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Recent Submissions

Evaluating the Generalisability of Convolutional Neural Networks for Diabetic Retinopathy Detection in Latin America and Sub-Saharan Africa
(MDPI, 2026-06-03) Mwavu,Rogers; Kaggwa,Fred; Arunga,Simon; Wasswa, William
Diabetic retinopathy is a leading cause of vision loss worldwide, particularly impacting individuals in low- and middle-income countries with limited healthcare access. Early detection through automated screening systems is essential for improving outcomes, as timely intervention can prevent severe vision impairment. However, most of the available AI models have not been evaluated in low-resource settings. Hence, this study presents an evaluation of the efficacy of advanced deep learning architectures for detecting rDR across diverse population datasets. A dual-phase validation approach was employed to assess model performance. Internal validation utilised the BrSET dataset to establish baseline performance metrics, while external validation was conducted on the MoDRIA dataset, which encompasses various conditions and demographics, to evaluate model robustness. Key performance metrics, including accuracy, specificity, sensitivity, F1-score, and calibration scores, were systematically recorded and analysed. Internal validation revealed high accuracy across all models, EfficientNetB0 achieved the highest classification accuracy (0.9561; 95% CI 0.9490–0.9630), EfficientNetB3 demonstrated superior overall discriminative performance, achieving the highest AUROC (0.9892; 95% CI 0.9841–0.9934) highest sensitivity (0.9573), and lowest Brier score (0.0168). Meanwhile, DenseNet ex hibited the most balanced clinical screening performance, achieving the highest F1-score (0.7259; 95% CI 0.6797–0.7669) and Youden Index (0.2381), indicating improved balance between sensitivity and specificity. In contrast, external validation revealed substantial deterioration in model performance across all architectures, highlighting major limitations in cross-population generalisability. Although EfficientNetB0 achieved the highest external accuracy (0.8821; 95% CI 0.8746–0.8898), AUROC values declined markedly across models (0.5140–0.6104), accompanied by poor sensitivity, reduced F1-scores, and substantial calibra tion instability. EfficientNetB3 achieved the highest external sensitivity (0.5939), whereas calibration analyses demonstrated unreliable probability estimation under domain-shift conditions. These findings suggest that AI models trained on geographically homogeneous retinal imaging datasets may not generalise reliably across underrepresented populations. Population differences and imaging variability substantially affected external model per formance, highlighting the need for diverse datasets, rigorous external validation, and adaptive recalibration before clinical deployment of AI-driven DR screening systems.
“I Did What I Could Manage”: Caregiver Burden and Rational Triage of Stroke Discharge Instructions in Rural Uganda – A Qualitative Study
(Journal of Multidisciplinary Healthcare, 2026-07-22) Kakongi,Nathan; Owokuhaisa, Judith; Asiimwe,Derrick; Nuwahereza,Amon
Background: In rural Uganda, informal caregivers provide most post-discharge stroke care, often without formal training, written guidance, or community rehabilitation support. This study explored caregiver burden and factors shaping implementation of stroke discharge instructions in rural southwestern Uganda. Methods: We conducted a qualitative study at Mbarara and Kabale Regional Referral Hospitals. Eleven informal caregivers of stroke survivors participated in semi-structured in-depth interviews. Interviews were audio-recorded, transcribed, translated into English, and analysed in Atlas.ti 9 using thematic analysis with a deductive codebook refined inductively during analysis. Results: Four themes were identified: multidimensional caregiving burden; variable discharge instruction content and delivery; barriers to implementing instructions; and facilitators that sustained care. Burden was physical, financial, psychological, and social, often concentrated on one family member. Discharge instructions commonly focused on exercises, medications, diet, and follow-up, but were frequently verbal and lacked clear medication resupply or review plans. A central finding was caregivers’ rational “triage logic”: when resources were insufficient, they prioritized zero-cost instructions such as exercises and delayed or abandoned costly instructions such as medicines, transport, and follow-up visits. Facilitators included love and duty, family support, retained discharge knowledge, resource mobilisation, and occasional home-based health worker visits. Conclusion: Caregivers of stroke survivors in rural southwestern Uganda experience substantial multidimensional burden and implement discharge instructions within severe structural constraints. Written discharge protocols, caregiver screening, clearer follow up pathways, and task-shared community rehabilitation may improve post-stroke continuity of care in similar low
Prophylactic antiseizure medication administration practices in neonates with hypoxic-ischaemic encephalopathy: a scoping review protocol
(BMJ open, 2026) Nalwanga,Lillian Edith; Ayesiga,Innocent; Ediamu,Tom Didimus
