Muni Repository (MR)
This repository contains open access publications of Muni University Library.
Objectives:
- To digitally collect, preserve and provide electronic access to scholarly works and research output of Muni University.
- Increase the visibility and impact of our research, making it easy for researchers, students, policymakers and journalists to reference, replicate, and re-use the work.
- Issue permanent, unique and trustworthy identifiers when creating URLs to access the resource without concern that the location of the resource may change.
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- Contact the library through email: libsupport@muni.ac.ug
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Recent Submissions
Progression from uncomplicated to severe malaria among children in settings receiving different malaria control interventions in sub-Saharan Africa: a systematic review protocol
(BMJ Group, 2025-08-11) Okek, Erick Jacob; Lutwama, Julius; Kinengyere, Alison Annet; Asio, Juliet; Awor, Silvia; Le Doare, Kirsty; Musinguzi, Benson; Sande, James Obondo; Ocan, Moses; Kayondo, Jonathan
Background Different malaria control measures are deployed simultaneously in endemic settings globally, with varying impacts on malaria burden. In sub-Saharan Africa, which bears the greatest burden of malaria, evidence on the impact of implementing various control interventions on malaria immunity remains unknown. This systematic review seeks to collate evidence on the extent of progression from uncomplicated to severe malaria among populations in sub-Saharan Africa settings receiving concurrent deployment of various malaria control measures.
Methods The review will use a priori criteria contained in the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. An experienced librarian (AAK) will independently search for articles from the following databases: PubMed, Web of Science, Embase, Scopus and Google Scholar. Boolean operators ‘AND’ and ‘OR’ will be used in the article search. Identified articles will be managed using EndNote. Article screening for inclusion and data extraction will be done in duplicate by two reviewers (EJO, and BM). Data extraction tools will be developed and customised in Excel. Data will be analysed using both narrative and quantitative synthesis. The level of heterogeneity between study outcomes will be measured using the I2 statistic. Subgroup analysis will be conducted to explore heterogeneity and establish the impact of different control interventions on progression from uncomplicated to severe malaria. A full systematic review and meta-analysis is expected to be ready for dissemination by the end of December 2025.
Appropriateness, barriers, and facilitators of multi-month dispensing of tuberculosis drugs in rural eastern Uganda: A qualitative study to inform a non-inferiority randomized trial
(PLOS, 2025-09-05) Izudi, Jonathan; Bajunirwe, Francis; Adithya, Cattamanchi; West, Nora
Multi-month dispensing of tuberculosis (TB) drugs is an innovative strategy that may reduce frequent clinic visits and travel costs among people with TB (PWTB) in rural areas. To inform a planned trial, we explored the appropriateness, barriers, and facilitators to multi-month dispensing among PWTB and healthcare providers in rural eastern Uganda. We used qualitative methods situated within the Consolidated Framework for Implementation Research to explore two refill schedules for multi-month dispensing of TB drugs—a four- or five-visit refill schedule. In December 2024, we collected data through interviews with PWTB, their treatment supporters, and healthcare providers at the regional, district, and health facility levels. Data were analyzed using thematic analysis. All participants (n = 39; 22 healthcare providers, 12 PWTB, and five treatment supporters) expressed willingness to adopt multi-month dispensing, with a four-visit schedule as the preferred option. Healthcare providers preferred the five-visit schedule for individuals with complex health conditions: severe illness, clinical instability, or bacteriologically confirmed pulmonary TB. Multi-month dispensing was perceived to benefit healthcare providers by reducing workload, improving patient flow, and enhancing patient management. Perceived benefits to PWTB included reduced clinic visits and travel costs, time savings, improved treatment adherence, reduced wait times and TB-related stigma, and increased satisfaction with care. Facilitators included integration with existing treatment models, person-centeredness, community and family support, reliable drug supply, clear operational guidelines, healthcare provider training and readiness, enhanced monitoring and evaluation, clinic accessibility, readiness to utilize multi-month dispensing, and leadership support. Barriers included undefined eligibility criteria, uncertain effects of multi-month dispensing, differing refill schedules for PWTB and HIV, treatment non-adherence due to forgetfulness and medication sharing, and patient disengagement due to insufficient follow-up. Multi-month dispensing is perceived to benefit PWTB and healthcare providers. Further studies to measure the impact on treatment outcomes should leverage facilitators and address barriers to adoption and effectiveness.
