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Recent Submissions

Towards Improved Geometry Instruction: Learners’ Experiences with Technology-Enhanced and Conventional Van Hiele Phased Instruction
(The Electronic Journal for Research in Science & Mathematics Education, 2025) Issa Ndungo; Sudi Balimuttajjo; Edwin Akugizibwe
This study investigated learners' experiences and understanding of transformation geometry using two instructional strategies: Conventional Van Hiele Phased Instruction (CVHPI) and Technology Enhanced Van Hiele Phased Instruction (TVHPI), incorporating GeoGebra as a digital tool. Through semi-structured interviews, qualitative data were collected from 48 Senior Three secondary school learners who participated. Thematic analysis revealed that TVHPI, supported by GeoGebra, enhanced visual learning and dynamic interaction with geometric concepts, though learners faced technical challenges and limited practice time. CVHPI, while providing structured and step-by-step instruction, particularly benefited lower achievers but was less effective in addressing complex misunderstandings. As a result of this study, a Geometry Pedagogical Improvement Cycle (GeoPIC) framework was developed to improve the teaching and learning of geometry through a continuous and systematic process. The GeoPIC framework emphasizes adopting instructional strategies, tailoring them to individual needs, aligning with learner expectations, and incorporating feedback through a cyclical reflection and adjustment process. This study highlights the potential of combining technology-enhanced tools with conventional instruction and presents GeoPIC as a model for refining pedagogical approaches in geometry education.
Transformation Geometry Attitude Scale (TGAS): Development and Validation for Secondary School Learners in Uganda
(International Journal of Advanced Research, 2025) Issa Ndungo; Sudi Balimuttajjo; Edwin Akugizibwe
Transformation geometry, a core topic in secondary school mathematics, strengthens students' spatial reasoning and problem-solving skills. Students’ attitudes toward transformation geometry significantly influence their engagement, motivation, and achievement in mathematics. However, existing attitude scales either focus on general mathematics/geometry, are designed for other educational levels or were developed outside Uganda, limiting their contextual relevance. This study aimed to develop and validate the Transformation Geometry Attitude Scale (TGAS) for assessing Ugandan secondary school learners' attitudes. The scale was developed through expert consultations and piloted among 132 secondary students. Validation involved Exploratory Factor Analysis (EFA) and reliability testing. The initial 36-item scale (α = 0.85) was refined to 22 items across three dimensions: Interest & Confidence (α = 0.80), Engagement & Metacognition (α = 0.77), and Relevance & Applications (α = 0.85). The validated TGAS provides a reliable tool for evaluating students’ attitudes and informing instructional strategies in transformation geometry. Future research should apply Confirmatory Factor Analysis (CFA) across diverse educational settings to further validate its structure.
Conceptual and Procedural Trajectories in Transformation Geometry- Comparative Study Of Technology-Enhanced and Conventional Van Hiele Phased Instruction
(International Journal of Education, Technology and Science, 2025) Issa Ndungo; Sudi Balimuttajjo; Edwin Akugizibwe
This study investigates the effectiveness of Technology-Enhanced Van Hiele Phased Instruction (TVHPI) compared to Conventional Van Hiele Phased Instruction (CVHPI) in enhancing learners' conceptual understanding and procedural fluency in transformation geometry. A quasiexperimental design was employed, involving 144 secondary school learners from six schools in Uganda. Conceptual and procedural understanding was assessed from learners’ test scripts using a 5-point performance scale, and performance across Van Hiele levels was analyzed using descriptive and inferential statistics. Results revealed that TVHPI significantly improved both conceptual understanding (t=10.861, p=0.00t=10.861, p=0.00) and procedural fluency (compared to CVHPI. Performance across Van Hiele levels showed foundational tasks (Levels 1 and 2) were better supported by both strategies, while TVHPI showed an advantage at intermediate levels (Level 3). The study recommends integrating technology like GeoGebra into instructional practices to enhance learning outcomes. These findings emphasize the potential of technology-enhanced strategies to improve geometric reasoning and inform curriculum design.