Introduction Hypoxic-ischaemic encephalopathy (HIE) is a leading cause of neonatal mortality and long-term neurodevelopmental impairment worldwide. Neonatal seizures are common in HIE and are associated with adverse outcomes. While antiseizure medications are routinely used for treatment, their prophylactic use in the absence of clinically evident seizures remains controversial, with limited consensus and variable clinical practices. Therefore, this review will map the existing evidence concerning the utilisation of antiseizure medication for prophylaxis among neonates with HIE. Methods and analysis The review will follow the Joanna Briggs Institute scoping review methodology and be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive search will be conducted across various scientific databases, including PubMed, Embase, Scopus and Web of Science, guided by the Population, Intervention, Concept and Context framework, starting between October and November 2026. The review will consider studies on the prophylactic use of antiseizure medication among neonates with HIE. The collected search results will be organised and uploaded to Covidence, where duplicates will be removed, and titles and abstracts will be screened. Search and screening processes have not yet started. Ethics and dissemination This will be a secondary study using already published information; therefore, ethical approval was not sought. All studies included in this review will be cited accordingly, as attributed to the publication licence. The data gathered will be summarised in a scoping review and submitted for publication in an international peer-reviewed journal. Datasets shall also be made publicly available in a data repository, such as the Open Science Framework
PEDCan: acceptability and feasibility of a mobile application to support primary health-care workers in recognising clinical features of childhood cancer in Uganda
(ecancer, 2026-06-26) Atwiine,Barnabas; Izath,Nura; Ssemitego,James; Nsiimenta,Naome; Birungi,Wilson; Kusaasira,Anitah; Nambogo,Nuriat; Mukama,Martin; Data, Santorino
Introduction: Early diagnosis of childhood cancer depends on a high index of suspicion and timely referral by primary healthcare workers (PHCWs) to tertiary centers. This study aimed to assess the acceptability and feasibility of a mobile application among PHCWs in recognising cancer-related clinical features in children. Methods: We developed a mobile application called (PEDCan) to support PHCWs in rec ognising cancer-related clinical features in children, initiating remote consultations with specialists and referring suspected cases to cancer centers when necessary. In May 2021, we conducted a cross-sectional descriptive study among consenting PHCWs in south western Uganda to collect data on their knowledge of childhood cancer, smartphone ownership and internet usage. After training participants on the use of the application through mock clinical vignettes, we assessed their ease of use and readiness to adopt the application. Descriptive statistics were used to calculate the proportions of participants able and willing to use the application. Ethical approval was obtained from the Research and Ethics Committee of Mbarara University of Science and Technology. Results: A total of 44 PHCWs participated in the study; 25 (56.8%) were nurses or mid wives, 8 (18.2%) were clinical officers, 3 (6.8%) were medical doctors and 8 (18.2%) belonged to other professional cadres. All participants had previously heard about child hood cancer, and 28 (63.6%) had previously encountered a child suspected to have can cer. Thirty-eight (86.4%) participants owned a smartphone and used the internet, while 12 (31.6%) reported having constant internet access. Thirty-eight (86.3%) participants found the PEDCan application very easy or easy to use, and all participants expressed willingness to use it. Conclusion: PHCWs in the participating health facilities were able and willing to use the PEDCan mobile application to recognise childhood cancer clinical features and initiate remote expert consultations using mock vignettes. A pilot study involving real patients would further demonstrate the application’s effectiveness in real-world clinical settings.
Mapping the use of interactive voice response (IVR) in healthcare in Africa: a scoping review protocol
(BMJ open, 2026) Kihumuro,Raymond Bernard; Ochen,Eric; Atimango,Lorna; Kizito,Samuel; Haberer,Jessica; Maling,Samuel; Lydston,Melis; Sundararajan,Radhika; Bebell,Lisa M
ABSTRACT Introduction Africa faces a substantial health burden characterised by a dual burden of communicable and non-communicable diseases compounded by persistent health system and infrastructure constraints. Digital health interventions offer scalable opportunities to strengthen healthcare delivery. Interactive voice response (IVR), an automated telephone-based technology, shows promise across African health settings; however, existing evidence is dispersed across isolated studies and demonstrates variability in outcomes and implementation approaches. This scoping review maps existing evidence on the use of IVR in healthcare in Africa, focusing on applications, outcomes and implementation experiences. Methods and analysis Eligible studies will include all designs that evaluate IVR-based health interventions in African healthcare settings, while non-voice digital interventions and non-empirical publications will be excluded. We will conduct a scoping review guided by the Arksey and O’Malley framework and the Joanna Briggs Institute and report findings using Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. We will systematically search bibliographic databases and grey literature from 2000 to the end of 2025. Two independent reviewers will screen studies, extract data and chart evidence on IVR characteristics, implementation strategies, barriers and facilitators and outcomes. A third reviewer will resolve disagreements. We will synthesise findings descriptively and thematically, presenting results in tables, visual maps and an equity-focused analysis guided by PROGRESS-Plus. Ethics and dissemination Ethical approval is not required because this scoping review synthesises previously published, publicly available literature and does not involve human participants or primary data collection. We will share the findings through a peer reviewed publication and conference presentations, and we will discuss the results with digital health stakeholders, clinicians and policymakers to inform future IVR work in Africa
Expression of p53 and p63 proteins and their correlation with histological grades among gastric carcinoma specimens at Mbarara Regional Referral Hospital
(African Journal of Laboratory Medicine, 2026-07-17) Ninsiima,Lydia Jolly; Birungi,Abraham; Kasadha,Richard; Mugisa,Michael Junior; Tibenderana,Leuben; Nuwashaba,Nicholas; Nabaasa,Saphurah; Wasswa,Hassan; Amadile,Lawrence; Ssedyabane,Frank
