assessment, Development and Evaluation (GRADE) framework. Results A total of 714 studies were identified and screened based on their titles and abstracts, of which 63 articles underwent full-text review. Ultimately, four studies, comprising 7,636 participants, met the predefined eligibility criteria and were included in the analysis. The pooled odds ratio (OR) for neonatal sepsis among infants exposed to INSTIs was 0.44 (95% confidence interval [CI]: 0.15–1.30, p = 0.137). The test for subgroup difference was not significant (p = 0.358): the pooled OR for dolutegravir was 0.27 (95% CI 0.06–1.23, p = 0.090) and for the single raltegravir study was 0.73 (95% CI 0.16–3.30, p = 0.681). Conclusion INSTI-based ART was not associated with a significant difference in neonatal sepsis risk compared with non-INSTI regimens. However, the low number of events limited the precision of the estimates, highlighting the need for further research.
Effect of prior TB preventive therapy on all cause mortality during TB treatment among people with HIV/TB in rural eastern Uganda: an observational causal analysis
(BMC Infectious Diseases, 2026) Izudi,Jonathan; Bajunirwe, Francis; Ssentongo, Saadick Mugerwa; Appeli,Saidi; Cattamanchi,Adithya
Background Tuberculosis preventive therapy (TPT) is the cornerstone for preventing TB disease. However, it is uncertain whether prior TPT completion improves survival once TB disease develops in people with human immunodeficiency virus (PWH) while on anti-retroviral therapy (ART). We evaluated the effect of prior TPT completion on all-cause mortality during TB treatment among PWH who developed TB disease while on ART in rural eastern Uganda. Prior TPT completion served as a marker of sustained engagement in HIV care. Methods We applied inverse probability of treatment weighting using propensity scores, a causal inference analysis approach, to mimic a randomized controlled trial using real-world retrospective cohort data. Inverse probability of treatment weighting addresses design flaws in observational studies, such as selection and confounding biases, providing less biased causal effect estimates. Individuals who had completed a full course of TPT before the start of the index TB treatment episode formed the intervention group, while the control group comprised those with no history of TPT before the index TB treatment initiation. Inverse probability of treatment weighting ensured balanced baseline covariates between the exposure groups. We estimated all-cause mortality rates using person-time methods and Kaplan-Meier curves and performed propensity-score weighted Cox proportional hazards analysis for cause effect estimation. We reported adjusted hazard ratios (aHR) with 95% confidence intervals (CI). Results Of 719 participants, 296 (41.2%) had completed a full course of TPT before the start of the index TB treatment episode, and 83 (11.5%) had died. The mortality rate was 7.13 per 10,000 person-days, higher among participants without prior TPT than those with prior TPT completion (18.0% vs. 2.4%, log-rank χ²(1) = 35.3, p < 0.001). Median survival was 277 days (95% CI: 213–689). Prior TPT completion was associated with an 87% lower hazard of all-cause mortality (aHR 0.13, 95% CI: 0.06–0.29). Conclusion Prior TPT completion substantially reduced all-cause mortality among PWH who developed drug susceptible TB disease while on ART. Therefore, there is a need to strengthen TPT completion and engagement in HIV care across HIV programs to lower all-cause mortality among PWH
Comparing technology-enhanced and conventional Van Hiele Phased Instruction in advancing learners through Van Hiele levels in transformation geometry
(Cogent Education, 2026) Ndungo,Issa; Balimuttajjo,Sudi; Akugizibwe, Edwin; Muwonge,Charles Magoba
Developing learners’ geometric reasoning remains a persistent challenge in secondary mathematics education, particularly in transformation geometry, where many learners struggle to progress through the hierarchical Van Hiele levels of geometric thinking. Although technology-enhanced instruction has been associated with improved mathema tics learning, limited evidence exists on how integrating GeoGebra within the phases of Van Hiele instruction influences learners’ progression through these levels. This study compared Technology-Enhanced Van Hiele Phased Instruction (TVHPI) with Conventional Van Hiele Phased Instruction (CVHPI) in promoting learners’ progression through the Van Hiele levels in transformation geometry. Guided by Van Hiele theory and constructivist learning principles, a quasi-experimental design involving 483 Ugandan secondary school learners (TVHPI ¼ 238; CVHPI ¼ 245) was employed. Learners’ progression was assessed using the Van Hiele Geometry Achievement Test and analysed using Wilcoxon signed- rank tests, ordinal logistic regression, and Difference-in-Differences analysis. Both instruc tional approaches significantly improved learners’ geometric reasoning; however, learners receiving TVHPI demonstrated greater progression through the Van Hiele levels than those receiving CVHPI. The findings suggest that integrating GeoGebra within the phases of Van Hiele instruction is associated with higher levels of geometric reasoning and pro vides empirical support for technology-enhanced, competency-based geometry instruc tion that promotes deeper conceptual understanding
Bundibugyo ebolavirus emergence in eastern Democratic Republic of Congo: The critical role of risk communication and community engagement in strengthening health security in fragile and conflict-affected settings
(Journal of Virus Eradication, 2026-08-11) Kihanduka, Elie; Tague,Christian; Nadarajah, Saralees; Rugendabanga,Excellent; Akilimali,Aymar; Muyisa,Beni; Mugenyi,Nathan; Byakika-Kibwika, Pauline
Since mid-May 2026, a rapidly evolving Ebola virus disease (EVD) outbreak caused by the Bundibugyo strain (Orthoebolavirus bundibugyoense) has been spreading in eastern Democratic Republic of Congo (Ituri, North and South Kivu provinces) and Uganda (Kampala and Wakiso areas). Uganda has so far reported 14 imported cases and 5 secondary transmissions according to the World Health Organization (WHO). As of 30 July 2026, 3605 confirmed cases, including 1587 deaths, have been reported in the Democratic Republic of the Congo. Unlike previous Zaire outbreaks, no specific licensed vaccine or antiviral treatment exists for the Bundibugyo strain, making behavioral and community-based interventions the only line of defense. However, armed conflict, chronic insecurity, massive population displacements (>2.1 million), and profound community distrust of health authorities are crippling the response. This article therefore argues that the current threat is a major warning sign for the Great Lakes region, and that investing in Risk Communication and Community Engagement (RCCE) such as involving community health workers, natives, and trusted leaders is the most urgent priority to avoid a regional health catastrophe. Without a humanitarian truce to guarantee access and a coordinated cross-border RCCE strategy, undetected transmission will continue to fuel this outbreak and future zoonotic emergencies.
