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

MUST-IR preserves research output from the MUST Community

Communities in MUST-IR

Select a community to browse its collections.

Now showing 1 - 10 of 10

Annual Research Dissemination Conference 3
Central Administration 124
This community will contain collections from the general Administrative staff
Faculty of Applied Sciences and Technology 58
Faculty of Business and Management Sciences 113
Faculty of Computing and Informatics 139
Faculty of Interdisciplinary Studies 212
Faculty of Medicine 2297
Faculty of Science 543
Institute of Tropical Forest Conservation 126
Maternal Newborn and Child Health Institute 18

Recent Submissions

Person-centered strategies for integrating TB treatment into community pharmacies for people with TB/HIV in Uganda: A human-centered design methodology study protocol
(Plos one, 2026) Jonathan Izudi; Adithya Cattamanchi; Christine Sekaggya-Wiltshire; Rachel King; Noah Kiwanuka; Amanda Sammann
Background: Community pharmacies (private retail drug shops or pharmacies) have successfully delivered antiretroviral therapy (ART) to people with human immunodeficiency virus (HIV) and could support integrated tuberculosis (TB) treatment, but the implementation strategies are unclear. To inform a planned pilot randomized trial, we aim to develop person-centered strategies for integrating TB treatment into community pharmacies targeting people with TB/HIV using a Human-Centered Design (HCD) methodology. Here, we describe the study protocol. Methods: We will employ a three-phased HCD methodology comprising inspiration, ideation, and implementation across six primary health facilities in Kampala, Uganda. Eligible participants will include people with TB/HIV, focal persons for TB and HIV, Ministry of Health officials, and community pharmacy healthcare providers. The inspiration phase will build the themes on barriers and facilitators to integrating TB treatment into community pharmacies from a qualitative study, complemented by participant observations at selected 2–3 community pharmacies to understand the care pathway of people with TB/HIV (journey mapping), including sketching the ideal pharmacy-based TB treatment pick-up. The ideation phase will use design workshops to consolidate identified themes, generate insight statements, including translating them into design opportunities, and conclude with forming low and high-fidelity prototypes. The implementation phase will comprise two rounds of prototype testing, low and high fidelity, with 12–16 participants per round, including people with TB/HIV, focal persons, Ministry of Health officials, and pharmacy health workers. Feedback on usability, desirability, feasibility, and viability will guide iterative refinement, with high-scoring prototypes in system usability surveys prioritized for trial. Discussion: Through iterative user engagement, we will adapt contextually relevant strategies that will leverage key facilitators and address barriers to TB treatment integration. Strategies demonstrating perceived usefulness, user-friendliness, high acceptability, person-centeredness, and contextual relevance will be adapted and piloted in a planned randomized trial aiming to determine feasibility, acceptability, and fidelity, including preliminary effectiveness.
Equiflow: An open-source software package for evaluating changes in cohort composition
(PLOS Digital Health, 2026) Jacob Gould Ellen; Chrystinne Fernandes; Martin Viola; Keagan Yap; Arinda Jordan; Mutesi Flavia Kirabo; João Mato; Pedro Moreira; Leo Anthony Celi
Clinical research studies routinely apply exclusion criteria and data preprocessing steps that can substantially alter dataset composition, potentially introducing hidden biases that affect validity and generalizability. This is particularly important in artificial intelligence/machine learning (AI/ML) studies where models learn patterns directly from training data. We developed Equiflow, an open-source Python package that automates creation of enhanced participant flow diagrams tracking both sample size and composition changes throughout studies. Equiflow quantifies distributional shifts at each exclusion step and generates visualizations showing how key clinical and demographic variables evolve during participant selection. In a case study of sepsis patients from the eICU database, sequential exclusions reduced the sample from 126,750–1,094 patients. Requiring non-missing troponin measurements in the final step of data processing caused substantial demographic shifts that would typically remain invisible in traditional reporting. By making compositional biases visible during cohort construction before modeling begins, Equiflow enables researchers to make informed decisions about analyses and acknowledge limitations in generalizability to their readers. This standardized, open-source approach promotes transparency in clinical research and supports development of more equitable clinical AI systems, addressing a critical need as healthcare increasingly relies on data-driven decision making.
Human Factors Shaping Cybersecurity Behavior in Work from Home Environment in Ugandan Universities
(INTERNATIONAL JOURNAL OF RESEARCH AND INNOVATION IN APPLIED SCIENCE (IJRIAS, 2026-02-19) Atuhe Aarone Mike; Akampurira Paul; Richard Ntwari
The shift to remote and hybrid work in Ugandan universities exposed new cybersecurity risks shaped by human motivation, cognitive load, and system usability challenges. As academic operations increasingly depended on digital platforms, understanding how individuals formed and enacted protective intentions within home-based work environments became critical. This study examined how human and contextual factors—including threat perception, copingappraisal, usability difficulty, cognitive load, and digital fatigue—influenced cybersecurity behaviour among staff working remotely in Ugandan universities. Guided by the Protection Motivation Theory (PMT) and supported by constructs from the Theory of Planned Behaviour (TPB), the research adopted a sequential explanatory mixed-methods design. The quantitative phase identified key motivational and contextual predictors, while the qualitative phase explored how fatigue, usability barriers, and environmental conditions shaped protective motivation. Integration was achieved through narrative comparison and joint display analysis. Quantitative findings revealed that coping confidence and usability difficulty were the most influential determinants of secure behaviour, whereas fatigue and cognitive load significantly undermined protective intentions. Qualitative narratives reinforced these patterns, highlighting themes of threat awareness, usability frustration, motivational fatigue, and uneven institutional support. The study concluded that cybersecurity behaviour in remote academic environments was driven by motivational and contextual dynamics rather than technical controls alone. Strengthening coping efficacy, reducing usability burdens, and addressing digital fatigue were identified as essential strategies for developing adaptive, human-centred cybersecurity interventions in higher education.
