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Recent Submissions

Prevalence of vitiligo among patients attending the skin clinic at Mbarara Regional Referral Hospital, southwestern Uganda: A retrospective review
(JAAD international, 2025) Simon Peter Mundeli; Aloyo Gladys Onguti; Mirembe Stephen Kizito; Mulyowa Grace Kitunzi; Timothy Obrien
To the Editor: Vitiligo is a chronic skin disorder characterized by the loss of melanocytes, resulting in depigmented macules and patches. It affects 0.1% to 2% of the global population1 and occurs equally in both genders, often presenting in early life. Despite its global prevalence, data on vitiligo in Uganda are limited, posing challenges for effective health care planning and management. This gap is further exacerbated by a critical shortage of specialist dermatologists in Uganda, with only 12 serving a population of over 45 million.
Monogenean parasites of Africa’s most cultivated fish, Clarias gariepinus (Clariidae): A review
(International Journal of Fisheries and Aquatic Studies, 2025) MG Begumis; J Yatuha; JB Nkurunungi; P Akoll
African catfish, Clarias gariepinus (Siluriformes; Clariidae) is the second most cultured fish in Africa. Apparently, monogeneans predominate the parasite community of C. gariepinus. Information on the biology, distribution and epizootiology of monogeneans is crucial for designing and effectively guiding aquaculture health management. The aim of this review is to systematically analyze available literature on monogeneans infesting C. gariepinus in Africa to better understand and identify gaps on parasite diversity and geographical distribution. From the 90 published records on monogeneans infesting C. gariepinus in Africa from 1960 to 2022, there are 23 Monogenea species belonging to four genera: Gyrodactylus Nordmann, 1832; Macrogyrodactylus Malmberg, 1957; Quadriacanthus Paperna, 1961; and Paraquadriacanthus Ergens, 1988. Species of genus Macrogyrodactylus and Quadriacanthus are the most reported while Paraquadriacanthus sp. is the least. Unlike Paraquadriacanthus which shows strict host-specificity, most monogenean genera exhibit a broader host spectrum. Most monogenean genera are moderately distributed across Africa except Paraquadriacanthus which is localized along the Nile in Egypt. Unlike Egypt and southern Africa, there is a scarcity of information on monogeneans infesting C. gariepinus from other parts of Africa. Reliance on only microscopic morphology for parasite identification is obsolete and incapable of yielding reliable insights into species diversity and geographical distribution of monogeneans infesting C. gariepinus.
Factors associated with relief from acute pain among patients admitted in medical ward of Mbarara Regional Referral Hospital, south western Uganda: A cross-sectional study
(Plos one, 2025-03-03) Silas Ojuka; Robert Tamukong; Tadele MekuriyaYadesa
Acute pain is an understudied subject among patients admitted in medical wards, especially in sub-Saharan Africa. Given that it is one of the commonest causes of hospital admissions, it is necessary to diagnose and adequately treat it in time. Unrelieved acute pain may have negative consequences such as; reduced quality of life, prolonged hospital stays and increased cost of treatment. The purpose of this study was to assess relief of acute pain and factors associated with it in medical ward of Mbarara Regional Referral Hospital, South-Western Uganda. Severity of pain was determined using the Brief Pain Inventory. Adequate drug therapy for acute pain was assessed using the Pain Management Index. Relief from acute pain was considered a change in pain grade from severe to mild or moderate to mild or mild to no pain. This was done by comparing baseline pain grade at enrollment (day one) and follow up pain grade on day two. Multivariate logistic regression was performed to identify associated factors that had statistical significance. Out of 280 patients with acute pain, analgesic drug therapy was adequate for 32 (11.43%) participants while relief from acute pain was achieved among 95 (34%). Multivariate logistic regression showed female gender to be significantly associated with relief from acute pain (adjusted Odds Ratio=1.86; 1.11-3.10 at 95% C.I; p value=0.018). Prevalence of adequacy of analgesic drug therapy for acute pain among patients admitted in medical ward of Mbarara Regional Referral Hospital was low. Proportion of patients with relief from acute pain was also low. Female patients were more likely to experience relief from acute pain compared to their male counterparts.