Background: Gastric carcinoma remains one of the most common and deadly cancers worldwide, especially among older men. In sub-Saharan Africa and Uganda in particular, the diagnostic biomarkers of gastric carcinomas are not well documented; also, limited studies have been conducted in Uganda regarding the prognostic and diagnostic value of p53 and p63 immunohistochemically expression in gastric carcinomas. Objective: We aimed to determine the immunohistochemically expression of p53 and p63 proteins and their correlation with different histological grades among archived gastric carcinoma specimens at Mbarara Regional Referral Hospital. Methods: This was a laboratory-based cross-sectional study. We retrieved 166 archived formalin-fixed paraffin-embedded gastric carcinoma tissue specimens from the histopathology laboratory. They were stained with Harris hematoxylin and eosin stain and subsequently stained with p63 and p53 monoclonal antibody immunohistochemistry. Results: Of the 166 gastric carcinoma specimens retrieved, almost a third of specimens were poorly differentiated (53/166; 32%) although the majority were moderately differentiated (68/166; 41%). P53 expression was 20/45 (44.4%), 27/68 (39.7) and 21/53 (39.6) in well differentiated, moderately differentiated and poorly differentiated gastric carcinoma. Statistically significant positive correlation was observed between p63 and weak immunohistochemically expression (Spearman rho 0.155, p-value 0.047). Conclusion: P53 expression was more than p63 expression in different histological grades. There was no significant correlation of p53 with different histological grades but significant correlation was observed between p63 and moderately differentiated gastric carcinoma specimens. We recommend a prospective study using advanced molecular tests on fresh gastric carcinoma specimens to assess the prognostic usefulness of p53 and p63 biomarkers. What this study adds: This study provides the first Ugandan data on p53 and p63 expression in gastric carcinoma, highlighting p63’s significant correlation with moderately differentiated tumors
Explainable transfer learning-based approach for Mango fruit damage detection and cause identification
(2026 6th International Symposium on Computer Technology and Information Science (ISCTIS), 2026) Safari,Yonasi; Nakibuule,Rose; Joyce Nabende; Nakasi,Rose
This study presents a deep learning approach to detect mango fruit damage and identify its underlying causes using one-stage and two-stage detectors. Unlike existing methods that focus mainly on detection, this approach integrates XAI techniques to provide interpretable, cause-level insights, and is evaluated on a dataset annotated with anthracnose, bacterial black spot, fruit fly, and other damage classes. RetinaNet achieved the best overall performance, attaining a precision of 0.77, recall of 0.75, and F1-score of 0.76. Per-class accuracy exceeded 0.80 in all categories, except for fruitfly, which remained more challenging to detect. XAI techniques that include Grad-CAM, Grad-CAM++, LIME, SHAP, and LRP were further used to highlight vital regions influencing model decisions. A quantitative evaluation of XAI performance was further conducted using faithfulness, robustness, complexity, localization, and randomization. LRP and SHAP results attained are indicative of more faithful and well-localized explanations, while Grad-CAM based methods exhibited limitations in localization, with LIME producing highly complex explanations that result in reduced interpretability
Development of a Simulation-Based Educational Intervention to Improve Nursing Competencies for Stroke Care in Southwestern Uganda
(Advances in Medical Education and Practice, 2026-07-16) Najjuma,Josephine N; Bajunirwe,Francis; Ssedyabane,Frank; Kaddumukasa,Mark; Mbalinda,Scovia N; Moore,Shirley; Tebulwa,Joanita B; Nankunda,Shifra; Atukunda,Esther C
Stroke is one of the leading causes of disability worldwide, and its prevalence is increasing in low- and middle-income countries (LMIC) like Uganda, presenting nursing care challenges. Simulation-based learning has been used successfully to train nurses in general care in LMIC but has not been applied to training for stroke care. In this study, we aimed to develop a simulation based stroke care education intervention for nurses involved in care for patients with stroke at a large hospital in southwestern Uganda. Methods: Between February 2024 and March 2025, we used the iterative design to develop an educational intervention for stroke care. We engaged stroke care content experts through in-depth qualitative interviews (n=14), generated content, and developed the first version of the intervention. Transcripts were derived, reviewed and coded to generate themes and categories using inductive content analytic approach. We then tested, analyzed and refined the intervention through three repetitive exposures of the intervention to final year Bachelor of Nursing students (n=20), with improvements after every exposure. That were grouped in teams of 5 students. Results: Qualitative data from content experts revealed three thematic areas of patient care including admission of a stroke patient, care for a stroke patient during their hospital stay and discharge of a stroke patient as key content for consideration during intervention development. This content was integrated into the “Uganda Simulation-Based Nursing Stroke Care intervention”. Post-exposure qualitative interviews with final year Bachelor of Nursing students revealed great satisfaction with the intervention, improved preparedness and ease to assess stroke patients. There were also high teamwork scores and improved clinical skills. To maintain efficiency with stroke care competencies, they preferred at least three exposures to the intervention per year. Conclusion: With diverse stakeholders, we used an iterative approach to develop a context specific, simulation-based stroke educational intervention. Future work will examine the feasibility, acceptability, and effectiveness of this intervention among nurses working with stroke patients and its effect on the patient outcomes