Integrating generative artificial intelligence in African higher education: university students’ awareness, attitudes, and use of ChatGPT in Zambia
(In Frontiers in Education, 2026) Steward Mudenda; Moses Mukosha; Ruth Lindizyani Mfune; Bernard Kathewera; Imukusi Mutanekelwa; Boris Mwanza; Webrod Mufwambi; Muchindu Hampango; Kingsley Kamvuma; Martha Mwaba; Tumelo Muyenga; Chikwanda Chileshe; Mildred Zulu; Rabecca Tembo; Florence Mwaba; Stefan Kafwimbi; Adriano Focus Lubanga; Chintu Choolwe Simweene; Shafiq Mohamed; Ngoni Veddie Muzondo; Andrew Silungwe; Mapenzi Masilani; Patience Amutuhaire; Nathan Mugenyi; Roland Nnaemeka Okoro; Jimmy Hangoma; Victor Daka; Brian Godman
Background: The rapid emergence of generative artificial intelligence (AI) tools such as ChatGPT is transforming teaching and learning practices in higher education. This study assessed the awareness, attitudes, and usage patterns of ChatGPT among university students in Zambia and examined factors associated with students’ attitudes toward the technology Methods: A multi-institutional cross-sectional study was conducted among 1,829 university students in Zambia using a structured questionnaire adapted from instruments informed by the Technology Acceptance Model (TAM). Data were analysed using SPSS version 26.0, with statistical significance set at p < 0.05. Results: Among the 1,829 participants, 81.7% were aged 18–25 years, 52.5% were female, and 92.4% were unmarried. Overall, 96.8% of the students had heard of ChatGPT, and 85.6% reported having used it before this study. Among AI-usage constructs, 74.8% of respondents perceived high risks associated with AI use, 73.3% perceived ChatGPT as easy to use, 64.0% perceived it as useful, and 56.8% reported behavioural intention to use AI tools. In multivariable analysis, students aged ≥40 years were more likely to report positive attitudes toward ChatGPT compared with those aged 18–25 years (aOR = 5.91; 95% CI: 1.23– 28.33; p = 0.026). Technology/social influence was also significantly associated with positive attitudes (aOR = 2.04; 95% CI: 1.55–2.68; p < 0.001). Conversely, perceived risks were associated with lower odds of positive attitudes (aOR = 0.57; 95% CI: 0.43–0.75; p < 0.001). Regarding ChatGPT use, perceived usefulness significantly predicted higher usage (aOR = 1.49; 95% CI: 1.17–1.89; p = 0.001), while perceived risks were associated with reduced usage (aOR = 0.61; 95% CI: 0.45–0.84; p = 0.003). Conclusion: Awareness and use of ChatGPT are widespread among university students in Zambia, with more than four out of five students reporting prior use. Perceived usefulness and social influence were positively associated with adoption, whereas perceived risks were linked to lower attitudes and reduced use. These findings highlight the need for higher education institutions to develop clear policies and integrate AI literacy into curricula to promote responsible and effective use of generative AI technologies in academic environments.
Prevalence and Risk Factors of Hypertension and Associated Factors
(F1000Research, 2026) John Tabakwot Ayuba; Victor Archibong; Zanak Achi John; Omoola Olasheu Oluwatosin; Theophilus pius; Makeri Danladi; Joseph Labalpiny; Wusa Makena; Josiah Eseoghene Ifie
Background: Hypertension (HTN) is the most prevalent preventable risk factor that causes a significant socioeconomic burden associated with cardiovascular diseases (CVDs) and is the single most common cause of heart failure and myocardial infarction. Sub-Saharan countries, including Uganda, are still among the worst hit in terms of CVD mortality rates due to hypertension. More than 15 million global disability-adjusted life-years in sub-Saharan Africa are attributable to HTN. Method: This was a cross-sectional study conducted among Kampala International University (KIU) staff. A total of 232 KIU staff members were selected randomly from among those who consented, including medical doctors, biomedical staff, and administration staff. The questionnaire was structured into three parts: socio-demographic characteristics, habit and lifestyle, awareness, family history, comorbidities, and clinical assessment. Blood pressure (BP) measurements were performed on the left arm of respondents in a sitting position using the Omron digital BP monitor, and data were entered into Microsoft Excel and exported to SPSS for analyses. Frequencies, percentages, and binary logistic regression were used to identify the risk factors for hypertension (p values < 0.5 were entered. Results: Our findings show that high salt intake from patronized western food vendors or processed foods, high alcohol consumption, and smoking were implicated in the high prevalence of hypertension among our respondents within the 25-34years age bracket Conclusion: High salt intake from patronized western food vendors or processed foods, high alcohol consumption, and smoking may be risk factors for the onset of HTN, and engagement in physical activities among younger adults can contribute to hypertension-free lives among the respondents and frequent consumption of fruits and vegetables. It is important that awareness of salt intake, alcohol intake, and smoking be propagated, especially among younger staff, in an effort to reduce the incidence of hypertension later in life. Regular health screening of KIU staff is recommended.