Excel-Based Qualitative Data Analysis; Methodological Guidelines for Systematic Organization, Iterative Coding, and Thematic Visualization
(International Journal of Education, Technology and Science, 2025) Issa Ndungo; Sudi Balimuttajjo; Edwin Akugizibwe
This paper addresses the need for a systematic, cost-effective methodology for qualitative analysis by detailing how Excel’s spreadsheet environment can support transparent coding, thematic synthesis, and visual interpretation. Particularly for small-scale projects, mixed methods designs, or researchers new to qualitative tools. Therefore, it presents the available opportunities for integrating manual coding rigor with Excel’s spreadsheet logic, offering the transparency of paper-based analysis with digital scalability for arranging, categorizing, and displaying qualitative data. Although more sophisticated tools are available in specialized qualitative analysis programs such as NVivo, ATLAS.ti, and MAXQDA, Excel offers researchers a more accessible, adaptable, and user-friendly option. This paper shows how systematic coding, data management, and visual aids in Excel can handle and evaluate qualitative data efficiently. The results demonstrate Excel's usefulness in qualitative research, especially for those seeking an affordable and comfortable platform without sacrificing analytical rigor, providing insights on the benefits and drawbacks of using Excel for qualitative data analysis.
Intensity of Innovation: mediator of Internal Control Systems and Financial Accountability
(International Journal of Finance and Accounting, 2026) Atubangire Joan Atubangire; John Muhunga Kule Baguma; John Rwakihembo
Purpose: This paper examined the mediating effect of the intensity of innovation in the relationship between internal control systems and financial accountability of higher local governments in South-Western Uganda. The purpose of this paper was to establish the mediating role of the intensity of innovations in the association between internal control systems and financial accountability. Design/methodology/approach:The paper employed the Medgraph program and the Kenny and Baron approach to test for mediation effects. Findings: It is crystal clear that the factual drivers of financial accountability in higher local governments are the intensity of innovation and internal control systems. However, the intensity of innovation exhibits a partial form of mediation in the relationship between internal control systems and financial accountability. Study implications: Since the intensity of innovation depicted a causal chain in the relation between internal control systems and financial accountability in this study, the management of higher local governments should aim to enhance the agents of intensity of innovation, i.e., innovative input, innovative process, and innovative output, since effective financial accountability is driven by effective governance mechanisms and financial management practices. Study limitations: A quantitative research approach was adopted in this study. Based on the limitations linked to this research approach, future research could be conducted through interviews to triangulate. Originality/value: This is the first study that focuses on testing the mediating effect of intensity of innovation in the relationship between internal control systems and financial accountability in the Uganda Higher local government sector.
Women on the Margin, Decision-making and the Unmet Need for Maternal Health in Rural Mbarara District Uganda
(International Journal of Maternal and Child Health, 2015) Viola Nilah Nyakato; Charles B Rwabukwali
This paper presents research findings from a study that was conducted between September 2009 and December 2010 in Mbarara District, Southwestern Uganda. The study examined intra-household social determinants of demand for maternal health care including family planning practices. A wide range of questions were included in a household survey to assess maternal healthcare decision-making. Among most Ugandan communities, household resource allocation and decision-making follow a hierarchy whereby men/husbands direct the process for allocation of resources. Household ownership of land, head of the family, source of income and level of education were the three individual socio-demographic characteristics that significantly affect use of the maternal health services. It was found that more than half of all maternal healthcare decisions that women make are in many ways influenced by men/husbands.
Financial Risk Management and Financial Performance of Construction Companies in Greater Kampala Metropolitan Area
(Journal of Economics and Behavioral Studies, 2025) Frederick Nsambu Kijjambu; Benjamin Musiita; Sheila Akampwera
The financial performance of construction companies depends significantly on their ability to manage financial risks. This study examined the effect of financial risk management on the financial performance of construction companies focusing on three dimensions: risk identification, risk assessment and evaluation, and risk management strategy. Guided by Modern Portfolio Theory, the study adopted a crosssectional survey design and collected data from 191 construction companies selected through proportionate sampling. Structured questionnaires were used for data collection and the validity and reliability of the instruments were confirmed through expert review and Cronbach’s Alpha. Data were analyzed using descriptive statistics, correlation analysis, and hierarchical regression. Findings revealed that all three financial risk management components were positively associated with financial