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

MUST-IR preserves research output from the MUST Community

Student Forms and Guides

Download the documents needed for self-archiving your research in MUST IR.

Self-Archiving Consent Form

Download, complete and sign the consent form.

Download Consent Form (PDF)

Student Self-Archiving Guide

Follow the steps for submitting research to MUST IR.

Download Student Guide (PDF)

Communities in MUST-IR

Select a community to browse its collections.

Now showing 1 - 11 of 11

Central Administration 132
This community will contain collections from the general Administrative staff
Faculty of Agriculture, Enviroment and Veterinary Sciences 2
Faculty of Applied Sciences and Technology 73
Faculty of Business and Management Sciences 127
Faculty of Computing and Informatics 152
Faculty of Health Science 2466
Faculty of Interdisciplinary Studies 227
Faculty of Science 576
Institute of Tropical Forest Conservation 124
Maternal Newborn and Child Health Institute 18
MUST Research Institute 3

Recent Submissions

Vasopressor Use Among Adults With Sepsis in Uganda and Rwanda: A Multicenter Retrospective Cohort Study
(Critical Care Explorations, 2026) Girard, William S.; Turkistani, Farah; Kakande, Reagan; Adejayan, Victor; Zulfiqar, Muhammad; Ndyomugabe, Michael; Gruccio, Phoebe; Ojuman, Philemon; Otoupalova, Eva; Banguti, Paulin R.; Hopkinson, Dennis; Mvukiyehe, Jean Paul; Syed, Aamer; Riviello, Elisabeth; Nuwagira, Edwin; Moore, Christopher C.
OBJECTIVES: Africa has the highest global sepsis burden. Yet, sepsis treatment guidelines, including those for vasopressor use, incorporate data from high income settings. We aimed to determine patterns of vasopressor use among adults admitted to hospital with sepsis in East Africa. DESIGN: Retrospective cohort study. SETTING: One hospital in Uganda and two hospitals in Rwanda. PATIENTS: Adults admitted to hospital with sepsis, defined as suspected infection and greater than or equal to 2 quick Sequential Organ Failure Assessment criteria. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We performed an analysis of pooled data from two retrospective studies of adults with sepsis admitted to hospital in Rwanda or Uganda. Of 471 septic patients analyzed, 263 (57%) were female, the median (interquartile) age was 51 years (36–65), 121 (26%) were living with HIV, 113 (24%) received a vasopressor, and death occurred in 139 patients (30%). In the univariable logistic regression analysis, higher respiratory rate and Universal Vital Assessment (UVA) scores; lower blood pressure, oxygen saturation, and Glasgow Coma Scale score at the time of sepsis diagnosis; presence of abdominal infection; and receiving a greater volume of IV fluids predicted receipt of a vasopressor. In the multivariable analysis, higher UVA mortality risk scores (adjusted odds ratio 1.25; 95% CI, 1.14–1.27; p < 0.001) predicted vasopressor receipt. We replicated these findings in exploratory machine learning analyses. CONCLUSIONS: In patients with sepsis in East Africa, UVA score and hospitalization in Uganda were predictive of vasopressor administration. Further research is required to address existing knowledge gaps in the role, timing, and indications for vasopressors in sepsis management in Africa.
Vaccination coverage among migrant and refugee populations in Uganda: A narrative review of challenges and recommendations
(Global Public Health, 2026) Nakachwa, Sarah Marion; Okorobe, Pascal Mathew; Onama, John
Uganda hosts one of Africa’s largest refugee populations, yet displaced and migrant communities face persistent barriers to routine immunisation. Despite commitments to vaccine equity, many remain unprotected against preventable diseases. This narrative review synthesises evidence from peer-reviewed studies, national surveys, and institutional reports up to September 2025 to assess immunisation coverage, challenges, and potential solutions among refugees and migrants in Uganda. The findings indicate that vaccination rates in refugee communities are generally lower than national averages due to administrative barriers, vaccine shortages, long distances to health facilities, language difficulties, misinformation, and challenges intensified during the COVID-19 pandemic. Economic hardship further limits healthcare access. However, several strategies show promise: integrating refugees into national immunisation systems, simplifying registration processes, strengthening mobile outreach, engaging community health workers, and improving cross-border data coordination. Addressing these inequities requires both technical and social commitment through adequate financing, inclusive policies, and meaningful community engagement. Achieving equitable immunisation for refugees in Uganda is essential for public health protection and the realisation of universal health coverage.
Screening and Characterization of Antimicrobial peptides from fish mucus in three major Lakes of Uganda
(Mbarara University of Science and Technology, 2022-12) Hedmon, Okella
Background: Antimicrobial peptides (AMPs) constitute a broad range of bioactive compounds in diverse organisms, including fish. Currently, several peptide antibiotics have been approved for clinical use. Still, skin mucosal AMPs of African catfish and African lungfish are largely unexplored despite their potential in contributing novel drug candidates. Accordingly, the African Catfish Antimicrobial peptides (ACAPs) were investigated. Methods: Native peptides were extracted from fish mucus scrapings in IO % acetic acid (v/v) and ultra-filtered using a 5 kDa molecular weight cut-off membrane. The ultrafiltrate were purified using CIS Solid-Phase Extraction cartridges. Later, their antibacterial activity was determined using the Agar Well Diffusion and broth-dilution methods utilizing Staphylococcus aureus (ATCC 25923) and Eschenchia coli (ATCC 25922). Sephadex G-25 gel filtration was further utilized in bio—guided isolation Of the most active fractions prior to peptide identification using Orbitrap Fusion Lumos Tribrid Mass Spectrometry. Discriminant Analysis Machine and Deep learning algorithms were utilized in predicting antimicrobial scores of each