Beyond facility-based births: Is Uganda delivering effective maternal and newborn care? An analysis of the 2022 demographic health survey and 2023 harmonized health facility assessment survey
(PLOS Global Public Health, 2025) Brian Turigye; Edgar Mugema Mulogo; Joseph Ngonzi; Peter M. Macharia; Miriam Acheng; Aliki Christou; Lenka Beňová
Maternal and newborn studies in Uganda have primarily focused on measuring contact coverage, such as the proportion of facility-based births. However, this is inadequate and may overestimate the benefits of services provided to women and newborns if the quality of care in the facilities is not considered. Effective coverage of care addresses this limitation and adjusts for the quality of services. This study assessed the effective coverage of maternal and newborn care for facility-based births in Uganda using the 2022 Uganda Demographic and Health Survey (DHS) and the 2023 Harmonized Health Facility Assessment (HHFA). The analysis included 5,618 women who had a live birth in the two years preceding the DHS, and 636 facilities providing childbirth care from the HHFA. Facility readiness was assessed using four domains: human resources, equipment, amenities, and drugs and supplies. Crude coverage was calculated as the percentage of facility births. Two measures of effective coverage were estimated: intervention coverage as a percentage of women who received all ten selected recommended interventions for their most recent birth, and readiness-adjusted coverage as a product of crude coverage and facility readiness using an ecological linking method by region. 85.9% of the women gave birth in a facility, but only 14.0% received all ten interventions. Readiness was highest in government hospitals (81.9%) and lowest in lower government health centers (46.4%). Only 47.8% of women gave birth in a ready facility. Readiness-adjusted coverage varied across regions, with the lowest in Kampala (40.9%) and the highest in the North-Eastern (61.4%). These Findings indicate a large gap between crude and effective coverage, disproportionately affecting regions and lower-level health centers, highlighting a need to enhance the capacity of lower-level health centers to deliver quality maternal and newborn care.
Influence of education status, age, and gender on HIV prevention awareness and preferences among youth in a rural Ugandan district: a cross-sectional study
(BMC Public Health, 2025) Paul Waswa Ssal; Timothy Mwanje Kintu; Tonny Kyagambiddwa; Immaculate Karungi; Agnes Kisakye Namuyaba; Ruth Namaseruka; Mark Agaba; Celestino Obua; Edith K. Wakida; Jerome Kahuma Kabakyenga
Background: Young people aged 15–24 years continue to be disproportionately affected by HIV globally. In sub-Saharan Africa, utilization of HIV prevention services remains suboptimal. Education plays a pivotal role in enhancing HIV prevention knowledge among youth, but its effectiveness is influenced by factors such as age, gender, and socioeconomic status. The objective of this study was to investigate how education status, age, and gender influence awareness use, and preferences of HIV prevention methods among youth in rural southwestern Uganda. Methods: A cross-sectional quantitative study was conducted in March 2022 among 216 adolescents and young adults aged 15–24 years in Rubirizi District, southwestern Uganda. Participants were recruited using stratified random sampling from three publicly funded schools and snowball sampling from local trading centers to include both school-going and non-school-going youth. Data from both sampling approaches were pooled for analysis. Data were collected using a structured questionnaire translated into the local language. Descriptive statistics and inferential analyses were performed using R software, with statistical significance set at p<0.05. Results: Participants had a mean age of 19.28±2.32 years, consisting of 50.46% females (n=109), and equal proportions of school-going and non-school-going youth A majority (72%) perceived themselves at low risk of HIV infection. The findings reflect pooled data from both school-going and non-school-going participants. School-going youth demonstrated higher awareness of abstinence (75% vs. 32%, p<0.001) and prevention of mother-to-child transmission (46% vs. 25%, p=0.002) compared to non-school-going youth. Younger individuals were more likely to practice abstinence (mean age 18.9 years vs. 19.7 years, p=0.017). Males also had higher awareness of being faithful (59% vs. 44%, p=0.04). Private doctors (46%) and hospitals (47%) were the most favored access points for PrEP Younger participants expressed greater concern about daily pill-taking inconvenience (mean age 20.4 years vs. 19.2 years, p=0.04). Radio (73%) and television (41%) were the most preferred methods for HIV information dissemination. Females preferred magazines more than males (21% vs. 10.3%, p=0.046). Conclusion: Education status, age, and gender influence HIV prevention awareness through differences in access to information, risk perception, and preference of prevention methods among youth in rural Uganda. Therefore, aligning HIV prevention strategies with the specific needs and preferences of different youth subgroups can enhance awareness, risk perception, and utilization of HIV prevention methods