performance. Risk identification showed a significant but modest relationship with financial performance (r = .300, p < .01), while risk assessment and evaluation exhibited the strongest association (r = .591, p < .01). Risk management strategy also demonstrated a significant positive relationship (r = .428, p < .01). Hierarchical regression results further indicated that risk assessment and evaluation contributed the largest increase in explained variance (24.9 percent), followed by risk management strategy (7.1 percent), whereas the influence of risk identification diminished after additional predictors were introduced. Overall, the models explained 42.7 percent of the variation in financial performance. The study concludes that financial risk management significantly improves financial performance, particularly when firms invest in thorough assessment and evaluation of risks and implement structured mitigation strategies. It recommends that construction firms adopt comprehensive risk management frameworks, strengthen analytical capacities and integrate proactive financial planning tools to enhance profitability, reduce exposure to uncertainty and improve long-term sustainability
Potential for optimisation of fuel yield and hydrocarbon distribution from plastic waste pyrolysis using Nanopyroxene catalysts
(Results in Chemistry, 2025) Derick Muloogi; Farad Sagala; Fortunate Ogene; Denis Bbosa; Grace Birungi
Plastic waste is a global concern, driven largely by the widespread use of single-use plastics. Despite advances in recycling technologies, scalable, and cost-effective plastic waste management solutions remain limited. Thermal pyrolysis offers a complementary pathway for plastic waste valorisation through energy recovery, but conventional processes are constrained by slow reaction rates, high energy demands, and low fuel yields. This study introduces, for the first time, nanopyroxene as a novel catalytic additive for plastic waste pyrolysis in a locally fabricated batch reactor, aiming to improve fuel yield and hydrocarbon distribution. A mixture of Low-density polyethylene (LDPE), High-density polyethylene (HDPE), and polypropylene (PP) (2:1:2 ratio) was thermally decomposed under catalysed and non-catalysed conditions. The physico-chemical properties of the resulting plastic-derived fuel oils (PDFOs) were benchmarked against commercial diesel. Catalytic pyrolysis significantly increased the fuel oil yield to 77 %, compared to 56 % from non-catalytic pyrolysis (p < 0.05). The catalyst promoted the formation of light hydrocarbons (C1–C9) and reduced intermediate fractions but increased ultraheavy hydrocarbons (C25–C56), which potentially affects combustion efficiency. Physical characterisation revealed no statistically significant differences (p > 0.05) between PDFOs and commercial diesel in key fuel properties, all of which fell within recommended standards. However, PDFOs exhibited higher volatility, density, and flammability, with lower flash and fire points (39 ◦C, 48 ◦C), suggesting suitability for high-energy combustion applications. These findings demonstrate the potential of nanopyroxene to enhance fuel yield and quality from plastic pyrolysis, though further optimisation, detailed catalytic mechanisms, and comprehensive environmental impact assessments are necessary for large-scale adoption.
Spatial variations in groundwater chemistry in Uganda: Geogenic origins and geochemical controls across diverse hydrogeological settings
(Applied Geochemistry, 2026) Derick Muloogi; George J.L. Wilson; Farah T. Ahmed; David A. Polya; Laura A. Richards
Groundwater sustains about 75 % of Uganda's population, particularly in rural and peri-urban areas. However, the baseline hydrogeochemistry of operational community water sources remains poorly understood. Using hydrochemical analysis and geochemical modelling, we assessed groundwater inorganic geochemistry and geochemical controls across five distinct hydrogeological settings in Uganda: Precambrian metasedimentary (MS; n = 30), granulitic-gneissic complex (GG; n = 21), unconsolidated sedimentary (SDM; n = 10), volcanics (VO; n = 7), and metavolcanics (MV; n = 6). Results show that Ca–HCO3 is the predominant hydrochemical facies in most settings, reflecting limited geochemical evolution, whereas Na–HCO3 and Na–Cl facies dominate MV and SDM, consistent with cation exchange and advanced geochemical evolution. World Health Organisation (WHO) drinking water guidelines for selected targets were exceeded in 3 % of samples (for Fe, F−, and Cl−), 5 % for Mn, and 14 % for NO3 −. By settings, exceedances were: (i) MS – 20 % NO3 −, 13 % Mn, and 7 % Cl−; (ii) GG – 14 % NO3 −, and 5 % Fe; (iii) MV –17 % Fe; and (iv) SDM – 10 % F−, indicating more frequent guideline exceedances in MS. Major-ion ratios, including (Na++K+)/Cl− ratios (> 1), HCO3 − /Na+ (1–4), (Ca2++Mg2+)/HCO3 − (~0.3–0.8), and (Ca2++Mg2+)/SO4 2− (>1), are consistent with active silicate weathering, cation exchange, and contributions from carbonate dissolution, with minimal influence from evaporative concentration and gypsum dissolution. Geochemical modelling shows under-saturation for calcite, dolomite, and gypsum, but quartz super-saturation. Thermodynamic modelling indicates kaolinite as the stable secondary mineral in VO, contrasting clinoptilolite in other settings, reflecting active monosiallitisation under rapid flow, well-drained conditions, and low silica -accumulation. This study establishes baseline hydrogeochemical characterisation across Uganda's diverse hydrogeologies, highlighting spatial variability and controls to inform targeted, sustainable groundwater management.