peptide. Toxicity of thc AMPs was assessed using rabbit blood cells alongside HLPpred-Fuse and ToxinPred servers. The AMPs possible mode of action was assessed using SevenGo Duo SG-23 digital conductivity meter, QuantiChrom Alkaline phosphatase kit, and molecular docking engines prior to their chemical synthesis. Results: The skin mucus extracts from fish in three major lakes of Uganda exhibited antimicrobial activity on E. coli and S. aureus. Lake Albert's African catfish demonstrated the highest antimicrobial activity with the lowest MIC of 2.84 and 0.71 gg/mL on S aureus and E. coli, respectively. Sephadex G-25 peak I muss spectrometry revealed seven short peptides (11—16 amino acid residues) of high antimicrobial scores (0.561—0.905 units). In addition, these peptides had a low molecular weight (1005.57—1622.05 Da) and had a percentage hydrophobicity above 54%. Partially purified extracts were non-hemotoxic peptide ACAP-V demonstrated the highest binding and global energies against Monomeric sarcosine oxidase (PDB [d: 2gbO; - 9.40 kcal/mol) and NADH peroxidase (PDB Id: Inhp; BE: -88.84 kcal/mol) respectively. Synthesized ACAP-IV and ACAP-V had the MIC of 520.7 and 625.0 gg/mL on E. coli. Conclusion and Recommendation: Collectively, the 7 African catfish antimicrobial peptides were identified as potential novel drug candidates. Future research is recommended to validate their activity in vivo on a wider range of bacteria.
Test Performance of Expired Malaria Rapid Diagnostic Tests: A Pilot Diagnostic Accuracy Study Conducted in Western Uganda
(The Journal of Infectious Diseases, 2026-02-19) Ndizeye, Ronnie; Gunderson, Annika K.; Baguma, Emmanuel; Giandomenico, Dana A.; Ntaro, Moses; Mulogo, Edgar Migema; Boyce, Ross M.
We evaluated the diagnostic agreement of expired malaria rapid diagnostic tests (mRDTs) with non-expired mRDTs in a clinical setting in western Uganda. Expired mRDTs (SD Bioline Ag Pf/Pan and First Response Ag pLDH/HRP2) were administered to each participant in parallel with a non-expired mRDT serving as the reference. Of 200 participants, 21 (10.5%) tested positive and 179 (89.5%) tested negative for malaria. All tests up to 9 months post-expiration were valid and consistent with reference mRDTs. All mRDTs 10–12 months post-expiration were invalid. These preliminary findings support further research into the use of expired mRDTs in resource-limited settings.
Severity of maternal anemia and the risk of giving birth to a small vulnerable newborn: A cohort analysis of the WOMAN- 2 trial in four countries
(International Journal of Gynecology & Obstetrics., 2026) Ochola, Henry ; Roberts, Ian; Webb, Emily L.; Lieber, Judith; Lawn, Joy E.; Blencow, Hannah; Chaudhr, Rizwana; Kayani, Aasia; Javaid, Kiran; Olayemi, Oladapo; Bello, Folasade A.; Mugayizi, Projestine; Lubeya, Mwansa Ketty; Vwalika, Bellington; Shakur-Still, Haleema; Balogun, Eni; Prowse, Danielle; Brennerr, Amy
Objective: To investigate the association between maternal hemoglobin concentra tion and the risk of birth to a small vulnerable newborn (SVN). Methods: We conducted a cohort analysis of women with moderate or severe anemia enrolled in the World Maternal Antifibrinolytic Trial- 2 (WOMAN- 2) across Nigeria, Pakistan, Tanzania, and Zambia (August 2019 to September 2023). Maternal hemo globin concentration at admission for vaginal birth was categorized into six groups. Results: Among 14 444 women, the median hemoglobin level was 85 g/L (interquar tile range [IQR] 77–91 g/L), and 39.5% (5703/14444) of newborns were classified as SVNs. A strong inverse relationship was observed between maternal hemoglobin and SVN. Compared with women with hemoglobin of 90–99 g/L, aOR values for SVN were 1.06 (95% CI 0.97–1.16) for 80–89 g/L; 1.27 (95% CI 1.15–1.41) for 70–79 g/L; 1.44 (95% CI 1.26–1.64) for 60–69 g/L; 2.00 (95% CI 1.64–2.43) for 50–59 g/L; and 2.51 (95% CI 1.85–3.41). Conclusions: Increasing severity of maternal anemia is associated with a marked increase in the risk of giving birth to SVNs. The disproportionately higher risk observed at lower hemoglobin levels supports prioritization of women with more severe anemia for intensified monitoring and treatment in high- burden settings.
Prevalence, factors associated, and adverse maternal outcomes of spinal induced hypotension among mothers undergoing caesarean section at a tertiary hospital South Western Uganda
(BMC anesthesiology, 2026) Sserunkuuma, Bruno; Olowo, Samuel; Tibaijuka, Leevan; Alum, Rachel Aguma; Kateregga, George; Kiwanuka, J.; Ttendo, Stephen; Kintu, Andrew; Kayondo, Musa
Background Spinal induced Hypotension during caesarean section remains common and is a serious complication which may lead to serious outcomes like cardiac arrest, morbidity and mortality. The study aimed to determine the prevalence of, factors associated with, and adverse maternal outcomes of spinal-induced hypotension following caesarean section at Mbarara Regional Referral Hospital. Methods and materials A hospital based cross-sectional study at Mbarara Regional Referral Hospital for the period of August 2022 to October 2022 was conducted on 394 mothers who underwent spinal anaesthesia during caesarean section. Systematic random sampling was used where we enrolled each second woman who had been delivered by caesarean section under spinal anaesthesia. Participant socio-demographic, baseline clinical, obstetric characteristics, intraoperative data and anaesthetic characteristics were obtained from the participant’s medical record. The prevalence of spinal-induced hypotension was the proportion of women with spinal-induced hypotension. Logistic regression analysis was used to determine the factors associated with spinal-induced hypotension. The adverse maternal outcomes of spinal-induced hypotension were reported as proportions and frequencies. The level of significance was set at 5%. Results Participants had a mean age of 26.71 ± 5.7 years and most women were multigravida (II-IV). The prevalence of spinal-induced hypotension was 67.5% (95% CI 62.7–71.9). At multivariable logistic regression, having a spinal block height proximal to T6 [aOR 1.92 95% C.I (1.09–3.39), p = 0.024], being given intrathecal bupivacaine dose above 10 mg [aOR 1.74 95% C.I (1.04–2.89), p = 0.034], emergency caesarean section [aOR 2.32 95% C.I (1.20–4.46), p = 0.012], and not receiving a prophylactic vasopressor [aOR 1.66 95% C.I (1.02–2.68), p = 0.039] were independently associated with Spinal-induced hypotension. Seven of our participants got high spinal. Conclusion The prevalence of spinal-induced hypotension among mothers undergoing caesarean section at MRRH is high. We recommend routine administration of prophylactic vasopressor during all caesarean sections and clinicians to recognize these factors associated with spinal induced hypotension.