Cannabis Use Among Ugandan Medical Students- Prevalence, Predictors, and Coping Strategies in a Cross-Sectional Study
(Brain and Behavior, 2026) Ronald Musinguzi; Musa kasujja; Marie Pascaline Sabine Ishimwe; Florent Ishimwe; Maxwell Okello; Theodore Nteziyaremye; Madrine Nakawuki; Ahmed Kiswezi Kazigo; Olabisi Surat Akib; Thomas Dawit; Rogers Kajabwangu; Nzanzu Vivalya Mutume; Umi Omar Bunu; Theoneste Hakizimana
Introduction and Aims: Cannabis use among university students is a growing concern, particularly in demanding medical programs. We estimated prevalence, identified predictors, and compared coping strategies among medical students in Uganda. Design and Methods: Cross-sectional survey of 318 undergraduates at Kampala International University (Western Campus). Cannabis use and hazardous/disordered use were screened with CUDIT-R (hazardous 8–11; probable use disorder ≥12, DSM-5-TR aligned). Coping was measured with the Brief COPE. Predictors were assessed using logistic regression; coping differences with the Wilcoxon rank-sum test. Results: Cannabis use prevalence was 30.8% (n = 98); 7.6% met criteria for hazardous use and 9.4% for probable cannabis use disorder.Independent predictors of use were being separated (AOR=12.00), being single (AOR=3.45),Catholic faith (AOR=2.76), and longer time at campus (AOR = 1.16 per year). Users reported higher emotion-focused and avoidant coping; problem-focused coping did not differ. Discussion and Conclusions: Cannabis use among Ugandan medical students is common and associated with relationship status, religion, and time at campus. Coping profiles suggest greater reliance on maladaptive strategies among users. Findings support campus policies and mental-health programsthat integrate substance-use screening and strengthen adaptive coping skills.
Between the ghetto and the establishment: Bobi Wine, Uganda’s NUP and the challenges of movement-to-party transition in an electoral autocracy
(The Journal of Modern African Studies, 2025) Kristof Titeca; Anders Sjögren; Frank Ahimbisibwe
What does the institutionalisation of a protest movement into an opposition party in an electoral autocracy mean for its members? This article examines this question by analysing the conversion of People Power, a political pressure group in Uganda, into the National Unity Platform (NUP), focusing on the dilemmas of organisation, strategy and identity. NUP sought to broaden and institutionalise People Power’s activities to be seen as a credible party capable of holding state power. Simultaneously, its initial political weight was closely tied to the defiant, extra parliamentary energy of the grassroots – a resource the party needed to preserve. These tensions were intensified by Uganda’s authoritarian context, where state repression and demobilisation intersected with uneven access to resources and patronage, producing frictions between privileged actors and grassroots members. The paper shows how these dilemmas generated frustrations among bottom-up constituencies and highlights the importance of examining intraparty processes from a grassroots perspective.
Evaluation of the Emergency Care Preparedness of Frontline Junior Doctors: A Training Needs Assessment in Ghana
(Cureus, 2026) Nkechi O. Dike; Jonathan Kajjimu; Nana Serwaa A. Quao; Sonia Cobbold; Solomon N. Kotey
Introduction: In low- and middle-income countries (LMICs) like Ghana, junior doctors - house officers and medical officers - serve as the primary frontline providers of emergency care, often in resource-limited settings. Despite their critical role, emergency medicine (EM) training in undergraduate and horsemanship curricula remains non-standardized. This study conducted a bottom-up training needs assessment to identify clinical and procedural gaps among junior doctors in Ghana. Methods: A cross-sectional digital survey was conducted among 75 junior doctors (house officers and medical officers with not more than five years of practice) between October and December 2018. Using 5-point Likert scales, participants self-assessed their comfort with life-saving procedures and their confidence in managing acute medical and trauma presentations. Data were analyzed using descriptive statistics and thematic categorization of qualitative responses. Results: Although 40% (n = 30) of participants reported managing emergencies “always” in their current roles, only 17.8% (n = 13) felt extremely comfortable as the first-on-call to attend to an emergency or acutely ill patient. While comfort was high for basic tasks like venipuncture (85.9%), it was critically low for advanced procedures; only 8.9% felt comfortable with chest tube insertion, and 87.5% had never performed defibrillation. Confidence was high for managing asthma (90.6%) and hypertensive emergencies (85.0%), but significantly lower for peri-arrest conditions like bradyarrhythmias (70.8% low confidence) and tension pneumothorax. Only 13.5% felt medical school provided excellent preparedness for emergency care, while 100% expressed interest in regular simulation-based training. Conclusion: A profound mismatch exists between the clinical responsibilities and the formal emergency care training of junior doctors in Ghana. These findings have informed the development of targeted simulation-based training initiatives and have strengthened the case for mandatory EM integration into undergraduate and housemanship curricula across Ghana. To bridge this gap nationally, we recommend that EM be transitioned from an optional to a mandatory component of undergraduate and housemanship training, integrated with decentralized simulation-based medical education.