Bicornuate Uterus with Recurrent Miscarriage Following a Successful Term Pregnancy: A Case Report
(International Journal of Women's Health, 2026-08-10) Olwit,Gerald; Omalla, Ivan Darcy; Kaheru, Sean Arthur; Chris-Uchendu,Hans Chinomso; Nek,Arthur Jonathan; Mugisha,Aime Ishimwe; Ndyomugabe,Michael; Bbosa,Geofrey; Nkoyoyo,Crispus; Okello,Peter; Odongo,Leo; Komagum,Patrick; Turanzomwe,Stuart
Bicornuate uterus is an uncommon congenital Müllerian duct anomaly resulting from incomplete fusion of the para mesonephric ducts and is associated with adverse reproductive outcomes, including recurrent pregnancy loss, preterm birth, and malpresentation. However, some affected women may achieve successful pregnancies before the anomaly becomes clinically apparent, creating diagnostic challenges that can delay recognition and treatment. We report the case of a 28-year-old multiparous woman from rural Southwestern Uganda who presented with recurrent pregnancy loss following a previously uncomplicated term vaginal delivery. Ultrasonographic evaluation revealed a bicornuate unicollis uterus after two consecutive first-trimester miscarriages. Diagnostic uncertainty persisted throughout, as definitive differentiation from a septate uterus was not possible given the imaging limitations in our setting. The diagnosis was complicated by limited access to advanced imaging modalities such as three-dimensional ultrasono graphy, hysteroscopy, and magnetic resonance imaging (MRI), highlighting challenges commonly encountered in low-resource environments. Given her adverse reproductive history, desire for future fertility, and the lack of access to laparoscopic surgical services within our setting, she underwent an open Strassman metroplasty, which was technically successful in restoring a unified uterine cavity. The postoperative course was uneventful, and extensive counseling was provided regarding fertility expectations, contraception, and timing of future conception. At the time of reporting this case, she remained clinically stable at 2 months of follow- up, although reproductive outcomes following surgery could not yet be assessed, and definitive conclusions regarding reproductive benefit cannot be drawn at this stage. This case highlights the paradoxical presentation of bicornuate uterus with an initial successful term pregnancy followed by recurrent miscarriage, underscores the diagnostic and management barriers faced in resource-constrained settings, and emphasizes the importance of considering congenital uterine anomalies in women presenting with secondary recurrent pregnancy loss despite a previously favorable obstetric history.
Baseline Risk of Treatment Abandonment and Survival of Children With Common and Curable Cancers in the Zero Abandonment Cash Transfer Programme—A Multi-Centre Prospective CANCaRe Africa Study
(Pediatric Blood & Cancer, 2026) Molla,Yalew Melkamu; Mezgebu,Esubalew; Atwiine,Barnabas; Mdoka,Cecilia; Wassie,Mulugeta; Branchard,Mushabe; Yimer,Mulugeta Ayalew; Zobeck,Mark; Fufa,Diriba; Israels,Trijn
Background: The WHO Global Initiative for Childhood Cancer (GICC) targets a global survival rate of 60% for childhood cancer, focusing initially on six common and curable cancers. This study assessed the risk of treatment abandonment (TxA) and the impact on survival of five of these cancers in sub-Saharan Africa in preparation for a cash transfer intervention. Methods: This multi-centre, prospective, observational cohort study included newly diagnosed children ( < 16 years) with Burkitt lymphoma (BL), acute lymphoblastic leukaemia (ALL), Wilms tumour (WT), retinoblastoma (RB) or Hodgkin disease (HD), enrolled between January 2022 and April 2024 from hospitals in Ethiopia ( n = 2) and Uganda. Event-free survival (EFS) was estimated using Kaplan–Meier methods, and the cumulative incidence of TxA was estimated using competing risks methods. Results: Of 370 patients enrolled (median age 6 years, 62% boys), ALL was the most common diagnosis (30%, 112/370). Median follow-up was 26 months (range 6–35 months). The overall risk of treatment abandonment was 43%, ranging from 20% in Mbarara, Uganda to 54% in Gondar, Ethiopia. It was highest in patients with WT (48%) and RB (49%). Overall, 2-year EFS was 28% (confidence interval [CI] 24%–34%) with TxA as an event and 59% (53%–66%) when TxA cases were censored. Conclusion: The overall risk of treatment abandonment is high, 43%, in this baseline ‘Zero Abandonment’ study in participating hospitals in Ethiopia and Uganda. Treatment abandonment significantly affects survival, currently 28%, and potentially to increase to 59% if treatment abandonment was completely prevented.
