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.
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- 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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Recent Submissions
Draft genome of Orthopoxvirus monkeypox virus hMpxV/Uganda/MUWRP-H1922SL/2025 detected in Uganda
(American Society for Microbiology, 2026-06-15) Alafi, Stephen; Wokorach, Godfrey; Tugume, Titus; Erima, Bernard; Mworozi, Edison A.; sensamba, Jude T. S; Kiyengo, James; Kibuuka, Hannah; Musinguzi, Ambrose K.; Koehler, Jeffrey W.; ichardson, Joshua B. R; Paola, Nicholas Di; Kugelman, Jeffrey; Wabwire-Mangen, Fred; Byarugaba, Denis K.
Mpox virus from Clade I exhibits high virulence and poses significant mortality risks, especially among children. We isolated a strain of the mpox virus (hMpxV/Uganda/MUWRP-H1922SL/2025) from an adult woman in Uganda. Using phylogenetic tree analysis and PoxServer evaluation, we determined that this strain belongs to Clade/Lineage Ib.
Polymorphism of pfmdr1 gene mutation conferring resistance to artemisinin‐based combination therapy in plasmodium falciparum in patients at Gulu regional referral hospital in northern Uganda
(John Wiley & Son, 2026-06-09) Amito, Florence Peace; Angwech, Harriet; Ojok, Lonzy; Wokorach, Godfrey; Ochaya, Stephen; Ogwang, Quinto; Opiro, Robert; Echodu, Richard
Background
Malaria is one of the most devastating infectious diseases in humans, and antimalarial drugs have been used to combat it with minimal success. Worldwide, malaria treatment is threatened by the emergence and spread of artemisinin resistance, which is associated with mutations in the PfK13 propeller domain. In Sub-saharan Africa, data relating to the prevalence of Plasmodium falciparum malaria infection in association with the Kelch 13 mutations are mainly from research settings outside disease-endemic areas. This study is aimed at establishing the prevalence of P. falciparum malaria infection in association with Kelch 13 mutations among patients presenting with fever at Gulu Regional Referral Hospital (GRRH) in northern Uganda.
Methods
This cross-sectional study enrolled all participants presenting with fever at GRRH between April 2022 and January 2024. Data on adults and children aged ≥ 6 months with fever and confirmed diagnosis of malaria using mRDT, microscopy, and PCR were collected. Parasite DNA was extracted using the Chelex method and sequenced for multidrug resistance genes, and Sanger customized CRF forms were used to capture variables on social demographics, clinical presentation, and treatment. Data were analyzed using IBM SPSS Version 25, and the sequenced data were analyzed using molecular evolutionary genetic analysis (MEGA) Version 11.1.10. All sequences from a single population were aligned using the National Center for Biotechnology Information (NCBI) database.
Results
In total, 353 participants were recruited, and the overall prevalence of P. falciparum malaria was 60.6% (n = 214), with the highest number of cases registered in Gulu City (24.9%). Women were the most affected participants (37.1%). The most common clinical presentations among the participants were fever (91.8%; n = 324), chills (90.7%; n = 320), and headaches (72.0%; n = 254). Genotyping results of the mutant genes showed that of all 214 P. falciparum isolates examined, the pfmdr1 SNP at Codon 1034 1042 (29.6%, n = 94) had the highest prevalence, followed by the pfmdr SNP at Codon 86 184 (28%, n = 89), and the SNP fragment at codon 1246 (25.8%, n = 82) recorded the lowest prevalence. Kelch 13 propeller gene, known to be associated with artemisinin resistance, was also isolated in 16.7% (n = 53) of the samples. There was a 90.1% (n = 318) prevalence of the SNPs 86 184, 1034 1042 of the pfmdr1 gene, and K13 propeller gene, with no significant difference between the sexes (p = 0.756). The SNP at Codon 1246 of pfmdr1 showed a significant difference between the location and mutation (p = 0.017). The median parasite load in patients with mutations in 86 184, 1034 1042, and K13 propeller genes varied significantly among patients who received treatment p ≤ 0.0001, p = 0.0061, and p = 0.012, respectively.
Conclusion
The presence of pfmdr1 mutant genes suggests resistance of P. falciparum to most antimalarial drugs used in treatment. Therefore, it is important to monitor the prevalence of Kelch 13 mutations and P. falciparum to contribute to global efforts to control and eliminate malaria.
Genomic architecture of fourth-generation cephalosporin-resistant Klebsiella pneumoniae Species Complex (KpSC) from patients and their hospital environment in Uganda
(Springer Nature, 2026-06-01) Byarugaba, Denis K.; Wokorach, Godfrey; Hounmanou, Yaovi M.H.; Wanyana, Agnes; Alafi, Stephen; Wabwire‑Mangen, Fred; Christensen, Henrik; Olsen, John E.
The emergence of fourth-generation cephalosporin-resistant (4GCR) K. pneumoniae species complex (KpSC) is a human health concern due to limited therapeutic options and association of the bacteria with severe morbidity and mortality. This study investigated the genomic characteristics of 4GCR K. pneumoniae species complex strains from patients and their hospital environment in Uganda. Twenty-seven isolates were obtained from two tertiary healthcare hospitals in Uganda. Whole genomic sequence (WGS) analysis revealed dominance of phylogroup Kp1 (70.4%). Isolates were highly diverse genetically, representing 15 clonal groups and 10 different serotypes, with isolates of CG17 (6/27) and serotype O5 (25%) as the most common. Core genome SNP-based phylogenetic comparison placed Ugandan strains together with strains from African lineages; however, with a few strains clustering with global references. Most strains carried multiple resistance genes, particularly CTX-M-15 (24/27) and aminoglycoside-modifying enzymes. A search for virulence factors revealed that most isolates carried few virulence genes, particularly those associated with hypervirulence. A yersiniabactin loci was detected in a subset of Kp1 isolates. Ten plasmid replicons and multiple insertion sequences were detected that may mediate resistance dissemination. These findings provide evidence of 4GCR KpSC in clinical settings and patient environments in Uganda. This underscores the need for ongoing genomic surveillance and antimicrobial stewardship to enable early detection of resistant strains and prevent localized clusters from escalating into widespread outbreaks in hospitals across the country.