Enhancing Emergency Trauma Management Skills Through Simulation: A Quality Improvement Initiative in Ghana
(Cureus, 2026) Nkechi O. Dike; Priscilla Okyere; Jonathan Kajjimu; Emmanuel K. Achampong
Introduction: In Ghana, persistent gaps in emergency and trauma care are linked to limited training opportunities and uneven workforce distribution. This pilot program evaluated the feasibility and outcomes of a regional, simulation-based quality improvement initiative for emergency trauma care in the Central Region of Ghana. Methods: A pre- and post-test pilot was conducted as part of a regional quality improvement effort among multidisciplinary clinicians of various facilities. Two simulation-based continuous professional development (CPD) modules, Basic Emergency and Trauma Management and Suture Techniques & Wound Care, were delivered. Quantitative data were analyzed using chi-square tests (p<0.05), and open-ended responses were analyzed thematically. Results: The majority of participants were nurses (51.1%, n=24) and from district hospitals (61.7%, n=29). Additionally, 53.2% (n=25) of facilities reported functional resuscitation areas, and 27.7% (n=13) had access to blood transfusion services. Knowledge scores improved significantly across all domains, from a mean of 52.6% pre-training to 85.9% post-training (p<0.001). The largest gains were in spinal precautions, focused abdominal sonography in trauma (FAST) interpretation, and bite wound management. All participants expressed high satisfaction, citing the realism and interactivity of the simulation as major strengths, and recommended integrating simulation into regular CPD. Key challenges reported included limited trauma equipment (76.6%, n=36), staffing shortages (66.0%, n=31), and weak referral systems (51.1%, n=24). Conclusion: This pilot demonstrated that simulation-based training is both feasible and effective for building emergency and trauma care competence in resource-limited settings. Embedding simulation-based CPD within regional quality improvement frameworks offers a scalable strategy for workforce development and health system strengthening in Ghana.
Effectiveness of Mediation in Reducing Dispute Resolution Time in Construction Projects
(Revista Ingeniería de Construcción, 2026) M. K. Kakobanta; P. Yohanna; E.O.E Nnadi; S.A. Abubakar
Construction disputes remain a persistent barrier to timely project delivery in developing countries, where litigation continues to dominate despite its high costs and prolonged resolution timelines. This study examined the effectiveness of mediation as an alternative dispute resolution mechanism, assessed the factors influencing its performance, and evaluated stakeholder satisfaction with the process. A cross-sectional quantitative design was employed, targeting 311 construction stakeholders, of which 276 valid responses (88.7%) were obtained through structured questionnaires, which included engineers, contractors, consultants, clients, and accredited mediators, and analyzed using descriptive statistics, chi-square, factor analysis, Analysis of Variance (ANOVA), correlation analysis, and multiple regression. The findings demonstrate that mediation resolves disputes substantially faster than litigation, reducing average duration from 23.8 months to 4.2 months, an 82.4% improvement. Mediator expertise, stakeholder willingness, legal clarity, mediation cost, and project complexity significantly predicted mediation effectiveness, jointly explaining 70.4% of the variance. Stakeholders reported high satisfaction with mediation’s timeliness, fairness, and affordability, but concerns were noted regarding the enforceability of mediated outcomes. The study concludes that mediation offers a practical, efficient, and relationship-preserving avenue for managing construction disputes. The study recommends strengthening the Alternative Dispute Resolution (ADR) legal framework, enhancing mediator training, and institutionalizing mediation within construction contracts and regulatory systems to improve dispute-management outcomes.
Willingness to Use a Mobile Application for Scheduling Consultation Appointments Among Patients, Caregivers, and Healthcare Providers in Southwestern Uganda
(Cureus, 2026) Edgar Mulogo; Nuriat Nambogo; Nura Izath; Martin Mukama; Emmanuel Kamuhire; Davis Ntamakemwa; Moses Openja; Data Santorino
Background: Mobile applications are increasingly used to support healthcare delivery in Uganda. MobiCare is a mobile application developed to facilitate the scheduling of patient appointments at health facilities. This study assessed the willingness of patients/caregivers and healthcare providers to use the MobiCare application in private health facilities in Mbarara Municipality, Uganda. Methods: A cross-sectional survey was conducted between July and September 2019 in five private hospitals in Mbarara Municipality. Structured interviewer-administered questionnaires were used to collect data from 97 patients/caregivers and 32 healthcare providers. Descriptive statistics were used to summarize findings, and inferential analysis was conducted among healthcare providers. Results: All patients/caregivers owned a smartphone and reported internet use (97/97; 100.0%), and nearly all had previously used a mobile application (96/97; 99.0%). Awareness of mobile applications linking patients to healthcare providers was low (8/97; 8.2%). Willingness to use MobiCare was high among patients/caregivers (97/97; 100.0%) and healthcare providers (31/32; 96.9%). Most patients/caregivers recommended the application for scheduling appointments for children under five years (92/97; 94.8%). Among healthcare providers, dissatisfaction with existing appointment scheduling systems was associated with willingness to use MobiCare (OR = 3.7, 95% CI: 1.2-11.4; p = 0.02). Conclusion: Willingness to use the MobiCare application was high among patients/caregivers and healthcare providers in private health facilities in Mbarara Municipality. Widespread smartphone ownership and internet use, together with dissatisfaction with existing appointment systems among providers, suggest favorable conditions for introducing digital appointment-scheduling tools in urban private healthcare settings. Further implementation research is needed to assess real-world uptake, usability, and impact on service delivery.