Association of a single prior cesarean delivery with adverse birth outcomes at a tertiary referral hospital in southwestern Uganda: A secondary analysis of four observational studies
(International Journal of Gynecology & Obstetrics, 2026) Tibaijuka,Leevan; Ngonzi,Joseph; Correia,Katharine; Goldstein,Jeffery A.; Wang, James Z.; Walker, Rachel E.; Kumbakumba,Elias; Boatin, Adeline A.; Bebell, Lisa M.
Background: Prior cesarean delivery (CD) is a leading indication for repeat CD and a key driver of rising cesarean rates in Sub- Saharan Africa. Evidence on associations between prior CD and adverse outcomes in low- resource settings remains limited. Objective: We examined the association between one prior CD and adverse maternal and perinatal outcomes and examined current delivery mode as a mediator of this association among women delivering at Mbarara Regional Referral Hospital (MRRH), Uganda. Methods: We conducted a secondary analysis of four prospective studies at MRRH (2014–2024). The exposure was having one prior CD, and outcomes included com posite adverse maternal outcomes (postpartum hemorrhage, infection, blood transfu sion, prolonged hospital stay, and others) and composite adverse perinatal outcomes (stillbirth, neonatal death, preterm birth, low birthweight, low Apgar score, and neo natal intensive care unit admission). We compared the odds of adverse outcomes for women with one prior CD to those with none using multivariable logistic regression. Causal mediation analysis was used to assess whether current CD mediated the effect of prior CD on adverse maternal outcomes. Results: Of 2222 women with at least one prior delivery, 611 (27.5%) had one prior CD. Women with one prior CD more often delivered by cesarean (73.7% vs. 26.4%) and experienced more adverse maternal outcomes (24.5% vs. 15.4%, P 1.69), and low antenatal care (ANC) attendance (aOR: 1.66) independently predicted perinatal outcomes. Conclusion: While prior CD was associated with higher odds of poor maternal out comes due to repeat cesarean, HIV- positive serostatus, facility referral, and low ANC attendance (but not prior CD) independently predicted adverse perinatal outcomes. Individualized delivery planning and improving surgical safety for women with prior CD and strengthened antenatal surveillance are critical to reducing maternal and peri natal morbidity at referral facilities in low- resource settings.
Fire Hawk Optimizer Adjusted Tri-Stage (1+PI)-PI-TID Cascade Controller for Automatic Generation Control of PSI
(IEEE Access, 2025) Awal,Moses; Atim,Michael Robson; Wanzala,Jimmy Nabende; Obungoloch,Johnes; Barakat,Mohamed
This study aims to enhance the performance of automatic generation control (AGC) in power systems interconnection (PSI) by employing the fire hawk optimizer (FHO), a green algorithm, to optimize a novel tri-stage cascade controllers (CCs) configuration: (1+PI)-PI-PID and (1+PI)-PI-TID CCs. The FHO draws inspiration from the foraging behaviors of whistling kites, black kites, and brown falcons, known for their unique prey-catching method involving fire propagation. Evaluation of the proposed FHO: (1+PI)-PI-T/PID scheme is conducted using the integral time multiplied absolute error (ITAE) criteria. The versatility of this technique is demonstrated across four PSI test models, including a two-area non-reheat thermal PSI (NRTPSI) and a multi-unit multi-area (MUMA) system incorporating reheat, hydro, and gas units. Challenges are addressed by initially testing NRTPSI with and without governor dead band (GDB) nonlinearity, showing the superior performance of the proposed method. Next, the HVDC link in MUMA is employed under different scenarios. To assess the robustness of the FHO: (1+PI)-PI-T/PID CCs, real world AGC issues, such as sudden load perturbations and nonlinearities like generation rate constraint, GDB, boiler dynamics, and communication time delay in MUMA, are employed. Also, sensitivity analysis involving a range variation of }40% in PSI model parameters is conducted for validation. The proposed scheme also undergoes evaluation under random step-load perturbations. The results demonstrate significant improvements in the performance of ITAE by 84.3%, 10.7%, 42.1%, and 16.7% for scenario 1 across all four tested models. The FHO: (1+PI)-PI-TID CC significantly improves system performance compared to existing controllers like the HHO: PD-PI CC, FHO: TID, FHO: PID, and the proposed FHO: (1+PI)-PI-PID CCs. This shows that this approach is effective at improving AGC capabilities and can be used in real life. Update each group’s position using their respective equations
The Association Between Neutrophil-to- Lymphocyte and Platelet-to-Lymphocyte Ratios and Anemia in Adults with Hypertension in Southwestern Uganda: A Cross-Sectional Study