Prevalence of abnormal spirometry and correlates of lung function decline among a population in rural Uganda
(Journal of Global Health, 2026) Pierre-Louis, Marvah Hill; Qian, Yiqi; Satinsky, Emily N.; Nuwagira, Edwin; Baguma, Charles; Ayebare, Patience; Gumisiriza, Patrick; Lam, Megan; Lee, Mi-Sun; Christiani, David C.; Asiimwe, Stephen; Kakuhikire, Bernard; Tsai, Alexander C.; Siedner, Mark J.; North, Crystal M.
Background Chronic lung disease, which is the third leading cause of death globally, places a disproportionate burden of morbidity and mortality on sub-Saharan Africa, where limited infrastructure results in a lack of understanding of how lung function changes over time, whether it varies among susceptible populations, or whether at-risk individuals could be identified before abnormal lung function develops. To address this gap, we aimed to characterise lung function patterns and identify correlates of lung function decline in rural Uganda. Methods Adults completed health questionnaires and American Tho racic Society/European Respiratory Society-acceptable spirometry up to three times over four years (2015–2019). Our primary outcome was lung function (forced expiratory volume in 1 second (FEV1 ) and FEV1 / forced vital capacity (FVC)); our secondary outcome was spirometry patterns. We characterised baseline patterns using Global Lung Initiative (GLI)-Global prediction equations and identified correlates of decline using generalised mixed effects linear regression. We then explored effect modification by sex, smoking, and socioeconomic status using interaction terms, with inverse probability of treatment weights balancing baseline characteristics. Results A total of 902 participants completed 1,471 ATS/ERS-acceptable spirometry tests. Their median age was 35 years, 56% were women, 75% were never-smokers, and 31% experienced chronic respiratory symptoms. Conclusions Lung function decline may be more rapid in this young, mostly non-smoking population. Our findings extend the understanding of non-obstructive lung disease in sub-Saharan Africa and emphasise that risk persists despite normal spirometry. These data can inform regional public health strategies for risk mitigation, early disease detection, and building healthcare infrastructure for the growing population at risk for or living with chronic lung disease.
Prevalence and factors associated with chemotherapy induced peripheral neuropathy among adult patients with cancer at Mbarara Regional Cancer Centre: a cross sectional study
(BMC neurology, 2026-06-23) Avaga, Stanslas; Ngbape, Simon Ndrusini; Damale, Abdu; Kato, Idrine Kalinge; Bacia, Laura; Nakate, Caroline; Kyomya, Julius; Isiiko, John; Tamukong, Robert; Yadesa, Tadele Mekuriya
Background Chemotherapy is a common modality used for management of cancers but some agents are known to cause peripheral neuropathy. Chemotherapy induced peripheral neuropathy (CIPN) refers to a disorder in structure and functionality of peripheral sensory, motor, and autonomic neurons triggered by the toxic effects of these drugs. CIPN is a common adverse drug reaction (ADR) caused by mainly platinum analogs, vinca alkaloids and taxanes. Severe CIPN can cause paresis, complete immobilization and disability. The objectives of this study were to determine the prevalence, factors associated with and evaluate treatment of CIPN among adult patients with cancer at Mbarara Regional Cancer Centre. Methods A cross-sectional study was conducted for a period of 2 months among adult patients with cancer receiving chemotherapy at Mbarara Regional Cancer Centre. Consecutive sampling technique was used to enroll 235 participants into the study. Data collection was done through patient interviews and file reviews. Assessment of the clinical features of CIPN was done using EORTC-QLQ-CIPN20 tool. SPSS version 27 was used for data entry and analysis. Results The prevalence of CIPN was 31.1%. The factors associated with occurrence of CIPN include age greater or equal to 60 years (aOR = 2.04, 95% CI: 1.07–3.91, p-value = 0.031), concurrent administration of non-chemotherapeutic neurotoxic drugs (aOR = 6.50, 95% CI: 1.64–9.36), past resolved neuropathy prior to initiation of chemotherapy (aOR = 6.99, 95% CI: 2.28–9.21). 30.1% of patients with CIPN received treatment and were managed with agents such as pregabalin, gabapentin, cachnerve, Nat B, neuroton, amitriptyline and vitamin B complex. The American Society of Clinical Oncology guideline recommends use of duloxetine for treatment of CIPN. Conclusion Nearly one-third of patients at Mbarara Regional Cancer Centre had CIPN. Patient age 60 years and above, past resolved neuropathy and concurrent administration of non-chemotherapeutic neurotoxic drugs are factors associated with occurrence of CIPN. Therefore, such patients require close monitoring for the symptoms of peripheral neuropathy so that appropriate treatment can be initiated promptly
Metabolic syndrome prevalence and correlates among university and hospital staff in southwestern Uganda
(Scientific Reports, 2026-10-16) Chuwa, Agapiti Hipoliti; Kangwagye, Peter; Agaba, David Collins; Omolo, Ronald Ouma; Migisha, Richard
