Faculty of Health Sciences

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A qualitative study of knowledge, experiences, and healthcare needs of people living with lymphedema in Kamwenge District, rural Uganda
(Springer Nature, 2025-10-27) Mwesigye, Vicent; Tebulwa, Joanita Berytah; Musinguzi, Benson; Agaba, Bosco Bekita; Muyambi, Raul; Asiimwe, Gerevasio Kalemire; Zamarano, Henry; Birungi, Caroline; Bagenda, Charles Nkubi; Bajunirwe, Francis; Bazira, Joel; Itabangi, Herbert; Byarugaba, Frederick; Mulogo, Edgar Mugema
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.
Adaptation and carry over effects of extreme sporadic heat stress in Culex mosquitoes
(Elsevier, 2024-10-09) Padde, John Roberts; Zhou, Yinghui; Chen, Yunxuan; Zhu, Yuxiao; Yang, Yuxuan; Hou, Min; Chen, Lu; Xu, Zhipeng; Zhang, Donghui; Chen, Lin
Mosquitoes, as temperature-sensitive ectothermic vectors, exhibit temperature-dependence. This study investigates Culex pipiens pallens (Cx. pallens) responses to abrupt temperature increases and their implications on mosquito physiology. First instar larvae (24hr post hatching) and newly enclosed adults (24hr post emergence) were separately exposed to heat shock regimes of 33 °C, 37 °C, and 42 °C for 3 days alongside a control temperature of 27 °C. Results showed that mortality was triggered at 42 °C within a day. Adult male mosquitoes were less tolerant to all temperatures than larvae and adult females (p < 0.05). Exposing larvae to constant temperatures for 3 days significantly decreased larvae's development time, growth rate and adult emergence (p < 0.05). Reproductive fitness was significantly reduced (p < 0.05) in males emerging from larvae exposed to 37 °C. Life table parameters showed significant increased mortality rate, kill power and decreased life expectancy at the embryonic stage (p < 0.05). Furthermore, heatwaves deactivated the Transient receptor protein ankyrin 1 at 37 °C (p < 0.05) in larvae but not adults. Calmodium, Heat shock protein 90, and small heat shock protein expression were significantly decreased in larvae at 37 °C (p < 0.05) as compared to larvae raised at 33 °C and 27 °C. In conclusion, we classified the heat waves into three categories: adaptable (33 °C), critical (37 °C), and fatal (42 °C). Prolonged exposure of Culex pallens larvae to extreme heat affects the male reproductive output. These findings may serve as an important reference for forecasting vector and pest dynamics and used to tailor mosquito prevention and control measures.
Adverse drug reaction reporting with the Med Safety app inUganda: a cluster-randomised, controlled trial
(Elsevier, 2025-10) Kiguba, Ronald; Ndagije, Helen B.; Mwebaza, Norah; Ssenyonga, Ronald; Giibwa, Lilian; Isabirye, Gerald; Owiny, Jonathan; Nambasa, Victoria; Ntale, Ismail; Atuhaire, Joanitah; Mwesigwa, Douglas; Mayengo, Julius; Walusimbi, David; Mugisa, Ian; Katureebe, Cordelia; Harrison, Kendal; Karamagi, Charles; Pirmohamed, Munir
Background: The massive roll-out of new and repurposed medicines in low-income and middle-income countries (LMICs) highlights the need for more efficient pharmacovigilance systems, including use of digital technologies. We assessed the effectiveness of the Med Safety app in improving suspected adverse drug reaction (ADR) reporting by health-care workers to Uganda's National Pharmacovigilance Centre. Methods: This was a pragmatic, multicentre, open-label, cluster-randomised, controlled trial undertaken at health facilities (clusters), providing dolutegravir-based combination antiretroviral therapy in Uganda. Clusters were randomly assigned (1:1) to the intervention group or control group using a computer-generated simple randomisation sequence. In the intervention group, pharmacists with expertise in pharmacovigilance delivered 2 h of face-to-face training to health-care workers in clusters, regardless of their smartphone ownership, in Med Safety and traditional ADR reporting methods. The control group received the same training as the intervention group except for Med Safety training. The primary outcome was the cluster-level ADR reporting rate at the end of follow-up and was analysed in all sites that received the allocated intervention. The trial is registered with the Pan African Clinical Trials Registry (PACTR202009822379650) and is completed. Findings: Between Aug 11, 2020 and Nov 1, 2022, 382 clusters were randomly assigned and 367 received the allocated intervention and were included in the primary outcome analysis (184 in the intervention group and 183 in the control group), with 2464 health-care workers (1211 in the intervention group and 1253 in the control group). The follow-up time for the included clusters was variable and was median 37·8 months (IQR 34·2–39·8). In the primary analysis, the intervention group had a higher mean overall ADR reporting rate of 10·6 (SD 17·4) reports per 100 000 person-months versus 5·9 (17·9) in the control group (incidence rate ratio 1·73 [95% CI 1·26–2·37]; p=0·001). Interpretation: Med Safety increased ADR reporting rates among health-care workers in Uganda. Integrating digital technologies into pharmacovigilance systems could strengthen drug-safety monitoring in Uganda and other LMICs.