(Journal of Blood Medicine, 2026-08-23) Muwanguzi,Enoch; Tumusiime,Jazira; Kalyetsi,Rogers; Bagenda,Charles Nkubi; John,Elizabeth A; Okongo,Benson
Purpose:: This study aimed to determine the association of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with anemia among hypertensive patients in Southwestern Uganda. Patients and Methods: We conducted a secondary analysis of a cross-sectional study involving 386 consecutively enrolled hypertensive patients at Bwizibwera Health Centre IV, Mbarara District, Uganda. Anemia was defined as hemoglobin <12.0 g/dL in women and <13.0 g/dL in men. Data were analyzed using STATA. Categorical variables were compared using chi-square or Fisher’s exact tests, continuous variables with the Mann–Whitney U-test. Logistic regression examined associations of NLR, PLR, and monocyte-to-lymphocyte ratio (MLR) with anemia. Predictive performance was assessed using receiver operating characteristic (ROC) curves. Results: Overall anemia prevalence was 17.1% (95% CI: 13.7–21.2). Prevalence was significantly higher among participants with uncontrolled versus controlled blood pressure (20.8% vs 12.6%; p=0.035). Anemic participants had significantly higher NLR (1.49 vs 1.14; p<0.001), PLR (156.06 vs 118.45; p<0.001), and MLR (0.23 vs 0.20; p=0.006). High NLR and PLR were independently associated with anemia. Participants in the top tertile of NLR had over twice the odds of anemia compared to those in the bottom tertile (aOR=2.29; 95% CI: 1.04–5.07; p=0.040). Similarly, those in the top tertile of PLR had higher odds of anemia (aOR=2.28; 95% CI: 1.05–4.97; p=0.038). Both ratios showed significant predictive ability to distinguish anemic from non-anemic participants: NLR AUC=0.63 (95% CI: 0.56–0.71); PLR AUC=0.64 (95% CI: 0.56–0.72). Conclusion: In hypertensive patients, higher NLR and PLR are independently associated with anemia. These inexpensive, readily available inflammatory hematological ratios may help identify individuals at elevated anemia risk.
Molecular Characterization of Extended- Spectrum Beta-Lactamase-Producing Enterobacterales Among Cancer Patients at the Mbarara Regional Referral Hospital, Southwestern Uganda
(Cureus, 2026-08-18) Zamarano,Henry; Iramiot,Jacob Stanley; Mulogo,Edgar; Natumanya,Debrah; Khakasa,Catherine; Musinguzi,Benson; Mwesigye,Vicent; Mumbere,Iving; Muhwezi,Ivan; Kawuma, Simon; Orikiriza, Patrick
Background and objective Extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) are an important cause of antimicrobial-resistant infections among immunocompromised patients. Cancer patients are vulnerable because of frequent hospital exposure, invasive procedures, chemotherapy-associated immunosuppression, and antibiotic use. This study aimed to determine the molecular characteristics of ESBL-PE among cancer patients at Mbarara Regional Referral Hospital (MRRH), Southwestern Uganda. Methods A laboratory-based cross-sectional study was conducted at the Microbiology and Molecular Laboratory of Mbarara University of Science and Technology (MUST). The study used archived clinical Enterobacterales isolates recovered from clinical specimens collected from inpatient and outpatient cancer patients receiving care at MRRH between June and November 2025. The isolates had been identified using standard microbiological methods, and ESBL-PE were confirmed using the double-disk synergy test (DDST). Molecular detection of ESBL and other antimicrobial resistance-associated genes was performed using conventional polymerase chain reaction (PCR) with gene-specific primers. Target genes included blaCTX-M, blaTEM, blaSHV, blaOXA-1, AmpC-blaCITM, blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48, AAC(6’)-Ib, mcr-1, qnr, FosA, and blaPER. PCR products were separated by agarose gel electrophoresis and visualized under ultraviolet illumination. Data were entered into a database and analyzed using frequencies and percentages to summarize the distribution of resistance genes among isolates. Results A total of 281 isolates were analyzed. Escherichia coli (E. coli) was predominant (155/281, 55.2%), followed by Klebsiella pneumoniae (K. pneumoniae) (85/281, 30.2%). CTX-M was the most frequently detected resistance gene (106/281, 37.7%), followed by TEM (81/281, 28.8%), SHV (26/281, 9.3%), and AAC (24/281, 8.5%). At least one target resistance gene was detected in 170/281 (60.5%) isolates, while 111/281 (39.5%) had no target genes detected within the PCR panel. Multi-gene carriage occurred in 76/281 (27.0%), with TEM + CTX-M as the most common co-carriage pattern (25/281, 8.9%). Carbapenemase-associated genes remained uncommon. Conclusions The findings of this study describe the distribution of ESBL-PE in this population and highlight the importance of continued surveillance of resistant Enterobacterales among patients receiving cancer care.