Metabolic syndrome (MetS) represents a convergence of interrelated cardiometabolic abnormalities that substantially increases the risk of type 2 diabetes mellitus and cardiovascular disease. University and hospital staff may have distinct occupational and lifestyle exposures that contribute to cardiometabolic risk, yet evidence from Uganda remains limited. This study assessed the prevalence, component patterns, and correlates of MetS among university and hospital staff in southwestern Uganda. We conducted an institution-based cross-sectional study among 231 university and hospital staff at Mbarara University of Science and Technology and Mbarara Regional Referral Hospital in Mbarara City, southwestern Uganda, during October 20, 2025–January 25, 2026. MetS was defined using modified harmonized Joint Interim Statement criteria as at least three of five cardiometabolic risk components: central obesity, elevated blood pressure, elevated triglycerides, reduced high density lipoprotein cholesterol, and dysglycaemia. Dysglycaemia was defined as HbA1c ≥ 5.7% or being on glucose-lowering medication. We used modified Poisson regression with robust variance to estimate crude and adjusted prevalence ratios (aPRs) with 95% confidence intervals (CIs). 164 (71.0%) were university staff and 139 (60.2%) were male. Overall MetS prevalence was 29.4% (68/231; 95% CI 23.6–35.8%). Reduced HDL C, dysglycaemia, and central obesity were present in 150 (64.9%), 118 (51.1%), and 74 (32.0%) participants, respectively. In multivariable analysis, MetS prevalence was higher among females than males (aPR = 3.01, 95% CI 2.00–4.51), among participants aged 35–49 years (aPR = 2.23, 95% CI 1.10–4.52) and ≥ 50 years (aPR = 2.72, 95% CI 1.17–6.32) compared with those aged 18–34 years, and among current alcohol consumers compared with non-consumers (aPR = 1.79, 95% CI 1.22–2.62). MetS affected nearly one-third of surveyed university and hospital staff in southwestern Uganda, and reduced HDL-C and dysglycaemia were the predominant abnormalities. Higher MetS prevalence was associated with female sex, older age, and current alcohol consumption. These findings indicate a substantial cardiometabolic risk burden in this institutional workforce and support consideration of workplace-based risk assessment and health-promotion strategies in similar settings.
Implementing an intra outbreak ring vaccination clinical trial for Sudan Ebola virus disease within four days of outbreak notification in Uganda
(Emerging Microbes & Infections, 2026-09-16) Muttamba, Winters; Kyobe, Henry Bosa; Wayengera, Misaki; Obuku, Andrew; Sekimpi, Maria; Kimbugwe, Geofrey; Sabiiti, Wilber; Byakika-Kibwika, Pauline; Kiwanuka, Noah; Nantanda, Rebecca; Atwine, Diana; Olaro, Charles; Abdourahamane, Diallo; Toure, Alhassane; Restrepo, Ana Maria Henao; Kaleebu, Pontiano; Kirenga, Bruce
East and Central Africa experiences heightened threats for Ebola Virus Disease (EVD), with the latest outbreak caused by the Bundibugyo ebola virus (BDBV) reported in the Democratic Republic of the Congo (DRC) and Uganda on 15th May 2026. The BDBV outbreak comes just over a year following the declaration of Sudan Virus Disease (SVD) outbreak in Uganda on 30th January 2025. Following the 2025 outbreak, a race against the clock mobilization occurred over the subsequent four days to launch a ring vaccination trial for a candidate vaccine against SVD. During this four-day period, the investigation team leveraged ongoing engagements with trial sponsors to activate prefinancing mechanisms and unlock in-kind financing from the government of Uganda. Further, the team activated a prepositioned research protocol to secure rapid ethics and regulatory clearance, and quickly accessed investigation product within the country, supportive ethics/regulatory systems, presence of logistical and data management systems established during the 2022 outbreak, collaborative relationship between the trial and the Ministry of Health outbreak response teams. Finally, previously trained field and community engagement personnel were mobilized overnight, offered refresher training and rapidly deployed to the field. In conclusion, the unprecedented four-day turnaround was made possible by the research, logistical and staffing capacities established during the 2022 SVD outbreak, an achievement that offers a blueprint for rapid evaluation of medical countermeasures during outbreaks.
Impact of the micro-research model on building research capacity in undergraduate health professions students in HIV-related research: a comprehensive evaluation using the RE-AIM framework
(BMC Medical Education, 2026) Rukundo, Godfrey Zari; Kellen, Peace; Karungi, Christine K.; Wakida, Edith K.; Kumakech, Edward; Maling, Samuel; Kabami, Jane; Samantha, Mary; Gutu, Jastine; Asasira, Jenipher; Ocan, Moses; Haberer, Jessica E.; Okello, Elialilia S.; Obua, Celestino
Background Low-income settings such as Uganda bear a disproportionately high burden of diseases such as HIV/AIDS, but contribute little to knowledge production to address their health challenges. The training of health professionals traditionally focuses on clinical skills with less emphasis on research; yet, in practice, health professionals are expected to do operational research. In this study, we evaluate the impact of a micro-research model on building the capacity of undergraduate health professions students to conduct locally relevant biomedical, behavioral, clinical, and operations research on HIV and its co-morbidities. Methods This study was within the Health Professional Education Partnership Initiative - Transforming Ugandan Institutions Training Against HIV/AIDS (HEPI-TUITAH; 2018–2024), using a sequential explanatory mixed methods design. We collected quantitative data on sociodemographic, number of trainings, concepts and written manuscripts. Thereafter, we conducted in-depth interviews and analyzed them using a thematic content approach. We used the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework to evaluate the impact (number trainings, protocols written, manuscripts written, publications, and change in attitudes) of the HEPI-TUITAH micro-research model. Results Of the 24 participants that were interviewed, 15 (62.5%) were male, aged 24–63 years (mean age, 35.3 years). Despite the challenges associated with the COVID-19 risk management measures, 41 (57%) out of the expected 72 manuscripts were published. Most participants expressed satisfaction with the recruitment process and the opportunities provided by the program. The process was described as transparent, competitive, and inclusive, allowing participation of multiple disciplines within the health professions training domains. The multi-disciplinary approach to team formation enriched the research process by leveraging diverse perspectives and expertise. Our data show that effective mentorship was a key driver of program success, facilitating skill development, fostering strong relationships, and ultimately contributing to the advancement of both mentees and mentors in their academic and professional pursuits. Training and mentorship sessions encompassed proposal development and manuscript writing. There was a general positive outlook regarding the sustainability at participating institutions. Conclusion The micro-research model is a successful model for building research capacity for undergraduate health professions students. This model is highly recommended for integration into curricula for health professions programs