Weighted average algorithm adjusted a novel (1+FOPI)-FOPI TID controller structure for AGC with integration of non-linearities and cyber-attack
(Scientific Reports, 2026) Moses Awal; Michael Robson Atim; Jimmy Nabende Wanzala; Johnes Obungoloch; Mohamed Barakat
The integration of diverse energy sources and the advent of smart grids have intensified the challenges in load frequency management (LFM). Modern power systems are increasingly vulnerable to inherent nonlinearities, such as generation rate constraints, governor dead bands, boiler dynamics, and communication delays, as well as sophisticated cyber-attacks, which collectively threaten frequency stability and tie-line power balance. To address these challenges, this study proposes a novel cascade controller, designated as (1+FOPI)-FOPI-TID, for robust automatic generation control in hybrid two-area power systems. The controller uniquely combines fractional-order (FO) dynamics with a tilt-integral-derivative stage and is optimized using a green metaheuristic, the weighted average algorithm (WAA). The WAA effectively balances exploration and exploitation to achieve superior parameter tuning. The proposed control architecture processes both area control error (ACE) and frequency deviation (ΔF) signals through dedicated stages, enabling enhanced disturbance rejection and transient response. The system model incorporates a comprehensive set of nonlinearities and evaluates resilience against resonance-based cyber-attacks. Comprehensive simulation studies under both AC and HVDC tie-line configurations demonstrate that the WAA-optimized (1+FOPI)- FOPI-TID controller significantly outperforms existing schemes, including PD-PI, PIFOD-(1+PI), and PIDF(1+FOD). Key performance metrics show a 45.3% reduction in the integral of time-weighted absolute error (ITAE) and improvements in settling times of 47.7% for ΔF₁ and 32.8% for ΔF₂. Sensitivity analysis confirms robustness under±25% parameter variations and random load perturbations. During cyber-attacks, the controller maintains the lowest Rate of Change of Frequency (RoCoF), underscoring its dual capability in stabilizing grid dynamics and mitigating cyber-physical threats. These results validate the controller’s potential to enhance operational resilience and reliability in future smart grids.
Prevalence and associated factors of unilateral spatial neglect among patients with stroke at Mbarara Regional Referral Hospital, Uganda: a cross-sectional study
(BMC Neurology, 2026) Asiimwe Derrick; Migisha Richard; Nuwahereza Amon; Nkoyooyo Dauglas; Lubwama Conrad; Namayanja Rosemary; Omolo Ouma Ronald; Martha Sajatovic; Josephine Nambi Najjuma; Mark Kaddumukasa; Elly Katabira; Kira Bullock; Agaba David Collin
Background Unilateral spatial neglect (USN) is a common neurocognitive deficit following stroke and is associated with impaired rehabilitation and functional outcomes. Evidence on its burden and associated factors in low- and middle-income countries remains limited. This study determined the prevalence of USN and its associated factors among patients with stroke at Mbarara Regional Referral Hospital (MRRH), southwestern Uganda. Methods We conducted a cross-sectional study from August 12 to December 15, 2024. Patients with a recent stroke event within the preceding 0–4 months receiving care at MRRH were enrolled using consecutive sampling. Patients who were unable to see, aged <18 years or had bilateral stroke were excluded. USN was assessed using the Sunnybrook Neglect Assessment Procedure (SNAP): scores >5 indicating USN. Sociodemographic, clinical, and lifestyle factors were collected via structured questionnaires. Multivariable modified Poisson regression was used to identify factors associated with USN, reporting adjusted prevalence ratios (aPR) with 95% confidence intervals (CI). Results We enrolled 116 participants with a median age of 68 years (inter-quartile range [IQR]: 56–78). Most were female (65.5%). The prevalence of USN was 54.3% (n=63; 95% CI: 44–63). Among participants with USN, 60.4% were in the acute phase and 39.6% were in the subacute phase. Factors independently associated with a higher prevalence of USN included severe stroke (aPR=1.47), right-hemisphere lesions (aPR=1.58), and age ≥60 years (aPR=1.66), while right-handedness was associated with a lower prevalence of USN (aPR=0.94). Conclusion This study revealed a high prevalence of USN among patients with stroke at a referral hospital in southwestern Uganda. Stroke severity, right-hemisphere lesions, advanced age, and right-handedness were associated with USN. Targeted rehabilitation and early screening for patients with stroke with risk factors, particularly those with severe strokes or advanced age, could optimize recovery and improve long-term outcomes.