Exploring Phosphatidylethanol Cutoffs for Self-Reported Unhealthy Alcohol Use: An International Multi-Site Analysis
(Alcohol: Clinical and Experimental Research, 2026) Murnane,Pamela M.; Xia,Fan; Afshar,Majid; Brown,Jennifer L.; Chamie,Gabriel; Cook,Robert L.; Couture,Marie Claude; DiClemente,Ralph J.; Fatch,Robin; Ferguson,Tekeda; Francis,Joel M.; Haberer,Jessica E.; Jacobson,Karen R.; Justice,Amy C.; Kapiga,Saidi; Kim,Theresa W.; Krupitsky,Evgeny; Marcus,Gregory M.; Molina,Patricia E.; Muyindike,Winnie R.; Myers,Bronwyn; Page,Kimberly; Phillips,Shane A.; Piano,Mariann R.; Richards,Veronica L.; So-Armah,Kaku; Stewart,Scott; Sulkowski,Mark S.; Tien,Phyllis C.; Woolf-King,Sarah; Hahn,Judith A.
Background: Unhealthy alcohol use is a preventable cause of morbidity and mortality, yet screening is hampered by inaccurate reporting. Phosphatidylethanol (PEth) is a biomarker that quantifies total drinking over the past 2–4 weeks, but PEth cutoffs for unhealthy drinking have not been well-examined. Methods: We pooled data from 22 studies (11,088 persons globally) that previously collected PEth and self-reported alcohol use. Within a 90% training set, we calculated PEth cutoffs per Youden's J in 1000 bootstrapped samples and explored differences by region, age, sex, race/ethnicity, body mass index (BMI), HIV status, hemoglobin level, and an indirect serum marker of liver fibrosis, FIB-4. For each cutoff, we estimated sensitivity, specificity, and positive and negative predictive values in a 10% validation dataset. We used two definitions for self-reported unhealthy drinking per Alcohol Use Disorders Identification Test Consumption (AUDIT-C) and National Institute on Alcohol Abuse and Alcoholism (NIAAA). Results: Optimal PEth cutoffs using self-reported alcohol use as the reference standard differed substantially by region. The cutoff for AUDIT-C- measured unhealthy alcohol use in studies from the United States (US) was 14.0 ng/mL (95% CI: 12.3–18.6) with 73.0% sensitivity (95% CI: 67.3–79.1) and 77.4% specificity (95% CI: 73.2–81.4); and was 65.7 ng/mL (95% CI 19.3–90.7) in studies from Africa, with 71.7% sensitivity (95% CI: 64.4–78.7) and 65.2% specificity (95% CI: 58.1–72.7). Cutoffs for AUDIT-C did not differ between subgroups in the US, but within Africa, cutoffs were higher for men and lower for those with BMI ≥ 25 kg/m2. Cutoffs for NIAAA defined unhealthy alcohol use were similar to those using the AUDIT-C. Conclusions: Using self-report as the reference standard, PEth cutoffs differed substantially by region and by some other characteristics, which may be attributable to differences in PEth formation, elimination and/or reporting bias. Further work using objective gold-standard measures of alcohol consumption is needed for more definitive conclusions.
The OTELO Survey: The main sequence of low-mass galaxies
(Astronomy & Astrophysics,, 2026) Cedrés,Bernabé; Cepa,Jordi; Padilla–Torres,Carmen P.; Bongiovanni,Ángel; Cerviño,Miguel; Diego,José A. de; Nadolny,Jakub; Danilo,Simon B. De; González–Otero,Mauro; Rodríguez,Monica I.; Gallego,Jesús; Povic,Mirjana; Lara–López,Maritza A.; González–Serrano,J. Ignacio; Sánchez–Portal,Miguel; Pérez–García,Ana María; Pérez–Martínez,Ricardo; Alfaro,Emilio J.
Aims. This paper describes the relationship between the star formation rate and the stellar mass, the so-called main sequence (MS), of low-mass galaxies at three different redshifts from the OTELO survey. In particular, we study H_ at z = 0:38, [O iii] at z = 0:83, and [O ii] at z = 1:43 emission line galaxies (ELGs). This is done to characterise the properties of low-mass ELGs. Methods. We fitted the spectral energy distribution (SED) of each emitter and obtained the stellar masses, the total infrared luminosity, and the star formation rate. We found that 100% of the H_ emitters and about 90% of the [O iii] and [O ii] emitters are low-mass galaxies (<1010M_). We generated a MS for each redshift regime, employing all galaxies and binning them in stellar mass. We obtained the parameters of the fit (turnover mass and slope of the low-mass regime) and compared them to results from the literature. Results. We found that the colour–magnitude method employed to select ELGs leaves out a significant number of them. We also found that the whole sample contains few luminous infrared galaxies and no ultra-luminous infrared galaxies. We also found that the lack of infrared constraints in the input SEDs may generate problems when determining the total infrared luminosity. When comparing the MS obtained for our sample of low-mass ELGs with those from the bibliography, we found, in general, very good agreement. We can consider the MS to be almost the same for the relatively unexplored regime of low-mass galaxies. However, the turnover mass obtained by this work is higher for all redshifts compared with the ones from the literature. We suggest that this is an effect of the different methods and samples used in the generation of the MS compared to those of the bibliography.