Association of high serum aspartate transaminase to high density lipoproteincholesterol ratio with probable dementia among people living with HIV on antiretroviral therapy in Southwestern Uganda
(Sage, 2025-08-11) Bagenda, Charles Nkubi; Mudondo, Hope; Ssemwanga, Elastus; Nzaramba, Daniel; Ssedyabane, Frank; Ojuko, Samuel; Musinguzi, Benson; Akiteng, Winnie; Agaba, Bosco Bekiita; Osuwat, Lawrence Obado; Maling, Samuel; Rugera, Simon Peter; Tusubira, Deusdedit
Objectives:
Previous studies present conflicting evidence on the relationship between hepatocellular damage biomarkers and dementia risk. While elevated serum transaminases have been associated with mild cognitive impairment, other studies link lower transaminase levels and reduced high-density lipoprotein-cholesterol levels to increased risk of cognitive decline. This study investigated the association between serum transaminase-to-high-density lipoprotein-cholesterol ratios and probable dementia among people living with HIV on antiretroviral therapy.
Methods:
We conducted a secondary data analysis using a dataset from a cross-sectional study conducted among 377 people living with HIV on dolutegravir-based antiretroviral therapy in southwestern Uganda. Probable dementia was screened using the brief Community Screening Instrument for Dementia and defined as a Community Screening Instrument for Dementia cognitive score ⩽4. Serum alanine aminotransferase/high-density lipoprotein-cholesterol and aspartate aminotransferase/high-density lipoprotein-cholesterol ratios were calculated from the respective serum transaminases and high-density lipoprotein-cholesterol divided into tertiles. We used logistic regression to assess the association between the independent variables and probable dementia.
Results:
The median age of the study participants was 44 years (interquartile range: 30–59), with 56.2% being female. The median total cholesterol/high-density lipoprotein-cholesterol levels were significantly higher in participants with probable dementia compared to those without (3.86 versus 3.22, p = 0.03). Aspartate aminotransferase/high-density lipoprotein-cholesterol and alanine aminotransferase/high-density lipoprotein-cholesterol levels were also higher among participants with probable dementia compared to those without, although the differences did not reach statistical significance. In the fully adjusted model, compared to participants in the first tertile of aspartate aminotransferase/high-density lipoprotein-cholesterol ratio, the odds of probable dementia were higher in the second tertile (adjusted odds ratio: 1.71; 95% confidence interval: 0.62–4.74; p = 0.301) and significantly elevated in the third tertile (adjusted odds ratio: 4.48; 95% confidence interval: 1.15–17.46; p = 0.031).
Conclusions:
The findings suggest that an elevated aspartate aminotransferase/high-density lipoprotein-cholesterol ratio is significantly associated with probable dementia among people living with HIV on dolutegravir-based antiretroviral therapy. A high aspartate aminotransferase/high-density lipoprotein-cholesterol ratio is potentially associated with cognitive decline in this population.