Surface-derived groundwater contamination in Gulu District, Uganda: Chemical and microbial tracers
(Science of the Total Environment, 2024) George J.L. Wilson; Derick Muloogi; Rajabu Hamisi; Timna Denwood; Prosun Bhattacharya; Expedito Nuwategeka; Daren C. Gooddy; David A. Polya; Jonathan J. Huck; Laura A. Richards
Groundwater is consumed by over 2 billion people globally, though it can be impacted by microbial and chemical contamination in both rural and (peri-)urban areas. This issue is particularly pertinent in regions like East Africa, where rapid urbanisation has strained local infrastructure, including water and sanitation systems. We use selected tracers of human and animal waste to assess the quality of community drinking sources with regards to surface-derived groundwater inputs and to compare urban versus rural water quality, under the rapidly developing urban area of Gulu, Northern Uganda. Specifically, we examine bulk and fluorescent dissolved organic matter (DOM), microorganisms (total coliforms, E. coli) and inorganic tracers of anthropogenic waste (NO3 −, SO4 2− , Cl/Br) from various sources: boreholes (12–76 m depth; n = 90), protected springs (n = 11) and municipal taps (n = 4). Our results show that NO3 − and SO4 2− were elevated in groundwater sources in the Gulu city urban area and the Cl/Br ratio was elevated in springs, compared to concentrations in the more rural Aswa and Omoro County area (p < 0.05). Interestingly, human and animal waste indicators E. coli and Tryp:FA (the ratio of tryptophan-like to fulvic-like fluorescence) displayed no significant difference between rural and urban settings (p > 0.05), though total coliforms were significantly higher in rural boreholes (p < 0.05). The presence of a pollution source, pollution carrier and a breakdown of a sanitary barrier at the borehole, as spot-checked by a visual sanitary risk assessment, was significantly associated with groundwater E. coli abundances. Evidence suggests monitoring and mitigation should be improved for all water types in Gulu District to meet WHO and Uganda Standard guidelines for potable water. This study offers valuable insights for water management planning and risk assessment of community water sources particularly in the context of East Africa and similar settings.
Correlating Histological Results and Total Serum Levels of the Prostate-Specifc Antigen Among Patients in Southwestern Uganda
(Prostate Cancer, 2026) Saphurah Nabaasa; Marvin Mwesigwa Mutakooha; Lawrence Amadile; Charles Nkubi Bagenda; Jolly Lydia Ninsiima; Abraham Birung; Raymond Atwine; Hassan Wasswa; Richard Kasadha; Tibenderana Lauben; Frank Ssedyaban
Background: Both healthy and malignant prostate tissues express the glycoprotein marker known as prostate-specifc antigen (PSA). When checking for prostate lesions, serum total PSA levels are a major factor. However, the exact levels to rely on are not explicit. Objective: To ascertain the relationship between histopathological fndings and serum levels of the PSA in patients in southwest Uganda. Methods: This cross-sectional study involved 71 participants in southwestern Uganda from January to July 2023, who underwent histological examinations. Blood samples were taken off for total serum PSA level measurement. Stained formalin-fxed parafnembedded sections were examined. Histological results and PSA levels were correlated using Spearman’s correlation coefcient. Results: The study involved 74 participants with an average age of 74.20 ± 9.40 years and average Gleason score of 7.73 ± 1.04. Only 1/71 (1.41%) had prostatic intraepithelial neoplasia (PIN), 36/71 (50.70%) had benign prostate hyperplasia (BPH), and 34/71 (47.89%) had prostate adenocarcinoma (PAC). A signifcant correlation was observed between PSA levels above 100 ng/mL (p = 0.001, rho = 0.5955) and prostate cancer and between PSA levels up to 20 ng/mL (p = 0.010, rho = 0.03033). AUC of 0.85 (95% CI: 0.77–0.94) showed good predictive power of the test. PSA optimal cut of was 103.4 ng/mL, at sensitivity of 68% and specifcity of 92% with maximum Youden index (J): 0.595. Conclusion: There was a signifcant correlation between BPH with PSA levels up to 20 ng/mL and above 100 ng/mL for prostate adenocarcinoma. In some of the cases, however, total serum PSA levels were high for BPH and low for prostate adenocarcinoma. PSA test usefulness cannot be nullifed, but its accuracy and specifcity have to be ascertained in order to increase its reliability. Future researches are argued to focus more on how to refne PSA-based diagnostics through identifying any underlying unknown hereditary factors and probably better biomarkers that could be infuencing PSA levels. With this, dependability increases and unnecessary biopsing reduces,thus alleviating anxiety in patients and probably their caregivers.