Recent treatment outcomes of cervical intraepithelial neoplasia in south western Uganda: a six year retrospective study
(Gynecologic Oncology R, 2026-06-19) Ssedyabane,Frank; kajabwangu,Rogers; Mudondo,Hope; Tusubira,Deusdedit; Muhumuza,Joy; Namuli,Alexcer; Mwesigwa,Geoffrey; Bagenda,Charles Nkubi; Castro,Cesar M.; Lee,Hakho; Randall,Thomas C.; Ngonzi,Joseph
Background: There is limited real-world data on trends and distribution of treatment outcomes of cervical lesions in cervical cancer care settings in Uganda. We conducted this study to describe trends and the distribution of treatment outcomes for Cervical Intraepithelial Neoplasia (CIN) among women treated at Mbarara Regional Referral Hospital (MRRH), Southwestern Uganda. Methods: We conducted a retrospective census of women treated for CIN at the cervical cancer clinic and gynecology ward of MRRH from January 2020 to July 2025. Data on age, district of residence, HIV status, HPV test results, treatment modality, year of treatment, and treatment outcomes were extracted from clinic registers and patient records and analyzed using Stata 17. Results: We retrieved records of 184 women who had been treated for CIN, and their mean age was43.3 (±14.8). The majority (150/184, 81.5%) of CIN cases were documented as cured while the while 34/184 (18.5%) had persistent lesions. More than half of cases with persistent lesions also had unknown HIV status. Persistent CIN was mostly observed among women who were either positive with single HPV16 genotype (7/34, 20.6%) or HPV18/45 plus Other hrHPV genotypes (22/34, 64.7%). Conclusion: An increasing trend in persistent cervical intraepithelial neoplasia was observed over the study period, particularly among women with unknown HIV status and those with HPV16 infection or mixed HPV18/ 45 and other high-risk HPV infections. These findings highlight the need to strengthen integration of cervical precancer care into HIV services, reinforce the screen-and-treat approach, and improve post-treatment follow-up and monitoring.
Integrated feedstock chemistry and prepared-microstructure controls on inert decomposition of briquetted biomass residues: Groundnut shell versus pine wood chippings
(Next Materials, 2026-07-20) George,Onep Samuel; Barah,Obinna Onyebuchi; Nnamchi,Stephen Ndubuisi; Dennison,Milon Selvam
Feedstock variability remains a major constraint in small-scale biomass conversion systems, yet preliminary feedstock screening often relies on bulk fuel properties that provide limited insight into decomposition behavior. This study compares binder-less briquetted groundnut shell (GNS) and pine wood chippings (PWC) to determine how bulk composition, prepared-surface morphology, surface elemental signals, and broad functional-group signatures coincide with inert thermal decomposition behavior. Both feedstocks were conditioned to low moisture content and characterized using proximate analysis, higher heating value determination, thermogravimetric analysis under nitrogen, SEM-EDX, and ATR-FTIR. PWC exhibited higher volatile matter than GNS (71.88 vs. 67.40 wt% db.) and lower ash content (1.72 vs. 3.30 wt% db.), whereas GNS showed higher fixed carbon (19.94 vs. 17.18 wt% db.) and higher HHV (18.87 vs. 17.04 MJ kg⁻¹). Under inert heating, PWC decomposed earlier, with lower onset and peak decomposition temperatures, whereas GNS retained substantially more terminal residue at 1000 ◦C. SEM revealed a more heterogeneous, fracture-dominated prepared surface for GNS and a more fibrous, channel-like prepared surface for PWC. EDX and ATR-FTIR further supported differences in detected surface elemental balance and broad functional-group profiles. Overall, the results demonstrate statistically consistent differences between the two briquetted residues and establish a characterization-based basis for cautious preliminary screening. In the absence of ultimate analysis, direct lignocellulosic fractionation, mineralogical analysis, and reactor-scale gasification testing, the findings define a comparative laboratory basis for interpreting inert decomposition behavior, rather than a predictive framework for gasifier performance.
Hydrological convergence and surface–groundwater connectivity are associated with fluorescent groundwater DOM in the Victoria and Kyoga Basins, Uganda
(Applied Geochemistry, 2026-06-24) Muloogi,Derick; Gooddy,Daren C.; Polya,David A.; Richards,Laura A.
Dissolved organic matter (DOM) influences subsurface biogeochemistry yet controls on its composition in many tropical sub-Saharan aquifers remain poorly understood. Here, we integrated satellite-derived land-use/land-cover (LULC) data, terrain metrics, and inorganic tracers (NO3􀀀 /Cl􀀀 , SO42􀀀 /Cl􀀀 ) to evaluate how LULC patterns and terrain-driven hydrological convergence, expressed as topographic wetness index (TWI), influence bulk and fluorescent groundwater DOM (fDOM) across multiple spatial scales in Uganda. Groundwater DOM was dominated by weakly aromatic, highly processed material of mixed terrestrial and microbial origin (specific ultraviolet absorbance (SUVA) < 0.5 L mg􀀀 1.m􀀀 1; median humification index (HIXcorr) > 0.5, β:α < 1, and fluorescence index (FI) ~ 1.6). Total fluorescence (0.1 – 12.3 RU; median 0.3 RU) was dominated by fulvic-like (~35 %) and tryptophan-like (~29 %), followed by tyrosine-like (~18 %) and humic-like (~17 %) components. The combined influence of LULC and TWI was scale dependent, although LULC categories showed no significant associations with groundwater DOM, except surface-water cover. TWI was positively associated with dissolved organic carbon (DOC), and fDOM components consistent with potential lateral mobilisation and surface–groundwater interaction in hydrologically convergent zones. NO3􀀀 /Cl􀀀 ratios were negatively correlated with DOC (Spearman ρ ~ 􀀀 0.56), and positively with SUVA (ρ ~ 0.46), consistent with preferential depletion of relatively bioavailable DOM fractions and relative enrichment of more aromatic residual DOM under nitrate-enriched conditions. These results show that in the Victoria and Kyoga basins, hydrological convergence, rather than land use alone, likely influences groundwater DOM composition, highlighting surface waters and near-surface hyporheic zones as potential sources and transformation environments for organic matter entering aquifers.