Cloud computing-based collaborations on health research: A systematic review of applications, barriers to adoption, and migration strategies
(Digital Medicine, 2026) Mugonza,Robert; Ssembatya,Richard; Basaza-Ejiri,Annabella
Background: Modern biomedical research is undergoing a fundamental transformation driven by an exponential increase in data complexity and the integration of artificial intelligence and cloud computing into biomedical and public health infrastructure. While cloud computing offers a pivotal solution to the limitations of on-premise infrastructure, the transition is hindered by a complex set of domain-specific challenges. This systematic review maps the current landscape of cloud adoption, identifies systemic barriers to wider usage, and outlines practical requirements for successful cloud migration. Methods: We conducted a comprehensive systematic search of articles published between 2010 and early 2026 across PubMed and Google Scholar. To capture both clinical and technical literature, the search was expanded to include major computer science and engineering databases, namely IEEE Xplore and Web of Science. We identified 68 primary studies evaluating 50 unique applications and subjected these to a formal assessment using a 5-point informatics quality appraisal (IQA) scale to determine the maturity of evidence. Results: Our analysis revealed a highly mature ecosystem, with 96% of identified applications reaching production-ready or validated implementation stages (IQA scores = 3-5). These applications were categorized into three functional types: task specific tools, integrated platforms, and large-scale archives. Despite a projected market growth exceeding 17%, however, a significant readiness gap persists. Innovation remains concentrated in North America and is characterized by high data-egress costs, regulatory misalignments, and friction associated with technical interoperability. In contrast, initiatives such as the District Health Information System-2 (DHIS-2) demonstrate the potential for cloud applications to drive global health equity in resource limited settings. Conclusion: The cloud has successfully moved from being a conceptual framework to serving as the backbone of modern health research. Nevertheless, a considerable trust deficit coupled with persistent structural barriers related to costs, data sovereignty, and regulatory complexity continue to impede global collaboration. To fully realize the promise of democratizing research, future development must transition from performance-centric models to federated, context-aware architectures that prioritize accessibility, inclusivity and secure data sharing. From a policy and practice perspective, funding agencies, governments, and international research consortia should support the adoption of such architectures while promoting harmonized cross-border data governance frameworks and measures to reduce prohibitive cloud data-egress costs. These efforts are essential for enabling equitable participation in global health research ecosystems, particularly among institutions in low- and middle-income countries.
Barriers and facilitators to linkage to HIV care after hospital discharge among adults living with advanced HIV disease in Uganda: a COM B–guided qualitative study
(HIV Research & Clinical Practice, 2026-07-23) Katuramu,Richard; Semitala,Fred C.; Neumbe,Irene Mildred; Nekaka,Rebecca; Nangendo,Joan; Namuwenge,Proscovia M.; Katahoire,Anne R.; Byakika-Kibwika,Pauline; Kamya,Moses R.; Matovu,Joseph K. B.
Background: Hospital discharge represents a high-risk transition period for people living with HIV, particularly those with advanced HIV disease. In low-resource settings, substantial gaps persist in linking these individuals to outpatient HIV care following hospitalisation. This study explored barriers and facilitators to post-discharge linkage to care from the perspectives of patients and healthcare workers (HCWs) in Eastern Uganda. Methods: We conducted a descriptive qualitative study at Mbale Regional Referral Hospital between May and October 2025. Guided by the capability, opportunity, motivation, and behaviour (COM-B) model, we conducted 20 in-depth interviews with adults with advanced HIV disease who had recently been discharged from the medical ward (10 who successfully linked to care and 10 who did not), alongside 10 key informant interviews with HCWs involved in their care. Data were analysed using a thematic framework approach aligned with the COM-B constructs. Results: Patient-reported barriers included physical weakness (physical capability), limited knowledge of the linkage process (psychological capability), high transport costs and long travel distances (physical opportunity), and stigma or non-disclosure of HIV status (social opportunity). HCWs identified the absence of standardised linkage protocols, post-discharge follow-up mechanisms, and incentive structures as key systemic barriers (physical opportunity). Facilitators reported by patients included initiation or resumption of antiretroviral therapy (ART) before discharge (physical opportunity), support from peer supporters and disclosure to caregivers (social opportunity), and fear of clinical deterioration (reflective motivation). HCWs identified the existing TB–HIV linkage system (reflective motivation) and the presence of ward-based linkage counsellors (physical opportunity) as enabling factors. Conclusion: People living with advanced HIV disease face multiple, interrelated barriers to linkage with HIV care following hospital discharge, including physical debility, limited knowledge of the linkage process, financial and geographic constraints, and stigma. Conversely, pre-discharge ART initiation, peer support, and disclosure facilitate successful linkage. Strengthening post-discharge care will require standardised linkage protocols, structured follow-up mechanisms, and expanded use of peer supporters within health systems.