Effect of cumulative exposure to media channels for malaria messages on knowledge of malaria prevention among women (15– 49 years) in Uganda
(Springer Nature, 2026-05-05) Natuhamya, Charles; Obiora, Rejoice Uche; Nwankwo, Gideon Ikemdinachi; Agbi, Delight Mawufemor; Isiko, Isaac; Mwebesa, Edson
Introduction
Malaria remains a leading global public health concern, disproportionately affecting populations in low-resource settings. Uganda continues to contribute substantially to the global malaria burden, yet exposure to malaria-related health messages remains limited. In recent years, diverse media platforms have been adopted to disseminate prevention messages. This study assessed the influence of cumulative exposure to malaria message media channels on knowledge of malaria prevention and its associated factors among women of reproductive age in Uganda.
Methods
We conducted a secondary analysis of the 2018–2019 Uganda Malaria Indicator Survey (UMIS), comprising 7124 women aged 15–49 years selected using a two-stage cluster and stratified sampling design. Knowledge of four prevention methods recommended by World Health Organization (WHO), bed nets, insecticide-treated nets (ITNs), preventive medicine, and indoor residual spraying (IRS) was assessed. Associations between cumulative media exposure and malaria knowledge were examined using t-tests, margins analysis, and mixed-effects negative binomial regression models.
Results
Knowledge of malaria prevention was unevenly distributed: 76.5% of women reported awareness of bed nets, compared with only 9.1% for ITNs, 6.2% for preventive medicine, and 4.3% for IRS. Cumulative exposure to media channels was significantly associated with knowledge of ITNs (p < 0.001), preventive medicine (p = 0.002), and IRS (p < 0.001), but not bed nets. Education, age, wealth, residence, and region were significant determinants of exposure to media channels. Women with secondary or higher education were nearly twice as likely to report exposure to multiple channels compared to uneducated women (Incidence Rate Ratio, IRR = 1.86; 95% Confidence Interval, CI 1.59–2.17). Similarly, women aged ≥ 40 years were 69% more likely (IRR = 1.69; 95% CI 1.35–2.11) to report exposure to multiple channels than those under 20 years. In contrast, rural and refugee women reported significantly lower exposure relative to urban residents (IRR = 0.77 and 0.28, respectively).
Conclusions
Cumulative multi-channel exposure to malaria prevention messages significantly improves women’s knowledge of ITNs, preventive medicine, and IRS. However, structural inequities in education, wealth, and place of residence limit access to diverse channels. Integrated, context-specific, and equity-focused communication strategies are essential to broaden awareness beyond bed nets and to accelerate progress toward malaria control and elimination in Uganda.
Prevalence of microalbuminuria and associated factors among diabetic patients attending a general hospital in Central Uganda
(Taylor & Francis Group, 2026-02-02) Kemigisha, L; Bagenda, CN; Gumoshabe, C; Walusimbi, P; Deborah, A; Nantongo, C; Mudondo, H; Ssemwanga, E; John, EA; Mugisa, MJ; Mwesigye, V; Wafwoyo, JA; Osuwat, LO; Musinguzi, Benson; Akiteng, W; Rugera, SP; Tusubira, D; Wagubi, R
Introduction:
Microalbuminuria is an early indicator of kidney damage and a strong predictor of diabetic nephropathy in diabetic patients. Its prevalence and associated factors vary across populations, necessitating region-specific studies. This study evaluated the prevalence of microalbuminuria and its associated factors among diabetic patients attending a general hospital in Central Uganda.
Methods:
From September 2024 to December 2024, a structured questionnaire was used to carry out a descriptive and analytical cross-sectional study among patients with diabetes at Nakaseke General Hospital in Central Uganda. Blood and urine samples from each participant were also analysed for determination of HbA1c, serum gamma glutamyl transferase (GGT), and microalbumin respectively. Microalbuminuria was defined as urine microalbumin levels of 20–200 mg/L. Logistic regression analysis was used to assess associated factors.
Results:
Of 298 participants, 220 (73.8%, 95% CI: 68.52–78.52) had microalbuminuria. The majority were females: 193 (64.8%). GGT levels were significantly higher in participants with microalbuminuria: 45.5IU/L (IQR: 33.5–57) than in those with normoalbuminuria: 39.5IU/L (IQR: 29–50), p = 0.011. HbA1c levels, indicative of glycaemic control, were noticeably greater in the microalbuminuria group: 8.2% (IQR: 7.2–9.65) as compared with those with normoalbuminuria: 7.6% (IQR: 6.9–9.1), p = 0.012. After adjustment for confounders, factors significantly associated with microalbuminuria were HIV-positive status (aOR = 3.20, p = 0.030), hypertension (aOR = 4.43, p = 0.011), and unemployment status (aOR = 2.32, p = 0.023).
Conclusion:
Microalbuminuria is prevalent among patients with diabetes. Microalbuminuria is associated with elevated GGT, and HbA1c levels, HIV positivity, hypertension, and unemployment. Screening, more stringent glycaemic and blood pressure control, and targeted interventions are warranted in high-risk groups to prevent the onset of diabetic nephropathy.