Nurses and Midwives Mistakes and Errors in Pediatric Health Outcomes in Southwestern Uganda
(Pediatric Health, Medicine and Therapeutics, 2026) Milly Akantorana; Raymond Tumwesigye; Concepta Mary Nalwanga; Vallence Niyonzima; Rachel Luwaga; Esther Beebwa
Background: According to the World Health Organization, nearly 1 in 10 patients suffer harm during healthcare, resulting in over 3 million deaths in low- and middle-income countries. Alarmingly, more than half of these incidents are preventable, with medication errors being the primary cause. Children are particularly vulnerable to these errors and other adverse patient events. Therefore, this study explored nurses and midwives’ mistakes and errors in paediatric health outcomes in southwestern Uganda. Methods: We adopted a phenomenological qualitative research design. Purposive and consecutive sampling methods were used to recruit nurses and midwives who had served in their respective units for at least six months and were willing to participate and signed a written informed consent form. Data collection was done using a semi-structured interview guide. All interviews were face-to-face and audio-recorded upon participants’ consent. Thematic analysis was used to generate the themes. Results: The study revealed four themes that emerged from participants’ perceptions regarding the reasons for pediatric medication errors namely; work flow and work environment, work overload, limited resources and training and education need. Regarding participants’ experience of pediatric medication errors, omission and commission errors was quoted and three themes emerged from interventions to medication errors, namely; sticking to rights of drug administration, education and training, and resources. Conclusion: Results of this study indicate that although nurses demonstrated positive perceptions of strategies to improve pediatric medication safety, medication errors remain a serious challenge requiring close supervision. The primary problem identified as quoted verbatim by the participants is “…overcrowding of babies in limited clinical spaces”, which created a high-risk environment for errors. The findings highlight the urgent need to incorporate the voices of nurses into policy, education, and training initiatives. Such inclusion will contribute to the development of robust healthcare systems and more effective strategies to enhance pediatric medication safety
Willingness to pay for solid waste management services and associated factors in Mbarara District, Southwestern Uganda
(PLOS Global Public Health, 2026) Erastus Tugume; Abraham Muhwezi; Tom Murungi; Julius Kyomya; Edgar Mulogo Mugema; Richard Migisha; Moses Ntaro
Willingness to pay (WTP) for solid waste management services is essential for sustainability, yet it remains unassessed in Mbarara District. This study assessed the prevalence of WTP for solid waste management services and the associated factors among households in Mbarara District, Southwestern Uganda.This was a quantitative cross-sectional survey conducted among 250 individuals in households of Bwizibwera-Rutooma and Rubindi-Ruhumba town councils, Mbarara district. We used multistage sampling to select the administrative units and consecutively selected the participants from households. Data were collected using a 26-item interviewer-administered questionnaire, entered in Microsoft Excel and transferred to STATA version 17.0 for cleaning and analysis. Continuous variables were summarized using means and standard deviations, while categorical variables were pre sented as frequencies and proportions. Bivariate and multivariable logistic regression analysis at a 95% level of confidence was done to identify factors associated with WTP for solid waste management services.Overall, 62% (156/250; 95% C.I.: 56.2%- 68.2%) of the participants were willing to pay for solid waste management services. The majority, 64.1% (100/156), were willing to pay one thousand Uganda shillings or more for SWM. Factors associated with WTP for solid waste management services were; being male (aOR = 2.4, 95% CI: 1.2-4.6; p-value=0.011), having a monthly income>28 USD (aOR = 2.2, 95% CI: 1.7-4.1; p-value=0.015), disposing wastes using town council services (aOR = 7.75, 95% CI: 1.35-44.47; p-value=0.022) and receiving weekly waste collection services (aOR = 2.62; 95% CI: 1.06-6.50; p=0.038). The WTP for solid waste management services was relatively high and positively associated with being male, having a monthly income of>100,000 UGX, reliance on town council collection services, and weekly waste collection. Policymakers and local authorities should prioritize affordable, reliable waste collection and inclusive measures, like subsidies and targeted community engagement to boost participation and sustain waste management.