The anti-mycobacterial activity and safety profile of selected Crinum species in north western Uganda.
(Global Scientific Journals, 2021-06) Candia, Milton; Katuura, Esther; Waako, Paul
Crinum species is a source of many bioactive molecules with both antimicrobial and anti-tumor properties. Chloroform, methanol and aqueous extracts of Crinum scabrum and Crinum macowanii bulbs and leaves were investigated for their anti-mycobacterial activity against Mycobacteria tuberculosis using agar well diffusion, and broth dilution methods. Rifampicinstreptomycin resistant (R.S), pan African sensitive (H37Rv) and wild type (Sou 14827) strains of the bacteria were used. The investigation aimed to determine the anti-mycobacterial activity and safety profile of the crude extracts of Crinum scabrum and Crinum macowanii. The extracts had antimycobacterial activity that ranged between 1-5μg/ml. Their patterns of inhibition varied with the plant extract, solvent used for extraction and the organisms tested. Different concentrations of methanol extract were compared with similar concentrations of chloroform and aqueous extracts for their maximum zones of inhibition. All the extracts of Crinum macowanii were found inactive against Mycobacteria tuberculosis. Methanol leaf extract of Crinum scabrum was the most active, with minimum inhibitory concentration (MIC) less than1μg/ml and minimum bactericidal concentration (MBC) of 1μg/ml. acute toxicity test in mice for Crinum scabrum leaf was found to have LD50 greater than 2000mg/kg. In conclusion, the leaf of Crinum scabrum is a natural source of new anti-mycobacterial compound that is tolerable and effective in treatment of tuberculosis. The study recommends herbalists to use the leaves instead of bulb of C. scabrum Alani Davis for treating TB patients. In future, a comparative study should be done on activity of crude methanol leaf extract of C. scabrum and combination of the drugs used to treat multidrug resistant MTB. The active principles in the leaves of C. scabrum Alani Davis should also be isolated, identified and tested on strains of Mycobacteria tuberculosis resistant to at least two or three drugs.
Assessment of alternative approaches of primary cervical cancer screening among women in low-income environments
(Journal of Cancer Research and Experimental Oncology, 2021-01) Eilu, Emmanuel; Akinola, Saheed Adekunle; Tibyangye, Julius; Adeyemo, Rasheed Omotayo; Odoki, Martin; Adamu, Aliero Almustapha; Onkoba, Sarah Kemuma; Kemunto, Moindi Jeridah; Abyola, Ismail Adebayo; Kato, Charles Drago
Alternative techniques for detecting cancer of the cervix uteri alongside its early precancerous lesions still remain necessary for low income environments since morbidity and mortality due to cervical cancer continues to be on the rise. We recruited one thousand and seventy-seven women aged 15-55 years from selected study hospitals in Eastern Uganda and examined them using Papanicolaou (Pap) smear, direct visual inspection with 5% acetic acid solution (VIA), and human papillomavirus (HPV) DNA testing. Study participants detected with high-grade lesions (HSIL) or cancer cells on Pap smear test, positive VIA test (acetowhite lesions, cervical ulcer or growth), and positive high-risk HPV DNA (relative light units (RLU) were immediately scheduled for colposcopy and cervical biopsy. Of the forty percent of the women confirmed with pap smear positive, 43 of the 63 women had invasive carcinoma (68.3%), while 89 out of 137 women with confirmed biopsy were diagnosed with high grade CIN (CIN2,3) (65%). DVI identified 46 of 63 carcinomas (73%) as well as 47 of 74 high grades CIN (CIN 2, 3) (64%). There was a variation in HPV DNA results due to the cutoff value considered in defining the final result. HPV DNA of high-risk HPV types was detected 39 (61.9%) out the 63 women diagnosed invasive cervical cancer, while 66 (73.3%) or 46 (51%) was detected in the biopsy of women diagnosed with high grade CIN (CIN 2,3). Similarity in identification of high-grade cervical abnormalities was registered by the testing methods. Both VIA and HPV genetic testing methods diagnosed similar numbers of high grade CIN 2,3 and invasive cancer cases as Pap smears. Nevertheless, individual test methods categorized study participants with no cervical disease as being positive.