Build a neuro-fuzzy continuous protocol representation for ventilator adjustments in acute respiratory distress syndrome patients using fuzzy neural network.
(Scientific Report, 2026-08-26) Wanzala,Jimmy Nabende; Atim, Michael Robson; Awal,Moses; Mugabe,Robert
—Acute respiratory distress syndrome (ARDS) is on the increase due to many causes such as: corona virus disease 2019 (COVID-19) which worsens the arterial hypoxemia, smoke inhalation, and injuries that cause fluids to collect in the air sacs of the lungs. Standard clinical criteria have been developed to define ARDS severity, while titration protocols guide ventilator settings. The Berlin definition protocol classifies ARDS diagnostic severity based on the P aO2/F iO2 ratio, whereas positive end expiratory pressure (PEEP) titration is guided by the ARDS Network (ARDSNet) lower and higher PEEP scales. The challenges that however come with physicians manually implementing discrete lookup tables include step-discontinuities at threshold boundaries, performance accuracy, and timely intervention. With the increasing number of patients in the intensive care unit (ICU), physicians may be overwhelmed with the workload, that they may not efficiently control the parameters on the mechanical ventilation. Any slight change or delay in setting the parameters may lead to wrong outcomes. Therefore, the aim of this study was to apply artificial intelligence in guiding physicians during the process of setting ventilator parameters. Fuzzy neural network (FNN) was used in training and conversion of the non-fuzzified ARDS Net PEEP titration tables into a fuzzified continuous inference surface. In this computational study, model performance was evaluated using 5-fold cross validation and tested on unseen intermediate F iO2 set points (F iO2 ∈ {0.35, 0.45, 0.55, 0.65, 0.75, 0.85, 0.95}), achieving a validation Root Mean Squared Error (RMSE) of 0.018 cm H2O, Mean Absolute Error (MAE) of 0.012 cm H2O, and R 2 = 0.9998. The results show that the output of the fuzzified ARDSNet PEEP model is very accurate in comparison with non-fuzzified tables while eliminating abrupt step changes between F iO2 increments. Comparative analysis demonstrates that ANFIS provides smooth C 1 -continuous parameter transitions without the boundary slope discontinuities of linear interpolation or the overshoot oscillations of cubic splines. The potential for reduced clinician workload and error reduction represents a hypothesis for future prospective clinical trials
Wetland-use and wetland-cover change and ecological integrity of wetlands around Kibale National Park, Kamwenge District, Western Uganda
(Journal of Freshwater Ecology, 2026-08-14) Ayebazibwe,Francis; Tumusiime,Julius; Yatuha,Jane; Nyakoojo,Clement; Tinka,John; Ainebyona,Peter
Wetlands around Kibale National Park support biodiversity, regulate water quality and sustain livelihoods but face increasing anthropogenic pressures. This study assessed wetland-use and cover change (between 2016 and 2025), macrozoobenthos diversity and physico-chemical water quality in Bigodi, Kahunge and Businge wetland systems within a 5 km buffer of Kibale National Park, Kamwenge District, Uganda. Sentinel imagery was classified to determine cover change. Sampling sites were classified as high quality, medium quality and low quality using the wetland rapid assessment procedure (WRAP). These categories represented a disturbance gradient based on ecological and anthropogenic characteristics of the wetland sites. Macrozoobenthos were sampled in dry ( January 2025) and wet (April 2025) seasons across all quality sites a scoop net, identified to family level and analyzed for diversity indices and average score per Taxon (ASPT). Physico-chemical parameters were measured in situ and in a laboratory. Wetland-use and wetland-cover (WUWC) change varied: Bigodi wetland system gained 1.17% wetland, Kahunge wetland system lost 3.58% and Businge wetland system lost 8.47% with +7.64% grassland increase. Macrozoobenthos abundance was highest in Bigodi (1189 individuals, 22 families), moderate in Kahunge (538, 21 families) and lowest in Businge (216, 21 families). Seasonal effects were significant in Kahunge (diversity p = 0.002) and Businge (diversity p = 0.033, Average Score Per Taxon p = 0.048), while ASPT differences across disturbance gradients were significant only in Businge (p = 0.004). Physico-chemical parameters generally met National Environment Management Authority standards, with minor nitrite exceedance in isolated low-quality sites. A principal component analysis showed system- and season-specific water chemistry: Businge dry-season linked to higher nitrates (mean = 0.413 ± 0.393 mg/L) and hardness (mean = 175 ± 144.3); Bigodi wet-season to higher Total dissolved solids (mean = 142.5 ± 80.6 ppm) and nitrates (mean = 0.675 ± 0.496 mg/L). Despite acceptable water quality, significant wetland loss, especially in Businge, threatens ecological integrity, warranting targeted habitat protection and stricter wetland-use controls.