Enablers and challenges of integrating digital health into medical education curricula: a scoping review
(Discover Education, 2025) Wilson Tumuhimbise; Stefanie Theuring; Esther C. Atukunda; Mugyenyi R. Godfrey; Doreen Babirye; Fred Kaggwa; Mwavu Rogers; Kizza Gerald; Rebecca Nuwematsiko; Irene Wanyana; Daniel Atwine; Nelson Twinamasiko; John Paul Bagala; Richard Mugahi; Geoffrey Namara; Joseph Ngonzi; Rhoda Wanyenze; Juliet N. Sekandi; Angella Musiimenta
Background The global strategy for digital health advocates digital health literacy in formal education and training curricula for all health professionals. However, little is known about the enablers and challenges of integrating digital health into medical training curricula. Methods Guided by Arksey and O’Malley’s scoping review methodology, we searched the PubMed, Google Scholar, and ScienceDirect scholarly databases for peer-reviewed articles published between 2014 and 2024. Data extraction was guided by the consolidated framework for implementation research. Results Thirty studies met the inclusion criteria and were analyzed. The enablers identified include the need for healthcare digitalization, reshaping the future daily work of healthcare professionals, decreasing students’ doubts about digital health and increasing the quality of patients’ care. On the other hand, a lack of infrastructure and educational materials, the dense nature of the existing curriculum, and bureaucratic tendencies were identified as challenges. The provision of consolidated funds and the establishment of dedicated digital health infrastructure, starting with elective and audited modular approaches, raising awareness, and educating stakeholders, emerged as implementation strategies for mitigating these challenges. Conclusion Global progress toward integrating digital health literacy in formal medical training curricula remains slow. There is a need for concerted efforts and political commitment to offer guidance and moral and financial support for this integration.
Barriers and Facilitators of Simulation-Based Education in Stroke Nursing Management at a Regional Referral Hospital in Southwestern Uganda: A Qualitative Study
(Advances in Medical Education and Practice, 2025) Josephine Nambi Najjuma; Francis Bajunirwe; Scovia Nalugo Mbalinda; Frank Ssedyabane; Gerald Mwebembezi; Shirley Moore; Mark Kaddumukasa; Esther C Atukunda
Introduction: Simulation-based education (SBE) improves skills and knowledge among health professionals. Stroke nursing necessitates swift decision-making, elevated levels of clinical competence, and interdisciplinary collaboration. SBE improves these competencies but encounters implementation challenges. The objective of this study was to explore the barriers and facilitators of SBE implementation for stroke care for nurses at a referral hospital in Uganda. Methods: From March to July 2024, a descriptive qualitative study was carried out at Mbarara Regional Referral Hospital and Mbarara University of Science and Technology using focus group discussions (FGDs), and key-informant interviews (KIIs). The FGDs were carried out with nursing students. The KIIs participants included purposively selected nurses, nurse educators, and other health care providers involved in stroke care and bedside teaching. The study was guided by the Consolidated Framework for Implementation Research (CFIR) and used deductive thematic analysis to identify barriers and facilitators for simulation-based stroke education (SBSE). Results: We conducted 4 FGDs, and 12 KIIs. The FGDs participants’ mean age was 24 years and 36 years for other participants in KIIs. The barriers to SBSE included anticipated high cost for simulation methods, the anticipated high costs to translate lessons learned to real hospital setting, resistance to change from established routines. The high patient-to-nurse ratios and lack of stroke specific structured training are also barriers. The facilitators included strong institutional administrative support for simulation methodology, availability of training facilities at the simulation center, and prior exposure to simulation methodologies. Conclusion: Strong administrative support exists for SBSE. However, for successful implementation, there is a need to address the resource limitations, address anticipated resistance to change, and foster a culture of continuous learning and improvement within healthcare institutions. Future interventions should strategically address identified barriers while leveraging facilitators can enhance the success of SBSE stroke nursing care in resource-limited settings.