Exploring sensory changes and social withdrawal among stroke survivors: a qualitative study
(Discover Psychology, 2026-06-12) Khan, Muslim; Alghadie, Mshari; Atallah, Huthaifa; Alnasser, Saeed Mufleh; Alotaibi, Obaid; Barhouma, Hassan; Kharusi, Ahmed Ibrahim Al; Abdelnour, Hassan; Bleedy, Nermeen; Muteesasira, Edward
Background Sensory changes are common among stroke survivors, significantly impacting their ability to engage in meaningful activities of daily living and participation in social interactions. However, these sensory changes often go unrecognized in clinical settings often resulting into inadequate rehabilitation and reduced quality of life. This study aimed to examine how these sensory changes affect activity participation among stroke survivors. Methods This qualitative study had a total of 35 participants. These included 20 stroke survivors (12 males and 8 females) and 15 stakeholders (8 females and 7 males) consisting of 8 occupational therapists,4 physical therapists and 3 caregivers, with at least 2 or more years of professional experience. These were recruited through purposive sampling of regional stroke support groups, stroke outpatient clinics, and online rehabilitation forums in swat district, Pakistan. Data was collected through focus group discussions held via Zoom between January and March 2024 in order to investigate the lived experiences and perspectives on post-stroke sensory changes. Resulting data was thematically analyzed. Results The main themes identified by all participants (stroke survivors and stake holders) were; (1) sensory changes frequently go unnoticed during clinical assessments, (2) Sensory changes significantly disrupt routine engagement and active participation in activities of daily living, (3) sensory changes lead to social withdrawal and isolation, and (4) limited resources and the absence of standardized sensory assessment tools hinder effective management of these sensory changes. Conclusion The results highlight an urgent need to incorporate targeted sensory assessments and interventions into stroke rehabilitation programs. Future research should focus on creating standardized sensory changes assessment tools to assist in their mitigation.
Early Adverse Perinatal Outcomes Among Women With Placental Abruption: A Multicenter Prospective Cohort Study in Uganda
(Journal of Pregnancy, 2026) Siham, Idiris Omar; Ishimwe, Marie Pascaline Sabine; Nteziyaremye, Theodore; Kajabwangu, Rogers; Kazigo, Ahmed Kiswezi; Hakizimana, Theoneste
Background and Aims: Placental abruption is one of the leading causes of perinatal morbidity and mortality, particularly in low- and middle-income countries. In 2015, the World Health Organization prioritized improving maternal and newborn care to reduce preventable deaths. This study is aimed at determining the proportion of early adverse perinatal outcomes and iden tifying the factors associated with these outcomes among women with placental abruption delivering at three tertiary hospitals in Uganda. Methods: This prospective cohort study was conducted from September 30, 2023, to January 30, 2024, at Jinja, Fort Portal, and Mubende Regional Referral Hospitals. A total of 110 consecutive women with clinically diagnosed placental abruption were enrolled in labor suites. Data were collected via pretested questionnaires and analyzed via STATA Version 14.2. Descriptive statistics were used to determine the incidence and describe adverse perinatal outcomes. Associations between variables were assessed using bivariate and multivariate analyses, with a significance level set at p 50% placental detachment were 8 times more likely to experience adverse outcomes (aRR=2.59 , 95% CI: 1.48–3.13, p=0.005). Conclusions: Women with placental abruption experienced a high burden of early adverse perinatal outcomes. Abnormal fetal heart rate at admission, mode of delivery, and extent of placental detachment were independently associated with these out comes. These findings highlight the importance of timely diagnosis, close fetal monitoring, and prompt obstetric management among women presenting with placental abruption
Association between hypovitaminosis D and uterine leiomyomas among women of reproductive age attending selected hospitals in Uganda: A multicenter cross-sectional study
(Plos one, 2026) Nightingale, Senaji Khamonya; Kajabwangu, Rogers; Okello, Maxwell; Okurut, Emmanuel; Ishimwe, Marie Pascaline Sabine; Okello, Peter; Tukirinawe, Happy; Fernando, Perez; Almenares, Ubarnel; Okello, James; Fajardo, Yarine; Hakizimana, Theoneste