Maternal inflammation disrupts transplacental antibody transfer in pregnant individuals with and without HIV
(Frontiers in Immunology, 2026-08-28) Bernshtein,Biana; Butler,Audrey; Roberts,Drucilla J.; Atwine,Raymond; Adong,Julian; Alter,Galit; Ngonzi,Joseph; Correia,Katharine F. B.; Bebell,Lisa M.
Introduction: Maternally transferred immunity plays a critical role in protecting infants from pathogens during the vulnerable period before their own immune system matures. Maternal IgG antibodies cross the placenta and circulate in the infant's body for up to six months, providing protection against infection. Despite the importance of transplacental antibody transfer, the mechanisms regulating this process remain poorly understood, including the maternal and placental factors that influence transfer efficiency. Methods: We analyzed maternal and umbilical cord plasma samples from 354 mother-baby dyads in Uganda, of whom 176 were pregnant individuals with HIV taking antiretroviral therapy. We measured IgG antibody levels, antibody binding to Fc receptors, antibody glycosylation, and cytokine levels in both maternal and umbilical cord compartments, and we evaluated placental inflammatory states with placental histology. We used this comprehensive dataset to define correlations between transplacental antibody transfer efficiency, placental inflammation, and cytokine levels in maternal and umbilical cord plasma. Results: We found that antibody transfer efficiency was not impacted by histologic placental inflammation, but that higher maternal plasma levels of the pro-inflammatory cytokines TNF-a and IL-6 correlated with reduced transplacental antibody transfer efficiency. Discussion: Our findings reveal the impact of maternal systemic inflammation on antibody transfer across the placenta and have implications for maternal immunization strategies.
Simulation of a multi-parameter indoor air purification control system using fuzzy logic–PID hybrid control tuned by genetic algorithms
(Scientific Reports, 2026-07-15) Wanzala,Jimmy Nabende; Awamu,Abdallah; Atim,Michael Robson; Mugabe,Robert; Awal,Moses
Indoor Environmental Quality ( IEQ)critically im- pacts human health, comfort, and productivity yet existing air purification systems often rely on single-sensor data, manual monitoring, or cloud-based processing, resulting in limited intelligence, increased latency, and reduced suitability for resource- constrained environments such as Uganda. To address these challenges, this paper presents the design, mathematical modelling, and simulation of a novel multi-parameter indoor air purification control system. The proposed frame work integrates six environmental sensors (dust, smoke, gas, volatile organic compounds (VOC), temperature, and humidity) with a hybrid Fuzzy Logic–Proportional–Integral–Derivative (PID)controller whose parameters are optimally tuned using a Genetic Algorithm (GA).A first-principles mathematical model of the DC motor-driven purifier actuatoris developed to describe the relationship between the input voltage and volume tric air flow. To enhance the physical realism of the simulations, the system model incorporates practical operating factors, including fan inertia, room-air mixing, pollutant transport, filter dynamics, and environmental sensor noise. The complete system is implemented in the MATLAB/Simulink environment using a Mamdani-type fuzzy inferencesystemwith49rulesandaGA-basedmulti- objective fitness function to minimize over shoot, settling time, and steady-state error. Simulation results demonstrate that the proposed GA-tuned Fuzzy-PID controller achieves a stable and well-damped responsewitharisetimeof53.93s, a settling time of 119.99s, and amaximumovershootof2.14%, reflecting the expected dynamics of practical indoor air purification systems. The proposed frame work provides a scalable, low-latency, and network-independent intelligent control solution that establishes a realistic foundation for future prototype development and experimental validation in low-resource environments.