A qualitative study of knowledge, experiences, and healthcare needs of people living with lymphedema in Kamwenge District, rural Uganda
(Discover Public Health, 2025) Vicent Mwesigye; Joanita BerytahTebulwa; Benson Musinguzi; Bosco Bekita Agaba; Raul Muyambi; Gerevasio Kalemire Asiimwe; Henry Zamarano; Caroline Birungi; Charles Nkubi Bagenda; Francis Bajunirwe; Joel Bazira; Herbert Itabang; Frederick Byarugaba; Edgar Mugema Mulogo
Background: Lymphedema is a long-term, disabling condition caused by dysfunction of the lymphatic system, yet it continues to receive little attention in low-resource settings. In rural areas such as Kamwenge District, Uganda, those affected endure ongoing physical symptoms including swelling, pain, and reduced mobility alongside significant emotional and social challenges. Stigma, cultural misunderstandings, and poor access to timely diagnosis and effective care further hinder their well-being. While global neglected tropical disease (NTD) programs have made progress, many vulnerable communities remain overlooked. This qualitative study explored the lived experiences of lymphedema patients and caregivers in Kamwenge, focusing on local beliefs, knowledge gaps, and healthcare barriers to inform context-specific and stigma sensitive interventions. Methods: A community-based qualitative study design was employed. Data were collected through five focus group discussions (FGDs) involving lymphedema patients and caregivers, and seven key informant interviews (KIIs) with local health officials, community leaders, and religious figures. Participants were purposively sampled from Rukunyu Hospital and surrounding communities to capture diverse perspectives. Data were transcribed, translated, and analysed using Braun and Clarke’s thematic analysis approach. Results: Seven key themes emerged: (1) patients’ daily struggles with pain, dependence, and economic hardship; (2) stigma leading to social exclusion; (3) gaps in knowledge and culturally influenced misconceptions about causes and treatment; (4) gender-specific vulnerabilities such as abandonment and psychological distress; (5) weak healthcare infrastructure and limited access; (6) reliance on informal coping strategies including herbal remedies, faith, and peer support; and (7) institutional deficiencies alongside community-driven recommendations for improved care and prevention. Despite some health education efforts, misinformation and stigma remain widespread, and affected individuals are often excluded from social support programs. Conclusion: Lymphedema in Kamwenge District is a complex issue intersecting health, social stigma, and systemic weaknesses. Urgent, community-focused interventions are critical to closing knowledge gaps, enhancing healthcare services, reducing stigma, and integrating lymphedema management into national health policies.
Prevalence of Malaria Among Individuals Living With Lymphedema in Kamwenge District, Western Uganda
(Cureus, 2025-02-10) Vicent Mwesigye; Joanita Berytah Tebulwa; Benson Musinguzi; Twinomujuni Muzafaru; Henry Zamarano; Charles Nkubi Bagenda; Edgar Mulogo; Frederick Byarugaba; Itabangi Herbert
Lymphedema, also known as elephantiasis, is a long-term and often debilitating condition characterized by the progressive swelling of limbs due to poor lymphatic drainage. While lymphatic filariasis, a mosquito borne disease, is a common infectious cause globally, non-infectious forms such as podoconiosis resulting from prolonged exposure to mineral-rich soils are also prevalent in many low-resource, endemic regions. In areas where both malaria and lymphedema occur, malaria may further affect individuals already suffering from chronic swelling. In Kamwenge District, Western Uganda, lymphedema is a recognized public health concern, yet the contributing factors remain poorly understood. This lack of clarity complicates effective diagnosis, treatment, and disease control. This study aimed to assess the presence of malaria among individuals living with lymphedema in this setting. A cross-sectional study was conducted among 154 individuals with clinically confirmed lymphedema, recruited through purposive sampling from Rukunyu Hospital and surrounding communities. Data collection involved structured interviews, physical examinations, and venous blood sampling. Malaria infection was determined through microscopic examination of blood smears. Of the 154 participants, 71.4% were female, with an average age of 54.7 years. Plasmodium falciparum was detected in 3.3% (n=5) of the individuals. The majority (96.8%) had bilateral lower limb lymphedema and resided in rural areas, primarily engaged in subsistence farming. The presence of malaria among individuals with lymphedema highlights the need for integrated healthcare approaches in areas where multiple parasitic diseases are endemic. Although malaria was detected in a small portion of participants, its occurrence alongside lymphedema underscores the importance of continued disease surveillance, targeted interventions, and community education to support affected populations.