Seroprevalence of Toxoplasmosis and associated risk factors among HIV/AIDS patients attending ART clinic at Fort Portal Regional Referral Hospital in Kabarole district, Western Uganda: a hospital-based cross-sectional study
(PAMJ Clinical Medicine, 2026) Adolf Busobozi; Angella Tumwine; Ronnie Ndizeye; Charles Nkubi Bagenda; Pascal Sekyanzi; Ayub Toko; Pauline Irumba; Vicent Mwesigye; Rogers Kalyetsi
Introduction: Toxoplasmosisis a neglected opportunistic protozoan infection that occurs among patients with HIV/AIDS, thereby affecting response to Anti-Retroviral Therapy (ART). This study determined the seroprevalence of Toxoplasmosis and associated factors among HIV/AIDS patients at Fort Portal Regional Referral Hospital (FRRH) ART Clinic in Kabarole District, Western Uganda. Methods: a hospital-based cross-sectional study design was used to recruit368 study participants between May 2025 and June 2025 at the ART Clinic of FRRH. Study participants were sampled purposively, consented, and blood specimens were collected aseptically; socio-demographic characteristics were collected using a standard questionnaire. Data was entered into Microsoft Excel 2021, cleaned and exported into statistical data analysis (STATA) version 17 for analysis. Descriptive statistics were conducted using measures of central tendency. Categorical data was presented in the form of frequency distribution tables. The prevalence of Toxoplasmosis was expressed as a percentage of HIV/AIDS participants who had Toxoplasma gondii (T. gondii) antibody-positive test. Bivariate and multivariate logistic regression were conducted for the factors associated with Toxoplasmosis, and results were reported using crude and adjusted odds ratios at 95% CI. Statistical significance was at p<0.05. Results: the prevalence of Toxoplasmosis was 6.8% (95% CI: 4.6 - 9.9). Owning a cat(s) within the household was significantly associated with T. gondii infections (aOR = 4.25, 95% CI = 1.35-13.33, p=0.013). Conclusion: the findings revealed that undiagnosed Toxoplasmosis exists in some people living with HIV/AIDS while on therapy at ART clinic of Fort Portal Regional Referral Hospital. Furthermore, the presence of pets, mostly cats, as reservoirs or primary hosts within the household increases the likelihood of Toxoplasmosis. Therefore, routine screening for Toxoplasmosis among people living with HIV/AIDS on therapy should be done in addition to health education about deworming all the pets, and improved hygienic and sanitation practices in households with pets.
Identification and mapping of mHealth interventions applied in palliative care in sub-Saharan Africa: a scoping review protocol
(JBI Evidence Synthesis, 2026) John Bosco Ndinawe; Jerome Kabakyenga; Elizabeth Namukwaya; Edgar Mugema Mulogo; Eve Katushabe
Objective: The aim of this scoping review is to identify the currently available mHealth interventions for palliative care and factors influencing their use in sub-Saharan Africa (SSA). Introduction: Although palliative care is essential for improving quality of life, its use in SSA remains low. mHealth (an interaction with a mobile device) interventions could enhance and promote palliative care in the region. Integration of mHealth into palliative care has been observed across Europe and the USA to support pain management and improve communication between health professionals and patients; however, there is little evidence on its use in low- and middle income countries. Eligibility criteria: Eligible studies will involve key stakeholders in palliative care, such as patients with life-limiting illnesses (eg, cancer), health professionals, community volunteer workers, and community leaders. Studies reporting evidence on mHealth in the design, implementation, or evaluation of palliative care services in any country in SSA will be considered. Methods: The review will follow JBI methodology for scoping reviews and will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The following sources will be searched for published and unpublished literature: CINAHL (EBSCOhost), PubMed (Ovid), Embase (Ovid), the Cochrane Library, Google Scholar, Scopus, Web of Science, and ProQuest Dissertations and Theses Global. Study screening and selection will be conducted independently by 2 reviewers. Data will be extracted using a modified JBI data charting form, and will be presented in tabular format and narrative summary.