Prevalence, severity and predictors of Antipsychotic-Related Adverse Drug Reactions at the Psychiatry Clinic of a Regional Referral Hospital in Uganda
(PLoS One, 2026-08-13) Tumwebaza,John Martin; Bukke,Sarad Pawar Naik; Narapureddy,Bayapa Reddy; Kabera,Radiana Makuza; Sebisaalu,Joel; Abubakar,Amina; Kitheka,Patrick Muasya; Nimusiima,Godwin; Mohamed,Awad Osman Abdalla; Muwanguzi,Moses; Ashaba,Scholastic; Yadesa,Tadele Mekuriya
Background Adverse drug reactions (ADRs) are associated with hospitalization, increased health¬care cost, morbidity and mortality. This study aimed to investigate the prevalence, severity and associated factors of ADRs among patients taking antipsychotics at Mbarara Regional Referral Hospital (MRRH). Method A cross-sectional study was conducted among patients taking antipsychotics at the psychiatric clinic from March to May 2025. Consecutive sampling was employed whereby all eligible patients attending the psychiatric clinic during the study period were recruited until the required sample size was attained. All patients aged 18 years and above, diagnosed with a psychotic disorder, and who had received an antipsy¬chotic for at least the previous one month were interviewed. STATA version 17 was used for statistical data analysis. Descriptive statistics were presented as mean and standard deviation or median and interquartile ranges. ADRs were analyzed for severity using the modified Hartwig and Siegel scale. We run multivariable logistic regression analysis to determine factors associated with ADRs. Results A total of 415 participants were included in the study with a mean age of 38. Fifteen ADRs were commonly reported among patients taking antipsychotics. More than half of the participants (256/415, 61.70%) experienced at least one ADR, with sedation being the most frequent (31.3%). Of the reported ADRs, 12/15 (80%) were moderate in severity. Separation from spouses (AOR = 2.01, 95% CI [1.08–3.77], p = 0.029), diagnosed with bipolar disorder (AOR = 2.09, 95% CI [1.07–4.07], p = 0.031), and co-administering both IM & oral antipsychotic (AOR = 1.95, 95% CI [1.03–3.70], p = 0.041) were significantly associated with ADRs. Conclusion The current study showed that over 6 in 10 participants taking antipsychotics experi¬enced at least one ADR, the majority of which were moderate in severity. Separation from a spouse, bipolar disorder, concomitant use of oral and intramascular antipsy¬chotics were independently associated with ADRs. These findings highlight the need for strengthen monitoring and preventive strategies, particularly among high-risk patients taking antipsychotics. Integration of clinical pharmacists into the psychiatry care teams may further enhance ADR detection, monitoring and management.
Prevalence and factors associated with hepatitis B surface antigen (HBsAg) positivity in Bugoye Sub-County, Western Uganda
(Discover Public Health, 2026-08-12) Turigye,Brian; Mulogo,Edgar M.; Thompson,Peyton; Camille,Morgan; Goel,Varun; Baguma,Emmanuel; Bhatti,Khadijah; Boyce,Ross M.
Background Hepatitis B virus (HBV) infection is a major cause of global morbidity and mortality. National serosurveys suggest that Uganda has a prevalence of 4.3%of chronic HBV infection. However, there is limited information regarding the potential determinants for infection. Methods Secondary data from a population-based household survey in the Kasese District were used to estimate HBsAg positivity. From these results, two villages were purposefully selected (i.e., low and high prevalence) for a population-representative household survey and a descriptive cross-sectional study. Descriptive analyses were conducted to characterise HBsAg positivity according to demographic, social-behavioural, clinical, and health-system factors, and spatial kernel density analysis and scan statistics were used to detect high-risk areas. Results A total of 2,067 adults were tested for HBV, of whom 93 were HBsAg-positive, giving an overall seroprevalence of 4.5% (95% CI: 3.6–5.5). In the two selected villages, 286 participants were enrolled, including 125 individuals aged ≥ 15 years and 161 children aged < 15 years. HBsAg positivity was detected in 6 of 125 adults (4.8%) and in no children. Descriptive comparisons suggested that HBsAg-positive participants more frequently reported a history of HBV testing, blood transfusion, and receipt of parenteral medications. A significant spatial cluster of elevated HBV risk was identified in the central region of the study area (RR = 5.22, p = 0.0266). Conclusions The prevalence of HBsAg is highly variable between villages in rural western Uganda. Infection was exclusively found in adults, which suggests. This suggests the benefit of hepatitis vaccination among children and could suggest that vertical and early-life transmission may be less of a risk factor. In adults with HBV, we observed a higher frequency of prior healthcare-associated exposures, which merits further investigation into practices intended to prevent transmission of blood-borne pathogens.