Uncovering Gender Dimensions in Antimicrobial Resistance: A 10-Year Study of Clinical Bacterial Isolates in Uganda
(Cureus, 2025-03-10) Joel Bazira; Nakato Constance Nakimuli; Nalumaga Pauline Petra; Brenda Nakazibwe; Abel W. Walekhwa; Kawuma Simon; Hope Derick; Iramiot Jacob; Lawrence Mugisha
Background: Antimicrobial resistance (AMR) and multidrug resistance (MDR) are escalating global health threats, particularly in low- and middle-income countries (LMICs). Understanding gender-specific resistance patterns is essential for inclusive antimicrobial stewardship and gender-targeted interventions. Objective: This study aimed to investigate gender-specific trends in AMR and MDR among clinical bacterial isolates collected from Mbarara Regional Referral Hospital, Uganda, within a 10-year period (2014-2024). Methods: A total of 4,170 non-duplicate clinical isolates subjected to antimicrobial susceptibility testing (AST) were retrospectively analyzed. Gender-specific resistance patterns were calculated and compared using the Wilcoxon signed-rank test, Chi-square, and Fisher’s exact test. All analyses were performed in Python (Google Colab). Results: Among all isolates, 92.7% were resistant to at least one antibiotic, while 71.6% were multidrug resistant. While resistance appeared higher in female-submitted isolates in unadjusted analysis, adjusted models showed that urinary AMR was significantly higher among reproductive-age women (OR = 1.38, 95% CI: 1.22-1.57), while non-urine AMR was elevated in male-submitted specimens from children (OR = 1.45, 95% CI: 1.20-1.76) and adults aged ≥50 (OR = 1.36, 95% CI: 1.13-1.63). MDR showed distinct organism gender associations: it was more common in male-associated urinary Enterobacterales (OR = 1.41, 95% CI: 1.10-1.82), in female-linked non-urine Staphylococcus aureus (OR = 1.62, 95% CI: 1.16-2.27), and in male linked Pseudomonas aeruginosa (OR = 1.56, 95% CI: 1.12-2.18). Conclusion: This study reveals distinct gender disparities in AMR and MDR patterns, structured by age, specimen type, and organism. These findings support the integration of gender-sensitive variables such as pregnancy status, contraceptive use, and care-seeking behavior to better explain resistance pathways and support gender-responsive AMR control in LMICs.
Prevalence of Dental Caries and Its Associated Factors Among Diabetic Patients at Mbarara Regional Referral Hospital
(Cureus, 2025-09-30) Amon Mwesigwa; Evas Nimusiima; Godfrey Kwizera; Edgar M. Mulogo
Introduction: Dental caries continues to affect oral health quality of life among diabetic patients. However, there is limited data on the prevalence and factors associated with dental caries among diabetic patients in Uganda. Therefore, this study assessed the prevalence and factors associated with dental caries among diabetic patients attending a diabetic clinic at a regional referral hospital in Uganda. Method: A clinical cross-sectional study was conducted among 336 diabetic patients attending a diabetic clinic at Mbarara regional referral hospital from October to December 2023. A consecutive sampling technique was employed to enroll study participants. Data were collected using a pretested structured questionnaire, and analysis was performed using STATA version 17. Bivariable and multivariable logistic regressions were employed and variables with a p-value < 0.05 were declared statistically significant. The prevalence of dental caries was determined based DMFT index score and presented as a percentage. Results: The prevalence of dental caries was 72.9% (95%CI: 67.9, 77.4). Findings indicated that age >57years (AOR 2.131, 95% CI 1.192-3.809 P-Value 0.011), smoking (AOR 2.884, 95%CI 1.032-8.061, p0.043) and type 2 diabetes (AOR 0. 513, 95% CI 0.272-0.966, p0.039) and visiting a dental clinic once a year (AOR 3.198, 95%CI 1.709-5.982, p<0.001) were associated with increased odds of developing dental caries. Brushing twice a day (OR 0.394, 95%CI 0.158-0.981, p 0.045) was associated with reduced odds of developing dental caries. Conclusion. The prevalence of dental caries among diabetic patients is relatively high; this contributes significantly to their reduced oral health quality of life. Therefore, oral health promotion, preventive and curative services should be integrated in diabetic care to improve oral health and diabetic quality of life.