Graduate-level nursing education, practice, and research in Uganda: current challenges and opportunities for advanced practice nurses (APN). A review of literature, policy document and professional guidelines
(International Journal of Africa Nursing Sciences, 2026) Katende,Godfrey; Asiimwe,John Baptist; Among,Grace; Namboozi,Grace; Muwema,Mercy; Nimwesigwa,Christine
Objective: This paper examined the status of graduate-level nursing education, practice, and research in Uganda and identified associated challenges and opportunities. Materials and methods: An analysis of existing literature, policy documents, and professional guidelines was conducted. This approach was selected to highlight contextual and systemic opportunities and challenges for graduate-level nursing in Uganda. Results: Among the graduate-level programs offered in Uganda, identifying as whether it is an NP or CNS pose a challenge. Key challenges include uneven program distribution, faculty shortages, limited research infrastructure. High attrition and low completion rates (~38% in Africa) were due to financial and personal challenges. Opportunities include a growing pool of baccalaureate-prepared nurses, increasing numbers of doctorly prepared faculty, blended learning technologies, donor support, and policy frameworks supporting advanced practice nursing (APN) development. Conclusion: There is a lack of CNS or NP classification that will be needed for regulatory clarity or faculty development. Strengthening APN education and standardizing curricula could improve healthcare delivery and research output among nurses in Uganda. Strategic investment in education, faculty development, and research capacity is critical for advancing nursing nationally and regionally. Higher Education Institutions (HEIs) should undertake graduates tracer studies of existing programs to determine employment outcomes in relation to the scope of practice.
Distribution and Variability of the Abdominal Vagus Nerve: An Anatomical Study in Uganda
(International Journal of Morphology, 2026) Kamoga,Ronald; Kalungi,Samuel; Nakidde,Gladys; Mugagga,Kintu; Obua,Celestino; Ihunwo,Amadi Ogonda
Iatrogenic injury to the vagus nerve during gastrointestinal surgery may result in postoperative complications due to disruption of its anti-inflammatory and neuromodulatory functions. Although anatomical variations of the abdominal vagus nerve have been described, data from African populations, particularly Uganda, remain limited. This study aimed to describe the distribution and anatomical variations of the abdominal vagus nerve. This analytical cross-sectional study was conducted on 67 unclaimed postmortem human bodies. Dissections were performed using a standardized protocol, and anatomical findings were recorded using a pretested data collection form. Statistical analysis was performed using STATA version 13.0. The principal nerve of Latarjet was identified in 83.6 % of specimens, and a crow’s foot pattern was observed in 80 %. A single hepatic branch was present in all specimens, while an anterior vagal plexus was identified in 32.8 %. The number of anterior gastric branches varied among specimens. A principal posterior nerve of the lesser curvature was present in 4.5 % of cases, and a single celiac branch was observed in all specimens. The first branch of the posterior trunk (criminal nerve of Grassi) was identified in 9 % of specimens. The number of posterior gastric branches ranged from three to eight, and the distance between the esophageal hiatus and the first gastric branch showed considerable variability. No statistically significant differences in vagal branching patterns were observed between individuals or between sexes. The abdominal vagus nerve demonstrates considerable variability in its distribution and branching pattern. Recognition of these variations is important during intraabdominal surgical procedures to minimize inadvertent vagal injury.