Intersectional Stigma and Health of People Living with HIV on ART Who Use Alcohol in Southwestern Uganda
(AIDS and Behavior, 2026) Sarah A. Gutin; Esther Atukunda; Fatema Shafie Khorassani; Robin Fatch; Kaku So-Armah; Adah Tumwegamire; Nneka I. Emenyonu; Cristina Espinosa da Silva; Christine Ngabirano; Karsten Lunze; Julian Adong; Winnie Muyindike; Judith A. Hahn
HIV, TB, and alcohol use are stigmatized conditions that lead to poor care engagement and health outcomes. Stigmatized traits can operate independently or be intersectional. We examined the relationships between intersectional HIV-, TB-, and alcohol-related stigma on poorer perceived health among people with HIV (PWH) receiving antiretroviral therapy in a study examining TB infection risk among PWH in HIV care in southwestern Uganda (2022–2023). We used proportional odds models to examine associations between high intersectional HIV, TB, and alcohol stigma (defined as above median scores on validated scales) and the outcome of poorer perceived health. Among 379 PWH, 12% described their health status as fair/poor. High intersectional HIV and alcohol stigma was associated with increased odds of poorer perceived health (adjusted odds ratio [aOR]=1.62; 95% CI: 1.04–2.52), but we found no associations between other HIV, TB, and alcohol stigma intersections and this outcome. We found a significant interaction between intersectional HIV and alcohol stigma and marital status (Wald χ2=5.02, p=0.03), and upon stratification, high intersectional HIV and alcohol stigma was associated with an increased odds of poorer perceived health among unmarried participants (aOR=2.54; 95% CI: 1.33–4.86; p<0.01) but not among married participants (aOR=1.05; 95% CI: 0.56–1.95; p=0.88). High intersectional HIV and alcohol stigma was associated with poorer perceived health among PWH in care, particularly among unmarried persons. Given the possible benefits of partner support, interventions that strengthen social support for unmarried persons may help mitigate the negative health impact of intersectional stigma.
Capacity building for ethical use of artificial intelligence in health: protocol for a scoping review of training initiatives and gaps in Africa
(BMJ open, 2026) Joseph Mwaka; Ronald Mulebeke; Racheal Dedibo; Jane Frank Nalubega; Collins Ankunda; Drake Musoki; Wandera Uthmaan Muluga; Jesca Nataliya; Justine Kirabo; Edrin Jjuuko; vonne Karamagi; Bella Imanzi; Sylvia Nabukenya
Introduction: Artificial intelligence (AI) is increasingly embedded in health systems, with applications spanning diagnostic imaging, clinical decision support, disease surveillance and health system planning. While international guidance frameworks outline principles for safe and ethical AI deployment, effective governance depends on the capacity of regulators, research ethics committees, policymakers, health technology assessment bodies and frontline health professionals to evaluate, supervise and implement AI tools in practice. Across African Union (AU) member states, training and capacity-building initiatives related to ethical AI use in health remain fragmented and unevenly documented. This scoping review aims to systematically map, characterise and synthesise evidence on training initiatives that support the ethical use and governance of AI in health across Africa. Methods and analysis: This scoping review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines and applies the Joanna Briggs Institute population–concept–context framework. We will search PubMed/MEDLINE, Scopus, Web of Science Core Collection, Embase, IEEE Xplore, SSRN and African Journals Online, alongside structured grey literature searches of African regional bodies (eg, AU, Africa Centers for Disease Control and Prevention, AUDA-NEPAD, WHO Regional Office for Africa), national regulatory authorities, ministries of health, professional councils and donor programme portals. Searches will cover 1 January 2015 to 31 December 2025 and will be limited to English-language materials. Eligible sources must describe identifiable training, education or capacity-building initiatives focused on ethical use and/or governance of AI in health, including software as a medical device and AI-enabled medical devices, delivered in or explicitly targeting at least one AU member state. Purely technical AI training without governance or clinical integration components will be excluded. Two reviewers will independently screen records and extract data. Findings will be synthesised using descriptive statistics and reflexive thematic analysis. Where feasible, stakeholder consultation will be undertaken to contextualise the results and refine the draft competency framework. Ethics and dissemination: The review will analyse publicly available documents and does not involve human participants; formal ethical approval is not required. Findings will be disseminated through a peer-reviewed open-access publication, a policy brief targeted at regional and national health governance stakeholders, and a public webinar. Search strategies, screening decisions and extraction tools will be deposited on the Open Science Framework (OSF) to enhance transparency.
Antibiotic Use and Antibiotic Susceptibility of Common Environmental Bacterial Species in the Intensive Care Unit at Mbarara Regional Referral Hospital, Uganda
(Cureus, 2026) Daniel Chans Mwandah; Martha K. Namakula; Joshua Kiprotich; Stella Babirye; Namuyomba M. Kamoga; Splendour Masinde; Anna B. Nakiguli; Kevin Kiyimba; Nuru Mugide; Tadele M. Yadesa; Jonans Tusiimire; Stephen Ttendo; Joseph Oloro; Joel Bazira; Amon G. Agaba
Background: Environmental contamination in intensive care units (ICUs) is a recognized concern due to its potential role as a reservoir for pathogenic and antimicrobial-resistant bacteria. Understanding the extent and patterns of contamination is essential for strengthening infection prevention and control strategies, particularly in resource-limited settings. Methods: A cross-sectional environmental surveillance study was conducted in the ICU of Mbarara Regional Referral Hospital. A total of 34 high-touch surfaces were sampled using sterile pre-moistened swabs over a standardized area. Bacterial identification was based on colony morphology, hemolytic patterns, Gram staining, and microscopic characteristics. Antimicrobial susceptibility testing was performed using the disc diffusion method, with zones of inhibition measured in millimeters and interpreted as sensitive, intermediate, or resistant according to standard guidelines. Results: Of the 34 environmental samples collected, 32 (94.1%) yielded bacterial growth, resulting in a total of 40 isolates. Gram-positive bacteria accounted for 21 isolates (52.5%), while Gram-negative bacteria accounted for 19 isolates (47.5%). Common isolates included Staphylococcus aureus, Klebsiella species, and Escherichia coli. Antimicrobial susceptibility testing revealed varying resistance patterns across commonly used antibiotics, with notable resistance observed among several isolates. Descriptive patient data indicated frequent use of broad-spectrum antibiotics within the ICU. Conclusions: This study demonstrates a high level of bacterial contamination on ICU surfaces, with diverse organisms exhibiting varying antimicrobial resistance patterns. While no direct relationship between environmental contamination and patient infections was established, the findings highlight the importance of maintaining stringent infection prevention and control practices. Further studies incorporating advanced microbiological techniques are recommended to better understand transmission dynamics in ICU settings. The findings highlight the urgent need for strengthened antimicrobial stewardship programs and routine culture and sensitivity testing in resource-limited ICU settings.