Etiology, Patterns and Short-Term Outcomes of Lower Urinary Tract Trauma in Male Patients Admitted at Mbarara Regional Referral Hospital, Uganda
(East and Central African Journal of Surgery, 2025) Oscar Atwine; Marvin Mutakooha Mwesigwa; Edson Tayebwa; Joshua Muhumuza
Background: Trauma is a major public health challenge in Africa. This study was conducted to establish the etiology, patterns and short-term outcomes of patients with lower urinary tract trauma in males admitted at Mbarara Regional Referral Hospital. Methods: This was a hospital based prospective cohort study done on participants with lower urinary tract trauma admitted at MRRH for a period of eight months from August 2023 to April 2024. A total of 38 male participants were consecutively selected and enrolled into the study. The overall median age was 25, interquartile range (5-37) years. Results: A total of 50 lower urinary tract injuries were recorded. The urethra was the most injured organ at 70% (35/50). Motor vehicle crash was the most common cause seen in 52% (26/50). The urethral complete tear was the most common pattern of urethral injury seen in 62.9% (22/35) while bladder contusion was the most common bladder injury pattern at 60% (9/15). The anterior urethra was the most injured part at 60.0% (21/35). Overall, complications were seen in 57.9% of the participants (22/38) with urethral bleeding being the most common seen in 36.8 % (14/38) of the participants. Most patients stayed in the hospital for longer than one week 65.8% (25/38). Mortality was seen in 5.3% (2/38). Conclusion: Motor vehicle crash is the commonest cause of lower urinary tract trauma. Among pediatric population, circumcision was the commonest cause of urethra injury, hence laws should be put in place for pediatric circumcision to be done by a qualified health personnel.
Case Series On Acute Kidney Injury In Patients With Rift Valley Fever At Mbarara Regional Referral Hospital, Southwestern Uganda
(Journal of Medical Case Reports and Case Series, 2025-04-07) Rose Muhindo; Grace Kansiime; Badru Kayongo; Abel Mwine; Gerald Atukwase; Simon Ahimbisibwe; Musa Kitandwe; Christopher Mugabo; Ernest Ssewanyana; Silver Atuzarirwe; Oswald Katsigire; Nicholas Nuwashaba; Nelson Wandera
Introduction: Rift Valley Fever (RVF) is an endemic zoonotic viral disease which usually affects livestock in parts of Africa and the Middle East. In patients infected with RVF, there is a risk of acute kidney injury (AKI) and acute liver failure (ALF). In this report, we present a case series of four patients diagnosed with RVF infection, highlighting the complications of AKI and ALF, with varying outcomes, including the utilization and impact of dialysis. Methods: We conducted a retrospective analysis of medical records for four patients admitted and managed at Mbarara Regional Referral Hospital (MRRH) in Southwestern Uganda with confirmed Rift Valley Fever infection. Clinical, laboratory, and outcome data were collected and summarized. Results: All four patients presented with characteristic symptoms suggestive of RVF, and laboratory investigations confirmed the diagnosis. Each patient had complications of AKI and acute liver failure. All patients required dialysis for renal support; however, logistical issues prevented access to hemodialysis for all but two of the patients. Among the patients who received hemodialysis, both demonstrated recovery from AKI. Unfortunately, the two patients who were unable to access dialysis succumbed to the complications. Conclusion: RVF infection can lead to severe complications, including AKI and acute liver failure. The timely initiation of dialysis appears crucial for improved outcomes in these cases. However, logistical barriers may hinder access to dialysis, emphasizing the need for improved healthcare infrastructure and accessibility in regions endemic to RVF.
Factors associated with relief from acute pain among patients admitted in medical ward of Mbarara Regional Referral Hospital, south western Uganda: A cross-sectional study
(Plos one, 2025) Silas Ojuka; Robert Tamukong; Tadele Mekuriya Yadesa
Acute pain is an understudied subject among patients admitted in medical wards, especially in sub-Saharan Africa. Given that it is one of the commonest causes of hospital admissions, it is necessary to diagnose and adequately treat it in time. Unrelieved acute pain may have negative consequences such as; reduced quality of life, prolonged hospital stays and increased cost of treatment. The purpose of this study was to assess relief of acute pain and factors associated with it in medical ward of Mbarara Regional Referral Hospital, South-Western Uganda. Severity of pain was determined using the Brief Pain Inventory. Adequate drug therapy for acute pain was assessed using the Pain Management Index. Relief from acute pain was considered a change in pain grade from severe to mild or moderate to mild or mild to no pain. This was done by comparing baseline pain grade at enrollment (day one) and follow up pain grade on day two. Multivariate logistic regression was performed to identify associated factors that had statistical significance. Out of 280 patients with acute pain, analgesic drug therapy was adequate for 32 (11.43%) participants while relief from acute pain was achieved among 95 (34%). Multivariate logistic regression showed female gender to be significantly associated with relief from acute pain (adjusted Odds Ratio=1.86; 1.11-3.10 at 95% C.I; p value=0.018). Prevalence of adequacy of analgesic drug therapy for acute pain among patients admitted in medical ward of Mbarara Regional Referral Hospital was low. Proportion of patients with relief from acute pain was also low. Female patients were more likely to experience relief from acute pain compared to their male counterparts.