Assessment of biosafety and biorisk management practices among medical laboratory students in two institutions in Uganda
(Elsevier, 2022-09-07) Padde, John Roberts; Akiteng, Winnie; Edema, William; Atiku, Saad Mahjub; Tibyangye, Julius; Tekakwo, Job; Andruga, Cosmas; Hope, Derick; Musinguzi, Benson; Gesa, Jean Brenda; Amadile, Lawrence; Agondua, Robert
Medical laboratory workers handle clinical specimens, which are a threat of exposure to infectious agents. Notably, medical laboratory science students report for internships with only theoretical knowledge of biosafety and biorisk management practices, predisposing them to a higher risk of laboratory hazards. In this study, we assessed the influence of entry-level students' adherence to practices and attitudes towards biosafety and biorisk management during the Internship. An online survey tool was used to explore the practices and attitudes towards laboratory biosafety and risk management. Of the 96 students, 60 (62.5%) anonymous responses were received, and of these, 60.3% were direct entrants, and 32.8% were diploma entrants. Most (91.7%) of the students attended hospital internships, with 60.2% in Biosafety Level (BSL)-2 laboratories and 70.2% rotating in all the core areas of laboratory medicine. The 8.3% who did not attend any internship were under the direct entry category. Exposure to biohazards was not significantly associated with laboratory safety level and student entry category (P> 0.05). Recommended laboratory biosafety practices were not significantly associated with the safety level of the laboratory and student entry category (P> 0.05). Poor attitudes towards certain laboratory biosafety practices were not significantly associated with the biosafety level of the training laboratory (P> 0.05), whereas training (P = 0.021) and clean-up procedures (P = 0.048) were associated with laboratory safety levels, respectively. The direct entrants had no access to BSL-3 laboratories, and this category of students had a negative attitude towards internship attendance. Therefore, there is a need to create a multi-channel full range laboratory biosafety and biorisk management teaching reforms based on practical application, real case studies, and laboratory simulation to be incorporated into the curriculum to benefit the direct entrant.
Assessment of different genotyping markers and algorithms for distinguishing Plasmodium falciparum recrudescence from reinfection in Uganda
(Research Square, 2025-02-05) Mwesigwa, Alex; Golumbeanu, Monica; Jones, Sam; Cantoreggi, Sara L.; Musinguzi, Benson; Nankabirwa, Joaniter I.; Bikaitwoha, Everd Maniple; Kalyango, Joan N; Karamagi, Charles; Plucinski, Mateusz; Nsobya, Samuel L.; Nsanzabana, Christian; Byakika-Kibwika, Pauline
Antimalarial therapeutic efficacy studies are vital for monitoring the efficacy of antimalarial drugs in malaria-endemic regions. The WHO recommends genotyping of polymorphic markers including msp-1, msp-2, and glurp to aid distinguishing recrudescences from reinfections. Recently, WHO proposed replacing glurp with microsatellites (Poly-α, PfPK2, TA1). However, suitable combinations with msp-1 and msp-2 have not been systematically assessed. Additionally, the performance of different algorithms for classifying recrudescence is unclear. This study investigated various microsatellites alongside msp-1 and msp-2 for molecular correction and compared genotyping algorithms across three malaria-endemic areas in Uganda. Microsatellites 313, Poly-α, and 383 exhibited the highest diversity, while PfPK2 and Poly-α revealed elevated multiplicities of infection across all sites. The 3/3 match-counting algorithm classified fewer recrudescences than the ≥ 2/3, and Bayesian algorithms at both ≥ 0.7 and ≥ 0.8 probability cutoffs. The msp-1/msp-2/2490 combination identified more recrudescences using the ≥ 2/3 and 3/3 algorithms in the artemether-lumefantrine (AL) treatment arm, while msp-1/msp-2/glurp combination identified more cases of recrudescence using the ≥ 2/3 in the dihydroartemisinin-piperaquine (DP) arm. Microsatellites PfPK2 and Poly-α, potentially sensitive to detecting minority clones, are promising replacements for glurp. Discrepancies in recrudescence classification between match-counting and Bayesian algorithms highlight the need for standardized PCR correction practices.