Background Uterine leiomyoma, is a common benign neoplasm among women of reproductive age with a potential of causing significant health complications and financial burdens in severe cases. Recent research suggests a possible link between vitamin D deficiency and uterine leiomyoma development; however, this relationship has not been established in the Ugandan population. For this reason, there is no individualized or public health interventions targeting this modifiable risk factor. The study aimed to determine the relationship between hypovitaminosis D and uterine leiomyoma among women of reproductive age attending Jinja, Lira and Fort Portal Regional Referral Hospitals in Uganda. Methods A cross-sectional multicentre study was conducted at Jinja, Lira and Fort Portal Regional Referral Hospitals between 1st October 2022–31st January 2023. 246 non-pregnant women of reproductive age were included in the study. Question naires were administered to the participants, their serum vitamin D analysed and a transabdominal pelvic scan done. A p value of ≤0.05 was the threshold for statistical significance. Results The prevalence of hypovitaminosis D among participants was high at 54.1%. There was no significant difference in the proportions of leiomyoma among those with and without hypovitaminosis D (χ2 = 0.503, p = 0.478 > 0.05). The mean serum vitamin D level was lower in individuals with uterine leiomyomas compared to those without (19.954 ± 9.77 versus 21.552 ± 9.54 [95% CI: −0.04 to 4.24, p = 0.235]). There was no statistically significant association between hypovitaminosis D and uterine leiomy oma (OR 1.22, 95% CI 0.70–2.12; p = 0.478). There was a weak negative correlation observed between serum vitamin D levels and leiomyoma site number (r = −0.2482, p = 0.0342 < 0.05). Conclusion and recommendations The prevalence of hypovitaminosis D was high among women of reproductive age. There was no statistically significant relationship between hypovitaminosis D and uterine leiomyomas despite a weak negative correlation between vitamin D levels and leiomyoma site number which was statistically significant. High prevalence of hypovitaminosis D underscores the need for health education and public health measures by healthcare providers to manage and prevent vitamin D deficiency-related morbidity among women of reproductive age. Further research by the scientists is needed to investigate the potential association between hypovitaminosis D and uterine leiomyoma, in regards to increased site number, among the African population.
Adolescent Parenthood and Mental Health in South-Western Uganda: Psychosocial Vulnerabilities, Depression Prevalence, and Associated Factors
(Cureus, 2026) Atwiine, Scovia; Nyakato, Viola Nilah; Atwine, Daniel; Kemigisha, Elizabeth
Background Adolescent parenthood is associated with adverse psychosocial, economic, and mental health outcomes; however, evidence on adolescent parents remains limited. This study investigated these factors among adolescent parents in South-Western Uganda. Methods A cross-sectional study was conducted among 195 adolescent parents, including 155 (79.5%) adolescent mothers and 40 (20.5%) adolescent fathers in South-Western Uganda. The participants were aged 15-19 years. Data were collected using structured interviewer-administered questionnaires. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) with a score ≥10 indicating depressive symptoms, while common mental disorders (CMD) were assessed using the Shona Symptoms Questionnaire 14 (SSQ-14) with a score ≥8 indicating CMDs. Sociodemographic, socioeconomic, psychosocial, and attitude-related information was also collected. Descriptive statistics were used to summarize participant characteristics. Modified Poisson regression with robust standard errors was used to identify factors independently associated with depressive symptoms. Results Participants experienced substantial social and economic vulnerability characterized by school discontinuation, unstable livelihoods, low household assets, food insecurity, and limited support systems. The prevalence of depressive symptoms was 48.2% (n=92), while 72.6% (n=138) screened positive for other common mental disorders. Adolescent mothers had significantly higher depressive symptom prevalence than adolescent fathers (n=79, 52.0% vs n=13, 33.3%; p = 0.048), and severe depressive symptoms were observed only among adolescent mothers. Exposure to violence and mistreatment was common, with many adolescents reporting humiliation, threats, assault, and forced sex/rape. In multivariable analysis, unemployment (adjusted prevalence ratio (aPR) = 2.90, 95% CI: 1.17-7.14), household asset count = 0 (aPR = 2.57, 95% CI: 1.10-6.00), mistreatments by relatives (aPR = 1.52, 95% CI: 1.14-2.02), and mistreatment by neighbours (aPR = 1.43, 95% CI: 1.06-1.95) were independently associated with depressive symptoms. Conclusion Adolescent parents in South-Western Uganda experience a high burden of depressive symptoms and common mental disorders within contexts of poverty, violence, stigma, and limited social support. Adolescent mothers appear particularly vulnerable to severe depressive symptoms and forced sex/rape. Comprehensive adolescent-responsive interventions integrating mental health services, economic empowerment, violence prevention, educational reintegration, and community stigma reduction are urgently needed.
Knowledge, attitude, and practice of antifungal resistance and stewardship among pharmacy students in Zambia: a cross-sectional study to inform antifungal stewardship programs
(Frontiers in Education, 2026-08-16) Mudenda, Steward; Chibwe, Bweupe; Mukosha, Moses; Mufwambi, Webrod; Daka, Victor; Nachalwe, Precious Nkumbu; Kasanga, Maisa; Kamvuma, Kingsley; Mwaba, Martha; Fadare, Joseph; Lubanga, Adriano Focus; Mugenyi, Nathan; Gondwe, Moses; Chimbala, Adron Mweshi; Mohamed, Shafiq; Mukumbuta, Jean; Mwanza, Boris; Hampango, Muchindu; Muyenga, Tumelo; Chimombe, Tadious; Makasa, Mubanga
Background: Antifungal resistance (AFR) is a growing global health threat, particularly in low- and middle-income countries such as Zambia, where antifungals are often accessed without prescription. Antifungal stewardship (AFS) programs aim to optimise antifungal use, yet limited data exist on pharmacy students' knowledge, attitudes, and practices (KAP) toward AFR and AFS. This study evaluated pharmacy students' knowledge, attitudes, and practices (KAP) toward AFR and AFS in Zambia. Methods: A descriptive cross-sectional survey was conducted among 288 randomly selected pharmacy students between August and September 2024 using a structured questionnaire. Descriptive statistics summarised demographics and KAP responses. Associations were analysed using Chi-square and Fisher's Exact Tests, while multivariable logistic regression identified predictors of good KAP (p < 0.05). Results: Among respondents (55.2% female; 76.7% aged 18–25 years), most students (94.1%) knew how to define AFR, and 90.3% recognized