Digital levers for sustainability: a meta-analytic review of digital transformation’s influence on ESG performance
(Cogent Business & ManageMent, 2025) Dedrix stephenson Bindeeba; Eddy Kurobuza tukamushaba; Rennie Bakashaba
Digital transformation (Dt) is reshaping how firms meet environmental, social, and governance (esg) expectations. this meta-analysis pools 59 studies (2015–2025) covering 835,000 firm-year observations to quantify Dt’s esg impact. anchored in resource-Based view, stakeholder, and Dynamic capabilities theories, the effects of esg pillar and Dt typologies are separated. Dt raises esg scores; among technologies, business-process digitization delivers the largest gains, followed by data-infrastructure upgrades, while ai adds value only where ethics and oversight are mature. environmental metrics improve most consistently; social and governance benefits appear but hinge on firm capabilities and regulatory context. subgroup and meta-regression tests show stronger Dt–esg links in manufacturing and service sectors and in post-2022 samples, suggesting curves and tightening standards. results guide managers to sequence investments process first, analytics later and urge policymakers to link incentives to verifiable digital disclosures. Future work should extend evidence to under-studied regions and next-wave tools such as blockchain and digital twins.
Digital business process integration and sustainability among smes: the mediating role of operational efficiency and the moderating role of credit access
(Journal of Sustainable Business, 2025) Dedrix Stephenson Bindeeba; Susan Atuhaire; Rennie Bakashaba; Eddy Kurobuza Tukamushaba
This study investigates the impact of digital business process integration on economic performance and environmental performance among small and medium-sized enterprises in Uganda, a resource‐constrained context. It examines operational efficiency as a mediating mechanism and access to credit as a moderating factor. Drawing on the Resource-Based View and Dynamic Capabilities Theory, the research highlights how integrated digital processes and financial support jointly influence the sustainability and competitiveness of these enterprises. Data were collected from 228 enterprises via a structured survey and analyzed using covariance-based structural equation modeling in AMOS. Bootstrapping procedures tested indirect effects, and a multi-group analysis evaluated the moderating role of credit access. The results show that digital business process integration significantly improves both economic and environmental outcomes, with operational efficiency partially mediating these effects by enhancing workflow speed, optimizing resource use, and reducing errors. Furthermore, enterprises with access to credit experience greater operational and financial benefits from digital integration, whereas those without credit rely more heavily on operational efficiency to achieve environmental goals. These findings underscore the importance of robust digital infrastructure, process optimization, and inclusive financing in promoting sustainable development among small and medium-sized enterprises. The study offers actionable recommendations for policymakers and managers aiming to foster digital adoption and resource efficiency in low-income economies.
Toward a holistic model of sustainable investment decision-making in SMEs: a structural approach in a developing economy
(Future Business Journal, 2025) Dedrix Stephenson Bindeeba; Eddy Kurobuza Tukamushaba; Rennie Bakashaba
Sustainable investment practices are increasingly recognized globally, yet their uptake among Small and Medium Enterprises (SMEs) in developing economies is insufficiently understood. This study investigates the factors influencing sustainable investment decision-making among 372 SMEs in Kampala and Wakiso, Uganda. Data were collected using convenience sampling through a mixed-mode questionnaire administered via face-to-face inter views and online forms. Integrating Institutional Theory, Resource-Based View, and the Theory of Planned Behavior, the research examines how environmental risk exposure, perceived regulatory clarity, government incentives, technological capability, financial access, competitive pressure, and business network strength shape the perceived value of sustainable investment. Employing covariance-based structural equation modelling, the study tests both direct and mediated effects. Results reveal that environmental risk negatively influences perceived value, while technological capability, financial access, network strength, and competitive pressure positively influence it. In contrast, perceptions of regulatory strength and government support do not exhibit significant effects, likely due to low enforcement and institutional trust. The perceived value of sustainable investment strongly predicts actual sustainability-oriented investments, confirming its mediating role. These findings offer practical insights for policymakers and development actors seeking to foster sustainable transitions in resource-constrained environments.