Burden, challenges, and control of malaria among under-5s in Nigeria
(Journal of Tropical Pediatrics, 2026) Lenz Nwachinemere Okoro; Innocent Ayesiga; Michael Oppong Yeboah; Naya Gadzama Bulus; Jonathan Mawutor Gmanyami; Esther Ladidi Ismaila; Ovye Ahgu; Elijah Ogbu Otokpa; Eneh Nchiek Edet; Joy Malle Dogo; Tom Didimus Ediamu; Lorna Atimango; Isaac Isiko
Malaria remains a leading cause of morbidity and mortality among children under five years in Nigeria, a country accounting for over a quarter of global malaria cases. Despite the availability of interventions, Nigeria continues to face persistent challenges in controlling malaria, especially in the under-five population, thus, the need for this review. This narrative review synthesizes peer reviewed literature, national reports, and policy documents published since 2010. A structured search was conducted across PubMed, Google Scholar, Scopus, and relevant grey literature from the WHO, UNICEF, and the Nigerian Ministry of Health. The review adhered to SANRA guidelines to ensure methodological rigour and focused on studies reporting malaria epidemiology, interventions, and control efforts targeting children under five in Nigeria. Findings revealed a high malaria burden among children in Nigeria, with notable regional disparities. Northern states report the highest prevalence, with rural areas disproportionately affected. Contributing factors include socioeconomic deprivation, climate variability, and suboptimal coverage of interventions. Key challenges include diagnostic limitations, drug resistance, and inconsistent use of preventive measures. While interventions such as long-lasting insecticidal nets (LLINs), intermittent preventive therapy, and indoor residual spraying have shown effectiveness, gaps remain in coverage and implementation. Innovations in diagnostics, vaccines, and surveillance systems are promising but underutilized. Despite progress, Nigeria faces multifaceted challenges in malaria control among under-fives. A coordinated, multisectoral response involving innovative strategies, stronger health systems, and policy reforms is essential. Attention must also be directed to enhancing the acceptability, fidelity, and longevity of these interventions.
Fine-Needle Aspiration as a Key Diagnostic Tool in Pediatric Rosai-Dorfman Disease: A Case Report of a 12-Year-Old Male
(International Medical Case Reports Journal, 2026) Charles Malisaba Posite; Mahad Said Mohamed; Eluzai Ndiwelubula; Samuel Tumwesigire; Suleman Essa Ahmed; Henry Wabinga; Raymond Atwine; Biruk Legesse Tadesse
Background: Rosai-Dorfman Disease (RDD) is a rare, benign, non-Langerhans cell histiocytosis characterized primarily by massive, painless cervical lymphadenopathy. Its low prevalence (~ 1:200,000) and clinical similarity to endemic conditions like tuberculosis and lymphoma make the diagnosis challenging, particularly in resource-limited settings. Definitive diagnosis hinges on identifying S100- positive histiocytes exhibiting the pathognomonic feature of emperipolesis. Case Presentation: A previously healthy 12-year-old male from Uganda presented with a one-month history of progressive, asymptomatic, bilateral cervical lymphadenopathy. Systemic symptoms were absent. A provisional diagnosis of RDD was established rapidly via Fine Needle Aspiration Cytology (FNAC). Cytological smears showed abundant histiocytes demonstrating clear emperipolesis, confirming the classic cytological diagnosis. Despite the recommendation for a confirmatory excisional biopsy and further subtyping, the patient was lost to follow-up. Conclusion: This case demonstrates that high-quality FNAC can reliably establish the diagnosis of RDD in environments where advanced diagnostic tools are scarce, but also underscores the critical need to strengthen patient follow-up systems to ensure complete evaluation and long-term monitoring of rare histiocytic disorders.