antifungal misuse as a factor driving resistance. Nevertheless, only 18.1% showed good knowledge, 67.7% held positive attitudes (especially among fourth-year students, p < 0.001), and merely 2.4% practiced appropriately. Multivariable analysis found that being a fourth-year student increased the likelihood of a good attitude (aOR = 5.10, 95% CI: 2.28–11.43). Married students were more likely to demonstrate good practices (aOR = 2.75, 95% CI: 1.13–6.68) towards AFR and antifungal stewardship (AFS) compared to unmarried ones. Additionally, age above 33 years was not significantly associated with better knowledge (aOR = 1.29, 95% CI: 0.32–5.18). Conclusion: Pharmacy students in Zambia demonstrated positive attitudes towards AFR and AFS, but significant gaps in knowledge and practice remain. Strengthening AFR and AFS-related content and experiential training within the pharmacy curriculum is urgently needed to improve preparedness for clinical practice.
Metabolic syndrome and cervical cancer among women utilizing cancer prevention and treatment services at Mbarara Regional Referral Hospital.
(Mbarara University of Science and Technology, 2024-08) Kajabwangu, Rogers
ABSTRACT Background: Low and middle-income countries (LMICs) experience three times the number of new cases and six times the number of deaths from cervical cancer compared to high income countries (HICs). Additionally, up-to-date data to inform improvements in cervical cancer prevention is scarce in most LMICs. Since HPV is a necessary but not sufficient cause of cervical cancer, there's need to explore other factors like metabolic syndrome (MetS) that may potentially modify the risk for cervical cancer. The objectives of this study were i)To determine the magnitude and trends of cervical cancer in comparison to other gynecological malignancies at Mbarara regional referral hospital between 2017 and 2022; ii)To determine the association between metabolic syndrome and cervical cancer among women utilizing cervical cancer prevention and treatment services at Mbarara regional referral hospital and ; iii) To compare the histological findings ,stage at diagnosis and the mortality within one year after diagnosis among cervical cancer patients with and without MetS at Mbarara regional referral hospital. Methods: For Objective 1, a retrospective records review of charts of patients admitted with gynecological malignancies on the gynecological ward of Mbarara Regional Referral Hospital (MRRH) between January 2017 and December 2022 was conducted. For objective 2, We conducted an unmatched case-control study 470 participants (157 cervical cancer cases and 313 controls. We assessed for MetS using the National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) criteria. We used a multivariable binary logistic regression analysis to determine the association between MetS and its components with cervical cancer. For objective 3, we conducted a prospective cohort study for one year on 132 women with a new diagnosis of cervical cancer. Results: Over a 6-year period, 82.4% (721/875) of the patients admitted with gynecological malignancies had cervical cancer. Cervical cancer cases increased proportionately by 17% annually compared to other gynecological cancers (OR:1.17; 95% CI 1.06-1.28, p = 0.0046); with the majority of patients cervical cancer patients (92.7%, n=668) having squamous cell carcinoma. Most patients (87.9%, n=634) had late-stage disease. MetS was independently associated with cervical cancer (aOR 1.66; 95% CI 1.07-2.57). Age ≥ 50 years (aOR:2.20; 95% CI 1.35-3.56), HIV infection (aOR 2.51, 95% CI 1.56-4.05), increasing parity (aOR 1.16, 95% CI 1.06-1.26), and a lack of formal education (aOR 6.41, 95% CI 1.33-30.86) were also associated with cervical cancer diagnosis. None of the individual components of MetS was associated with cervical cancer. There was no difference in histology, stage at diagnosis in patients with and without MetS. The overall cumulative incidence of mortality in cervical cancer patients at one year following diagnosis was 42.3% (95% CI: 34.2-51.4). The cumulative incidence of mortality in cervical cancer patients with and without MetS was 44.1% (95% CI: 33.4-57.2) and 39.9% (95% CI: 28.9-53.2), respectively. There was no difference in cumulative incidence of mortality at one year following diagnosis in patients with and without MetS (Log-rank statistic =0.13, p=0.720). Conclusions and recommendations: The burden of cervical cancer among women at MRRH is high compared to other gynecological malignancies, with a significant annual increase. Majority of the cervical cancer patients at MRRH have squamous cell carcinoma and present with the late stage of the disease at diagnosis. Close to half of the patients diagnosed with cervical cancer at MRRH die within one year after diagnosis. MetS increases the risk of cervical cancer but does not affect the histology, stage at diagnosis and one-year mortality. We recommend scaling up of cervical cancer screening services with incorporation of screening for metabolic syndrome to reduce the burden of both morbidities.
Perceived norms, social network exposure, and physical discipline of children: Sociocentric network study of caregivers in rural Uganda
(Child Abuse & Neglect, 2026) Satinsky, Emily N.; Kakuhikire, Bernard; Baguma, Charles; Dyk, Sarah Sowell Van; Namara, Elizabeth B.; Ahereza, Phionah; Ayebare, Patience; Ashaba, Scholastic; Comfort, Alison B.; Tsai, Alexander C.; Perkins, Jessica M.