Rift Valley Fever Outbreak Investigation Associated with a Dairy Farm Abortion Storm, Mbarara District, Western Uganda, 2023
(Viruses, 2025) Luke Nyakarahuka; Shannon Whitmer; Sophia Mulei; Joanita Mutesi; Jimmy Baluku; Jackson Kyondo; AmyWhitesell; Carson Telford; Alex Tumusiime; Calvin Richie Torach; Dianah Namanya; Mariam Nambuya; Dominic Muhereza; Zainah Kabami; Annet Nankya; David Muwanguzi; Francis Mugabi; Nelson Wandera; Rose Muhindo; Joel M. Montgomery; Julius J. Lutwama; Stephen Karabyo Balinandi; John D. Klena; TrevorR.Shoemaker
In Africa, Rift Valley Fever poses a substantial risk to animal health, and human cases occur after contact with infected animals or their tissues. RVF has re-emerged in Uganda after nearly five decades, with multiple outbreaks recorded since 2016. We investigated a unique RVF outbreak associated with an animal abortion storm of 30 events and human cases on a dairy farm in Mbarara District, Western Uganda, in February 2023. Genomic analysis was performed, comparing animal and human RVF viruses (RVFV) circulating in the region. Acluster of thirteen human RVF cases and nine PCR-positive animals could directly be linked with the abortion storm. Overall, during the year 2023, we confirmed 61 human RVFVcases across Uganda, 88.5% of which were reported to have had direct contact with livestock, and a high case fatality rate of 31%. We recommend implementing extensive health education programs in affected communities and using sustainable mosquito control strategies to limit transmission in livestock, coupled with initiating animal vaccination trials in Uganda.
Symptomatic vulvovaginal candidiasis and antifungal resistance in HIV-1 positive women at Mbarara city health centre IV
(Scientific Reports, 2025) Nusifah Mbatudde; Pauline Petra Nalumaga; Joel Bazira; Taseera Kabanda
Vulvovaginal candidiasis (VVC) represents a universal health hazard that contributes to significant morbidity in HIV-positive women. Antifungal resistance is a worldwide increasing health problem that reduces treatment options while increasing treatment costs. The purpose of this study was to determine the prevalence of VVC, identify associated risk factors, characterize the distribution of Candida species, and assess their antifungal susceptibility patterns among HIV-positive women attending Mbarara City Health Centre IV. A laboratory-based, cross-sectional study design was conducted on 146 high vaginal swabs collected from HIV- positive women aged 18 years and above attending routine HIV care that presented with signs and symptoms of vulvovaginal candidiasis. These were subjected to microscopy and culture on Sabouraud Dextrose Agar. Candida isolates were identified by gram stain, germ tube, CHROM agar™, and Analytical profile index (API® Candida) tests. Susceptibility to fluconazole, clotrimazole, voriconazole, amphotericin B, miconazole, and nystatin by the disc diffusion method on Mueller Hinton agar supplemented with 2%w/v glucose and 0.5 µg/ ml methylene blue dye. Out of the 146 high vaginal swabs collected, 71(49%) were colonized with Candida species with 43(62%) being Candida albicans while 26 (37.6%) were non-Candida albicans. Candida species were susceptible to amphotericin B (68/71, 95.7%) and resistant to fluconazole and clotrimazole (33/71, 45%). Elevated blood glucose levels were significantly associated with vulvovaginal candidiasis (p = 0.018; odds ratio = 2.93). Candida albicans is the leading cause of VVC, with a higher prevalence than non-Candida albicans. It also demonstrates that amphotericin B and nystatin are the most effective antifungal medications. Furthermore, diabetes is associated with VVC compared to other studied factors. We recommend the use of nystatin for the management of vulvovaginal candidiasis among HIV adult women.
Refining and Expanding the Geometry Pedagogical Improvement Cycle (GeoPIC): A Conceptual Contribution to Competency-Based Geometry Instruction
(Journal of Research Innovation and Implications in Education, 2025) Issa Ndungo; Sudi Balimuttajjo; Edwin Akugizibwe
This conceptual paper refines and expands the Geometry Pedagogical Improvement Cycle (GeoPIC), a framework designed to improve the teaching and learning of geometry. Rooted in the Van Hiele Theory of Geometric Thinking, GeoPIC was initially developed to integrate the strengths of both Conventional Van Hiele Phased Instruction and its technology enhanced variant while addressing their contextual limitations. Building on prior empirical findings, the paper deepens the framework’s theoretical foundations, clarifies its six instructional phases, and illustrates how it aligns with the principles of Competency-Based Curriculum (CBC). Additionally, it offers brief, practical classroom scenarios to illustrate the application of each phase. The refined framework provides a dynamic, adaptive, and learner-centered instructional approach that facilitates progression through Van Hiele levels while accommodating diverse classroom contexts.