Recurrence Rate and Risk Factors for Apical Prolapse After Sacrospinous Ligament Fixation: A Prospective Cohort Study
(Cureus, 2026) Musa Kayondo; Rogers Kajabwangu; Onesmus Byamukama; Brenda Ainomugisha; Kalyebara Paul Kato; Leevan Tibaijuka; Henry M. Lugobe; Verena Geissbuehler
Objective: We aimed to determine the one-year recurrence rate of apical prolapse following sacrospinous ligament fixation and to identify clinical and surgical risk factors associated with recurrence in a low-resource setting. Methods: This was a prospective cohort study of women who underwent sacrospinous ligament fixation as part of surgery for apical prolapse at the urogynecology unit of Mbarara Regional Referral Hospital (MRRH) in Uganda. The surgeries performed included vaginal hysterectomy with sacrospinous ligament vault fixation, sacrospinous ligament hysteropexy, and sacrospinous ligament vault fixation for those with posthysterectomy vaginal vault prolapse. Concomitant procedures such as anterior or posterior repair, or both, were performed for women with prolapse in other compartments. The women were followed up for a period of one-year post-surgery. Recurrence was assessed with the women in lithotomy position under maximum strain using the Pelvic Organ Quantification (POP-Q) system. Recurrence was defined as apical prolapse of ≥POP-Q stage II. Multivariable log-binomial regression was performed to determine risk factors for recurrence. Results: A total of 123 participants were enrolled in this study, of which 111 (90.2%) completed follow-up. The mean age was 53.1 (SD ±13.6) years. The majority of apical prolapse was uterine (94.6%) and classified as POP-Q stage III (58.6%). The recurrence rate was 19.8% (22/111, 95% CI: 13.4-28.4). Risk factors for apical prolapse recurrence included body mass index (BMI) >25 kg/m2 (relative risk (RR) = 6.02; 95% confidence interval (CI): 2.05-17.67; p = 0.001) and post-operative complications (RR = 19.87; 95% CI: 5.77-68.47; p < 0.001). Undergoing vaginal hysterectomy as part of the prolapse surgery was found to be protective (RR = 0.09; 95% CI: 0.03-0.25; p < 0.001). Conclusions: Apical prolapse recurrence after sacrospinous ligament fixation is common in this setting. To reduce the risk of recurrence, management protocols should prioritize prevention and timely management of postoperative complications, and counseling for weight optimization. Furthermore, vaginal hysterectomy should be considered in uterine prolapse where uterine sparing surgery is not required.
Attitude towards human papillomavirus vaccine uptake among girls aged 9-13 years in Kyenjojo Primary School, Kyenjojo district. A cross-sectional study.
(East African Journal of Research and Innovation, 2026) Carolyn Ahurra; Jane Namagga Kasozi; Agnes Alupo; Olivia Sasirabo
Background: In Uganda, the burden of cervical cancer has increased significantly, partly due to low uptake of preventive measures such as HPV vaccination. This study assessed attitudes towards HPV vaccine uptake among girls aged 9–13 years at Kyenjojo Primary School in Kyenjojo District. Methodology: A cross-sectional study employing quantitative methods was conducted among 70 girls aged 9–13 years. Respondents were selected using simple random sampling. Data were collected using a structured, researcher-administered questionnaire translated into Rutooro. Data were analyzed using SPSS to generate descriptive statistics, including frequencies and percentages, and results were presented in tables and charts. Ethical approval, consent, and assent were obtained prior to data collection. Results: The majority of respondents (49.3%) were aged 13 years, with most being Batoro (53%) and Protestants (40.2%). Slightly more than half (52.8%) had received the HPV vaccine, indicating moderate uptake. Most vaccinations were conducted at school (39.3%). A large proportion (85%) reported no side effects following vaccination, suggesting generally positive experiences. However, 71% of respondents did not receive health education prior to vaccination, and information sources were inconsistent, with only a small proportion obtaining information from parents (14%) and health workers (17.6%). These gaps contribute to mixed attitudes, uncertainty, and hesitancy towards vaccination. Conclusion: Attitudes towards HPV vaccination among adolescent girls are mixed, with both positive experiences and significant gaps in awareness and pre-vaccination education influencing uptake. Recommendations: There is a need for strengthened health education programs targeting adolescents, increased involvement of parents, teachers, and healthcare workers, and improved communication strategies to foster positive attitudes and enhance HPV vaccine uptake.