How the chemical composition of solids influences the formation of planetesimals
(EDP Sciences, 2025-07-11) Xenos, Konstantinos Odysseas; Bitsch, Bertram; Andama, Geoffrey
The formation of planetesimals is a necessary step for the formation of planets. While several methods exist that can explain the formation of planetesimals, an increase in the local dust-to-gas ratio above unity is a strong requirement to trigger the collapse of the pebble cloud to form planetesimals. One prime location for this to happen is at the water-ice line, where large water-rich pebbles evaporate and release their smaller silicate cores, resulting in an increase in the local dust-to-gas ratio originating from the different inward velocities of the large and small pebbles. While previous work indicated that planetesimal formation becomes very challenging at overall dustto-gas ratios below 0.6%, in line with the occurrence of close-in super-Earths, it is unclear how the overall disc composition influences the formation of planetesimals. Observations of stellar abundances not only indicate a decrease in the overall C/O ratio for low metallicity stars, they also show a large spread in the C/O ratios. However, the C/O ratio sets the abundance of water ice within the disc. Using the 1D numerical disc evolution code chemcomp, we simulated protoplanetary discs with varying C/O ratios and dust-to-gas ratios over a 3 Myr timescale. Planetesimal formation is modelled by implementing conditions based on dust-gas dynamics and pebble fragmentation. Our results confirm that planetesimal formation is highly dependent on disc metallicity with lower metallicity discs forming significantly fewer planetesimals. We find that a decreased carbon fraction generally enhances planetesimal formation, while a higher carbon fraction suppresses it due to a reduced water abundance at the same dust-to-gas ratio. The opposite is the case with the oxygen ratio, where larger oxygen fractions allow a more efficient formation of planetesimals at the same overall dust-to-gas ratio. Consequently we make the prediction that planets around low metallicity stars should be more common if the stars have low C/O ratios, especially when their oxygen abundance is increased compared to other elements, testable through observations. Our simulations thus open a pathway to understanding whether the composition of the planet-forming material influences the growth of planets.
How have unintended pregnancies and contraceptive use among adolescent girls and young women changed in Uganda? Evidence from the 2014 and 2019 PMA national surveys
(Public Library of Science (PLOS), 2025-04-29) Kibira, Simon P.S.; Nakafeero, Mary; Amollo, Mathew; Ssenyonga, Ronald; Ndejjo, Rawlance; Anglewicz, Phil; Kukundakwe, Melody; Luzze, Mabel; Kagongwe, Samuel; Guma, Victor; Zalwango, Vivian; Makumbi, Fredrick Edward
Unintended pregnancies among adolescent girls and young women (AGYW), and any pregnancy among adolescent girls are still a challenge, especially in Sub-Saharan Africa and Uganda. We assess prevalence of unintended pregnancy in Uganda, associated factors and contraceptive use following unintended pregnancy among adolescent girls and young women in 2014 and 2019 in Uganda. Data are from the 2014 and 2019 performance monitoring for action (PMA) surveys. There were 1,479 AGYW reporting ever/ or current pregnancy in the two surveys, 780 in 2014 and 699 in 2019. Data included socio-demographics and pregnancy intendedness. Descriptive analyses were conducted stratified by adolescent girls and young women and compared between surveys. The percent of unintended pregnancies was determined as the number of AGYW reporting unintended pregnancy divided by eligible participants. A weighted comparison of the prevalence of unintended pregnancies was made between the surveys, and statistical significance determined at a 5% type-1 error rate. All analyses were conducted with Stata version15 using svy surveyset methodology accounting for complex survey design. Relative to 2014, the 2019 survey showed a significant reduction in percent of AGYW reporting ever pregnant or given birth, 60% to 49%, p = 0.007; a decline in unintended pregnancy among adolescent girls, 52% to 42%, p = 0.049, and among young women with secondary education, 36% to 13%, p = 0.001. Conversely, the 2019 survey showed significant increase in contraception among those ever pregnant, 26% to 40%, p < 0.001; higher in young women (30% to 47%, p = 0.001) compared to adolescent girls (16% to 25%, p = 0.005). The commonest contraceptive methods were short-acting at both surveys, while the long-acting methods significantly increased among young women (20% to 35%, p = 0.003). The decline in unintended pregnancies was consistent with increased use of contraceptive methods. Although we observed a significant decline in unintended pregnancy among adolescent girls, the proportion reporting unintended pregnancy remains high.