Effectiveness of ART optimization on viral load suppression in children and adolescents with HIV in Uganda- a quasi-experimental study
(Medicine, 2026) Esther M Nasuuna; Lillian Babirye; Joanita Kigozi; Alex Muganzi; Jonathan Izudi
Uganda implemented the antiretroviral therapy (ART) optimization program in July 2019, based on an eligibility rule. ART optimization targeted individuals with prior viral load (VL) < 1000 copies/mL, while those with VL ≥ 1000 copies/mL continued with non-optimized regimens. We assessed the effectiveness of ART optimization on VL suppression among children and adolescents with HIV (CAWH) in Uganda. We also assessed the compliance of human immunodeficiency virus (HIV) clinics with the eligibility rule and its effect on ART optimization. Therefore, we designed a quasi-experimental study using data from 21 urban and rural HIV clinics. The exposure was ART optimization, defined as the initiation or transition of CAWH on dolutegravir or a protease inhibitor (boosted lopinavir). Children and adolescents with HIV on an optimized ART regimen formed the exposed group, while those on a non-optimized ART regimen comprised the non-exposed group. The primary outcome was VL suppression, defined by VL < 1000 copies/mL after ≥6 months of ART optimization. We assessed the effectiveness of ART optimization on VL suppression using 2-stage least squares instrumental variable regression due to imperfect compliance with the eligibility rule across the clinics. We also established the effectiveness of the eligibility rule on ART optimization for individuals just below and just above the cutoff. Sensitivity analysis was performed using a non-causal approach. We analyzed data from 2999 CAWH aged ≤19 years and found an overall VL suppression of 76.1% (2282/2999). We found that ART optimization showed a trend toward improved VL suppression (risk ratio [RR] 1.81, 95% CI: 0.79–4.14). However, compliance with the rule was only for 2.6% of the participants, and the rule did not improve ART optimization (RR 0.96, 95% CI: 0.88–1.05). Overall, ART optimization, guided by an eligibility rule, did not achieve the target of ≥95% VL suppression among CAWH across the 21 public HIV clinics in Uganda, partly due to low compliance with the rule, although it showed a trend toward improvement. Addressing context-specific biological, behavioral, social, and structural barriers is needed to optimize VL outcomes.
Prevalence and Factors Associated With Hyperglycemia Among Patients on Dolutegravir-Based Antiretroviral Therapy: A Cross-Sectional Study From Central Uganda
(Journal of the International Association of Providers of AIDS Care (JIAPAC), 2026) Charles Nkubi Bagenda; Carol Nantongo; Michael Junior Mugisa; Elastus Ssemwanga; Sylivia Achieng Lumumba; Edward Kikabi; Ritah Kiconco; Simon Peter Rugera
Background: The use of dolutegravir (DTG)-based antiretroviral therapy (ART) has been associated with the development of hyperglycemia. This study determined the prevalence and factors associated with hyperglycemia among people living with HIV (PLWH) on DTG-based ART in Uganda. Methods: We conducted a cross-sectional study among 219 systematically recruited PLWH on DTG-based ART for ≥1 year at a Health Centre IV in Central Uganda. Data were collected using a structured questionnaire, anthropometric measurements, and laboratory investigations. Logistic regression was performed to identify factors associated with hyperglycemia. Results: Out of 219 participants, 45 had fasting glucose ≥110 mg/dL, giving a hyperglycemia prevalence of 20.55% (95% confidence interval [CI]: 15.68%-26.45%). Overweight (aOR 8.11, 95% CI: 2.76-23.85, P < .001) and abnormal waist-to-hip ratio (aOR 4.36, 95% CI: 1.23-15.37, P =.022) were significantly associated with hyperglycemia. Conclusions: Hyperglycemia is prevalent among PLWH on DTG-based ART and is potentially associated with overweight and abnormal waist-to-hip ratio.
A Pilot Study to Advance Task-Sharing of Gastroschisis Management in Uganda
(Annals of Global Health, 2026) ANTHONY N. EZE; FELIX OYANIA; WIGDAN S. HISSEIN; DAPHINE KYASIMIRE; IVAN N. NUWAGABA; GIFT ATUHEIRE; OYINOLUWA G ADARAMOLA; OLIVIA McGINNIS; SHANNON BARTER; TAMARA N. FITZGERALD
Introduction: Gastroschisis mortality in Africa is high partly due to delays in care. In Uganda, skilled birth attendants (SBAs) are the first point-of-contact for most babies, and with proper training, may be willing to participate in surgical task-sharing. Objective: Empower Ugandan skilled birth attendants with the knowledge and practical skills needed to care for babies with gastroschisis. Methods: Ugandan SBAs completed a one-day gastroschisis course, and resident physicians also requested to participate. A pre- and post-course test was administered to assess gastroschisis knowledge and confidence. Findings: A total of 69 SBAs (44 midwives, 25 nurses) and 17 residents participated. Participants were predominantly female (n = 64, 74%) with a median of 9 years of work experience. There was significant knowledge increase from pre- to post-course regarding differentiating gastroschisis from omphalocele (SBA 39% to 70%, p < 0.001; resident 48% to 77%, p < 0.001), gastroschisis incidence and outcomes (SBA 56% to 87%, p < 0.001; resident 65% to 89%, p < 0.001), risk factors (SBA 66% to 89%, p < 0.001; resident 67% to 86%, p < 0.0026), treatment (SBA 57% to 84%, p < 0.001; resident 63% to 79%, p < 0.001), and importance of community education (SBA 54% to 59%, p < 0.006; resident 56% to 65%, p < 0.0413). Only SBAs showed a significant increase in prenatal diagnosis (74% to 88%, p < 0.001). There was a significant boost in SBA clinical management confidence from 39% to 88%. Conclusion: A one-day training course can enable Ugandan SBAs to serve as task-sharers for babies with gastroschisis. While residents benefited, a future course should be developed for their learning needs. Continuing education is needed to ensure knowledge retention and clinical preparedness. Assessment of gastroschisis outcomes is necessary to determine if involving SBAs can improve survival.