Background: Physical discipline is associated with negative developmental, social, and emotional outcomes in children. However, social influences on caregivers' use of physical discipline, including perceived norms and social network exposure, remain understudied. Objectives: To assess whether caregivers' use of physical discipline was associated with perceived norms and social network exposure to physical discipline. Participants and setting: Adult caregivers (N = 1026) in rural Uganda. Methods: In this sociocentric study, participants reported their past-week use of physical discipline and perceptions of how often most caregivers in their villages used physical discipline. Partici pants also named other caregivers with whom they interacted across life domains. We compared perceived norms with aggregated self-reports of behavior and used multivariable Poisson regression models with cluster-robust standard errors to estimate associations between perceived norms, social network exposure to caregivers who used physical discipline, and personal engagement in physical discipline. Results: Most caregivers overestimated the prevalence and frequency of physical discipline among other caregivers in their villages. Misperceiving physical discipline as normative was positively associated with personal physical discipline behavior. For example, women who (mistakenly) perceived that most other women used physical discipline multiple times in the past week were almost twice as likely to use physical discipline themselves (adjusted relative risk [aRR] = 1.97, 95% confidence interval [CI] 1.40–2.77, p < .001). Network exposure to caregivers who used physical discipline was not associated with physical discipline use among women and was negatively associated with physical discipline use among men. Conclusions: Interventions that correct misperceived norms may be used to reduce physical discipline behaviors.
Patient Perspectives on Patronage of Traditional Bone Setting: A Systematic Review
(Annals of Global Health, 2026) Flynn, Sarah Elizabeth; Rajaratnam, Sumner; Kruse, Colin; Kisitu, Daniel K.; Petrisor, Bradley A.
Introduction: Traditional bone setters (TBS) treat orthopedic injuries using natural remedies and traditional medicine. These practices can result in complications, including malunion, non-union, or gangrenous extremities. Despite these complications, communities in low- and middle-income countries trust and rely on TBS for musculoskeletal injuries and pathologies. Understanding patients’ motives for patronizing TBS is necessary to work with TBS to reduce complications. Objectives: The objectives of this study were to assess the reasons patients patronize TBS, identify demographic trends associated with TBS usage, and evaluate how patient perspectives inform an understanding of TBS patronage. Methods: Four electronic databases, MEDLINE and Embase (via Ovid), Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL), were searched prior to April 2025. Primary studies examining reasons and patient perspectives on visiting TBS were included. Studies not reporting patient perspectives regarding TBS use were excluded. Study quality was assessed using the Joanna Briggs Institute critical appraisal tools. A narrative synthesis was conducted, with pooled descriptive statistics where appropriate. Results: A total of 28 studies involving 8,147 participants were included. A total of 5 articles directly included patients’ perspectives, while 24 articles reported themes among reasons for the patronage of TBS. The main reasons cited for patronizing TBS were the belief in TBS and affordability. Recommendations from family/friends and negative perspectives on allopathic medicine were both frequently cited. No consistent association between participant demographics and TBS patronage was identified. Conclusions/Discussion: The reasons for patronizing TBS are multifaceted, extending beyond pure affordability and accessibility. The analysis showed that the general preference for TBS over allopathic practitioners and the belief in TBS practices are strongly rooted in the individuals and communities that TBS serve. Despite differing recommendations, collaboration with TBS to improve access to care and reduce complication rates was identified as a future direction.
Hypocalcemia in traumatic brain injury: Pooled prevalence and narrative synthesis of associations with injury severity and early clinical outcomes - a systematic review and Meta-analysis
(Interdisciplinary Neurosurgery, 2026-09-21) Fillie, Paul Clement; Mukiibi, Enock; Bukyana, Sedrick; Kakooza, Jackson; Lewis, Catherine R.; Kazigo, Ahmed Kiswezi; Akankwasa, Prosper; Turyagumanawe, John; Oguttu, Benson; Ayesiga, Innocent; Balondemu, Evelyn Njawuzi; Hakizimana, Theoneste; Mumbere, Bienfait V.; Emeka, Anyanwu Godson; Mugenyi, Michael
Objective: To determine the prevalence of hypocalcemia and synthesize its reported associations with injury severity and early clinical outcomes in patients with traumatic brain injury (TBI). Methods: A systematic review and exploratory meta-analysis of observational studies reporting hypocalcemia in TBI was performed. A random-effects meta-analysis using restricted maximum-likelihood estimation was per formed on logit-transformed proportions. Because substantial clinical and methodological heterogeneity was anticipated, the pooled estimate was interpreted as exploratory. Publication bias and small-study effects were assessed using Egger's regression, Kendall's Tau, and funnel-plot inspection. Prespecified subgroup analysis by geographic region and leave-one-out sensitivity analysis were conducted. Associations between hypocalcemia, injury severity, and early clinical outcomes were synthesized narratively. Results: Twelve studies comprising 3485 TBI patients met the inclusion criteria. The exploratory pooled prevalence of hypocalcemia was 39.80% (95% CI: 23.78%–58.35%). Between-study heterogeneity was substantial (I2 =89.86% Q[11] =110.625, Pooled prevalence varied across geographic subgroups, from 29.34% in South Asia to 74.29% in the Qatar/ Romania subgroup. Leave-one-out estimates ranged from 35.40% to 44.96%. Narrative synthesis indicated that hypocalcemia was frequently associated with greater injury severity and adverse early clinical outcomes, although independent prognostic evidence was limited. Conclusions: Hypocalcemia is frequently reported in patients with TBI, but the available evidence is heterogeneous and geographically uneven. The pooled estimate should therefore be considered exploratory rather than a precise global prevalence. Associations with greater injury severity and adverse outcomes were reported in several studies, but causal or independent prognostic conclusions remain uncertain. Future prospective studies should use standardized calcium definitions, report total and ionized calcium separately, obtain serial measurements, and apply multivariable outcome models.