Compliance with WHO-recommended ≥8 antenatal contacts and associated factors among women at primary health facilities in Mbarara district, Uganda
(Sage Open Medicine, 2026) Agaba,Racheal; Ochola,Henry; Muhwezi,Abraham; Murungi,Tom; Namanya,Sylvester; Lule,Daniel; Turigye,Brian; Kabakyenga,Jerome
Background: The World Health Organisation (WHO) recommends ≥8 antenatal care (ANC) contacts to improve detection of pregnancy risks and maternal newborn outcomes. However, uptake of the 8-contact model remains low in many low-resource settings. Objectives: To assess compliance with the WHO-recommended ≥8 ANC contacts and associated factors among women attending primary health facilities in Mbarara District, south-western Uganda. Design: Facility-based cross-sectional study. Methods: Postnatal women attending postnatal and immunisation clinics at five randomly selected primary health facilities in Mbarara district were recruited between April and May 2025. Data were collected using interviewer-administered questionnaires and verified with antenatal cards. Data were analysed using Stata version 18 software. Descriptive statistics summarised participant characteristics. Bivariate and multivariable logistic regression analyses identified factors associated with compliance with the WHO-recommended ≥8 ANC contacts. Results: Of 433 participants enrolled (median age 27 years; interquartile range 23-31 years), the majority (67%; 290/433) were aged 21-34 years. Overall compliance with WHO-recommended ≥8 ANC Contacts was 15.0% (65/433; 95% CI: 11.8%–18.7%). The factors significantly associated with compliance with the WHO-recommended ≥8 Antenatal Contacts were initiating ANC in the first trimester of the index pregnancy (aOR = 43.08; 95% CI:14.84-124.97; p<0.001), staying within a distance of less than 5 km (aOR = 2.00; 95% CI:1.05-3.77; p=0.034), and monthly income of ≥100,000 Uganda shillings (aOR = 1.13; 95% CI:1.03-4.33; p=0.041). Conclusion: Compliance with the WHO-recommended ≥8 ANC contacts was low. Higher compliance was observed among women who initiated ANC early, lived closer to health facilities, and had higher incomes. Future strategies focus on factors associated with compliance, including early ANC initiation, geographic accessibility, and socioeconomic barriers.
Burden of extended-spectrum beta-lactamase- producing Enterobacteriaceae among cancer patients in Africa: a systematic review and meta-analysis
(Access Microbiology, 2026-06-12) Zamarano,Henry; Musinguzi,Benson; Twinomujuni,Muzafaru; Khakasa,Catherine; Mwesigye,Vicent; Muhwezi,Ivan; Mulogo,Edgar Mugema; Natumanya,Deborah; Kawuma,Simon; Orikiriza,Patrick; Iramiot,Jacob Stanley
Background. Extended-spectrum beta-lactamase- producing Enterobacteriaceae (ESBL-PE) exacerbate infections in cancer patients in settings where antimicrobial resistance threatens health outcomes. This study estimated the prevalence of ESBL-PE among cancer patients in Africa from 1 January 2010 to 31 December 2024. Methods. We searched PubMed, Embase, Web of Science, CINAHL and Global Health for observational studies reporting ESBL-PE prevalence in cancer patients. Studies published in English from 1 January 2010 to 31 December 2024 were included. Two reviewers independently screened studies, extracted data using standardized forms and assessed the quality of articles using the Newcastle–Ottawa Scale. Pooled prevalence was calculated using a random-effects model in RStudio v4.4.2, with heterogeneity assessed with the I2 statistic and publication bias assessed with funnel plots and Egger’s test. Results. Twelve studies from 9 African countries, involving a total of 1,252 cancer patients and 643 identified events, were included. The pooled prevalence of ESBL-PE was 49.4% (95% CI: 36.0–62.9%, I2=88.3%, P<0.001). Escherichia coli and Klebsiella pneumoniae predominated. There was no evidence of publication bias based on funnel plot symmetry, Egger’s test (t=−0.35, P=0.73) and trim-and- fill analysis (no studies imputed; adjusted estimate unchanged). Heterogeneity was substantial (I2=88.3%) with a wide 95% prediction interval (22.7–76.5%). Leave-one- out sensitivity analysis confirmed estimate stability (~49%) with persistently high heterogeneity (I2 range: 81.4–89.4%). Conclusions. The high ESBL-PE prevalence in African cancer patients signals a critical public health issue, necessitating enhanced surveillance, antimicrobial stewardship and intentional infection control measures
Electroencephalogram Utilization, Epileptiform Findings, and Associated Factors Among Children with Epilepsy in Southwestern Uganda: A 5-Year Retrospective Record Review
(Pediatric Health, Medicine and Therapeutics, 2026-08-18) Okumu,Fiona; Ochora,Moses; Turanzomwe,Stuart; Kayanja,Adrian S L; Wakweyika,Gerald; Keneema,Olive; Kalubi,Peters
Objective: Epilepsy is the most common neurological condition in children in Low and Middle Income Countries (LMIC). Although the diagnosis remains majorly clinical, EEG is fundamental in assessment and management of epilepsy. However, its uptake remains low in LMIC. We aimed to determine the proportion of children with epilepsy who have had an EEG, the proportion of epileptiform EEGs, and the factors associated with epileptiform EEGs among the children with epilepsy at a neurology clinic in South Western Uganda. Methods: We conducted a retrospective record review of 427 children less than 18 years old attending the Epilepsy Clinic at Mbarara Regional Referral Hospital. Records were selected by simple random sampling. A waiver of consent was obtained to study the medical records. Data was collected using REDCAP and analysed with STATA version 17. Proportions were reported as percentages and factors associated with epileptiform EEGs were analysed using the modified Poisson regression analysis. Results: Out of 427 participants in this study, 149 (34.9%) had done EEG. Epileptiform EEGs were observed among 102 (68.5%) children. The factors independently associated with epileptiform EEGs among the children with epilepsy included participants’ sex and type of seizure. Having an epileptiform EEG was 1.98 times more likely among females than males (cPR:1.98, P -value 0.005) while it was 1.87 times more likely in children with generalized seizures compared to those with focal seizures (cPR:1.87, P-value=0.019). Significance: There is need for more EEGs to be done especially among children with generalized seizures. More health workers also need to be trained in electro-encephalography.