Magnitude and correlates of overweight or obesity among adults with diabetes mellitus duration of five or more years in rural Uganda: A cross-sectional study
(Global Epidemiology, 2026) Boniface Amanee Elias Lumori; Lodiong Jackson Dumo Lodiong; Ucama Ufoymungu Patrick; Jonathan Izudi
Background: Overweight and obesity are major risk factors for micro and macrovascular diseases, with diabetes mellitus exacerbating these burdens. We determined the prevalence of overweight or obesity and its associated factors among adults with diabetes mellitus with a duration of ≥5 years at Mbarara Regional Referral Hospital in Southwestern Uganda. Methods: This analytic cross-sectional study was conducted over 5 months, from November 2017 to March 2018. We collected demographic and clinical data and measured body mass index (BMI). The outcome was overweight or obesity, measured as the proportion of individuals with a BMI of 25 kg/m2 or more. We used binary logistic regression to estimate associations of a priori selected variables with the outcome. Results: Of 189 participants, 138 (73%) were female, the mean age was 61.5 ± 11.1 years, and the median duration of diabetes mellitus since diagnosis was 10 years (interquartile range, 7–15). Overall, 122 (64.5%) participants were overweight or obese. In the multivariable logistic regression analysis, former cigarette smoking (adjusted odds ratio (AOR) 0.2, 95% confidence interval (CI) 0.1–0.6), every 1-year increase in the duration of diabetes mellitus (AOR 1.1, 95% CI 1.0–1.1), and hypertension (AOR 2.8, 95% CI 1.2–6.5) were independently associated with overweight or obesity. Conclusion: Overweight/obesity is prevalent among adults with diabetes mellitus duration of 5 years and over, in a rural Ugandan population. Former cigarette smokers have a decreased likelihood of being overweight or obese, while hypertension and every 1-year increase in the duration of diabetes mellitus are associated with a higher likelihood of being overweight or obese.
Psychiatric comorbidities of posttraumatic stress disorder among adolescent refugees in Uganda: A latent class analysis of patterns and covariates
(Comprehensive Psychiatry, 2026) Herbert E. Ainamani; Anne Wanjiru Mbwayo; Muthoni Mathai; Jonathan Hall; Godfrey Z. Rukundo; Florian Scharpf
Background: Although psychiatric comorbidities are common among trauma-exposed individuals with PTSD, their patterns and covariates among refugee adolescents in low-resource settings remain understudied. This study aimed to identify distinct patterns of psychiatric comorbidities and their associated factors among adolescent refugees with PTSD in Nakivale refugee settlement, Uganda. Methods: In this cross-sectional study, 325 refugee youth were assessed on various PTSD psychiatric comorbidities and covariates of (age, gender, war trauma, post-migration stressors) using MINI International Neuropsychiatric Interview 7.02 and standardized measures of war trauma and post-migration stressors. Latent class analysis (LCA) was used to identify patterns and covariates of comorbidity. Results: Of 269 adolescents with PTSD, 97% had at least one comorbid disorder: panic disorder (88.9%), generalized anxiety disorder (84%), agoraphobia (75.1%), depressive disorder (62.8%), obsessive compulsive disorder (60.6%), attention deficit disorder (43.9%), oppositional defiant disorder (40.9%), conduct disorder (33.8%), and alcohol use disorder (10.8%). LCA revealed three classes: low-moderate comorbidity (n = 66, 24.5%), high internalizing comorbidity (n = 101, 37.5%) with high probabilities of depression and anxiety disorders, and high overall comorbidity (n = 102, 37.9%) with relatively high probabilities of all disorders. The high overall comorbidity class had more girls than the other two classes. Both high comorbidity classes had higher war trauma and post-migration stressors than the low-moderate comorbidity class. Conclusions: Adolescent refugees with PTSD exhibit high psychiatric comorbidity that clusters in distinct patterns. These findings highlight the need for interventions that address the identified comorbidity patterns, consider gender disparities, and account for cumulative trauma and post-migration stressors to effectively support traumatized youth.