Interface-programmed nano energy systems for coupled solar conversion and thermoelectric power: a critical mini-review and translational roadmap
(Frontiers in Energy Research, 2026-07-26) Eze,Val Hyginus Udoka
Nano-enabled solar, thermoelectric, and hybrid photovoltaic–thermoelectric (PV–TEG) systems offer promising routes for improving renewable-energy utilization, yet the field remains fragmented across material classes, device architectures, and isolated performance metrics. This PRISMA-guided critical mini-review synthesizes 74 studies on nanomaterials for solar conversion, thermoelectric generation, and hybrid PV–TEG integration. The review develops an interface-programmed nano-energy framework in which photon absorption, charge-carrier extraction, phonon-mediated heat transport, interfacial thermal resistance, and device stability are treated as coupled design variables rather than separate material functions. The synthesis shows that quantum dots, perovskite nanocrystals, plasmonic nanoparticles, nanowires, superlattices, hierarchical nanocomposites, carbon nanomaterials, and two-dimensional materials enhance energy conversion mainly when their interfaces coordinate optical, electronic, and thermal pathways. For hybrid PV–TEG systems, the review shows that simple device stacking is insufficient because practical net energy gain depends on photovoltaic temperature control, thermal contact resistance, preservation of the thermoelectric temperature gradient, electrical load matching, packaging reliability, and comparison with PV-only and TEG-only references under matched operating conditions. The review further identifies a stability–toxicity–scalability trilemma that limits translation of high-efficiency or high-ZT nanomaterials into deployable energy systems, particularly for Pb-, Cd-, Te-, noble-metal-, and heat-sensitive platforms. To improve transparency and comparability, the review proposes an evidence-summary table, descriptive graphical synthesis, semi-quantitative material scoring, and a reporting checklist covering material identity, synthesis route, device architecture, performance metrics, stability testing, toxicity/sustainability evidence, scalability indicators, and net hybrid gain. Overall, this mini-review argues that future progress in nano-energy systems will depend on mechanism-aware, interface-programmed co-design that integrates efficient solar conversion, useful waste-heat recovery, durable interfaces, safer material chemistry, scalable processing, and validated system-level energy benefit.
Fault–responsive hybrid analytical–simulation framework for electric power transmission performance monitoring
(Scientific Reports, 2026-08-21) Mugabe,Robert; Atim,Michael Robson; Obungoloch,Johnes; Wanzala,Jimmy Nabende
Abstract—Continuous monitoring of electric power transmission systems I essential for maintaining reliable power transfer under increasingly dynamic operating conditions. Although analytical and simulation-based approaches have individually advanced transmission-system analysis, comparatively fewer studies have integrated their complementary strengths within a unified monitoring frame work. This paper proposes a fault-responsive hybrid analytical–simulation framework that combines distributed-parameter transmission-line modelling based on the ABCD parameter formulation with an equivalent π-model implemented in MATLAB/Simulink for continuous assessment of transmission-line performance. The frame work evaluates transmission efficiency, voltage regulation, and voltage-drop index under normal and abnormal operating conditions, including voltage overload low power factor, and balanced and unbalanced faults. Validation is performed against a benchmark distributed-parameter simulation using wave form comparison together with root mean square error (RMSE)and mean absolute error(MAE).The proposed hybrid framework consistently achieved the lowest prediction errors, reducing the average transmission-efficiency MAE from approximately 0.62% fortheanalyticalABCDmodeland0.05%forthe equivalent π-model toapproximately0.01%.Similarly,the average voltage-regulation MAE decreased from approximately 1.05% and0.65%toapproximately0.07%,whileaccurately reproducing transmission-line behavior during fault initiation, fault clearing, and post-fault recovery. These results demonstrate that integrating analytical modelling with dynamic simulation provides a practical, computationally efficient, and scalable frame work for continuous transmission-line performance monitoring and decision support.
Design and simulation of an energy efficient intelligent kitchen HVAC control system using RBFNN–PID and GA
(Discover Applied Sciences, 2026-07-29) Turyashaba,Mellon; Wanzala,Jimmy Nabende; Atim,Michael Robson; Awal,Moses; Mugabe,Robert
Abstract—Heating, Ventilation, and Air Conditioning systems are essential for maintaining thermal comfort, indoor air quality, and occupant health, particularly in energy-intensive environments such as indoor kitchens. However, conventional HVAC control systems often relyon fixed-gain PID controllers that struggle to handle non-linear dynamics, time-varying disturbances, and indoor air pollution, leading to reduced comfort and increased energy consumption. To address these challenges, this study designs and simulates an energy-efficient HVAC control system based on a hybrid Genetic Algorithm, Radial Basis Function Neural Network–PID approach for regulating indoor temperature, humidity, and carbonmonoxide concentration. The genetic algorithm is first employed to obtain optimal baseline PID gains, ensuring fast and stable initial system response, while the RBF neural network adapts these gains online to cope with environmental uncertainties and disturbances. The HVAC plant is modeled as a three-state dynamic system with realistic thermal, moisture, and pollution is turbances. The simulation results indicate accurate tracking of the reference set points across all controlled variables. The temperature regulation achieved a low RMS error of 0.26726 with a co-efficient-of determination of 0.75193, demonstrating good tracking performance. For relative humidity, the RMS errorwascalculatedas1.1548, while the corresponding R² value was 0 .11706, Carbon monoxide regulation exhibitedalowerRMSerrorof0.014568compared to temperature and humidity; andtheassociatedR²value of 0.99539 confirms satisfactory goodness off it and effective disturbance rejection despite intermittent pollutions pikes. The proposed GA–RBFNN–PID control system demonstrated rapid convergence characteristics, where the controlled parameters settled precisely at their respective points within approximately 1–2 minutes with no over shoot and observable steady-state error, thereby ensuring robust and stable indoor kitchen climate regulation.
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.