Association between childhood sexual violence and low educational attainment among young people aged 18-24: Evidence from the 2018 Uganda violence against children survey
(Child Protection and Practice, 2025-02-18) Ndibalekera, Maria; Bangirana, Clare Ahabwe; Amollo, Mathew; Olido, Kenneth; Kafuko, Agatha; Opobo, Timothy; Ssenyonga, Ronald
Background: Researchers have identified various factors that contribute to low levels of educational attainment. However, studies examining the association between childhood sexual violence victimization and educational attainment remain scarce. Understanding this relationship is vital since experiencing violence during childhood is associated with poor educational outcomes and a higher likelihood of financial difficulties and employment issues later in life. Objective: This study sought to understand the association between childhood sexual violence victimization and low educational attainment for male and female young adults. Participants and setting: The study uses data from the Uganda Violence Against Children Survey (2018), focusing on participants aged 18-24. Methods: Secondary analysis was done using STATA 14 among participants aged 18-24 years from whom responses on childhood sexual violence (CSV) victimization were solicited. CSV was measured in its different forms i.e., unwanted sexual touches, attempted forced sex, physically forced sex, pressured sex and sexual exploitation, while low educational attainment was defined as being out of school and having primary or less as the highest level of education. Bivariable analysis and multivariable logistic regressions were conducted. Results: The majority (67.2%) of the sample of 2312 young adults had low educational attainment. Basing on the different forms of childhood sexual violence victimization (sexual exploitation, unwanted sexual touches, attempted forced sex, physically forced sex and pressured sex), low education attainment ranged between 59.2% and 72.3% for males and 50.9% and 72.4% for females. The different forms of CSV were not significantly associated with low educational attainment except attempted forced sex among females (P=0.011) in the bivariate analysis and child marriage in the multivariate model (P=0.022). Conclusion: Low levels of educational attainment in Uganda are prevalent and could be influenced by various factors that warrant further investigation. There is a need for additional research to clarify the association between childhood sexual violence victimization and low educational attainment. Considering the well -established advantages of education for individuals and communities, it is essential to strengthen initiatives aimed at increasing both access to and the quality of educational services.
Association between childhood sexual violence and low educational attainment among young people aged 18–24: Evidence from the 2018 Uganda violence against children survey
(Elsevier, 2025-02-21) Ndibalekera, Maria; Bangirana, Clare Ahabwe; Amollo, Mathew; Olido, Kenneth; Kafuko, Agatha; Opobo, Timothy; Ssenyonga, Ronald
Background Researchers have identified various factors that contribute to low levels of educational attainment. However, studies examining the association between childhood sexual violence victimization and educational attainment remain scarce. Understanding this relationship is vital since experiencing violence during childhood is associated with poor educational outcomes and a higher likelihood of financial difficulties and employment issues later in life. Objective This study sought to understand the association between childhood sexual violence victimization and low educational attainment for male and female young adults. Participants and setting. The study uses data from the Uganda Violence Against Children Survey (2018), focusing on participants aged 18–24. Methods Secondary analysis was done using STATA 14 among participants aged 18–24 years from whom responses on childhood sexual violence (CSV) victimization were solicited. CSV was measured in its different forms i.e., unwanted sexual touches, attempted forced sex, physically forced sex, pressured sex and sexual exploitation, while low educational attainment was defined as being out of school and having primary or less as the highest level of education. Bivariable analysis and multivariable logistic regressions were conducted. Results The majority (67.2%) of the sample of 2312 young adults had low educational attainment. Basing on the different forms of childhood sexual violence victimization (sexual exploitation, unwanted sexual touches, attempted forced sex, physically forced sex and pressured sex), low education attainment ranged between 59.2% and 72.3% for males and 50.9% and 72.4% for females. The different forms of CSV were not significantly associated with low educational attainment except attempted forced sex among females (P = 0.011) in the bivariate analysis and child marriage in the multivariate model (P = 0.022). Conclusion Low levels of educational attainment in Uganda are prevalent and could be influenced by various factors that warrant further investigation. There is a need for additional research to clarify the association between childhood sexual violence victimization and low educational attainment. Considering the well established advantages of education for individuals and communities, it is essential to strengthen initiatives aimed at increasing both access to and the quality of educational services.
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.
Bacteriological profile, antibiotic susceptibility and factors associated with neonatal Septicaemia at Kilembe mines hospital, Kasese District Western Uganda
(Springer Nature, 2021-11-04) Zamarano, Henry; Musinguzi, Benson; Kabajulizi, Immaculate; Manirakiza, Godfrey; Guti, Walker; Muhwezi, Ivan; Ayan, Ahmed Hussein; Baweera, Agnes; Kabahinda, Boaz; Itabangi, Herbert; Bazira, Joel; Kabanda, Taseera
Neonatal septicaemia is one of the most common leading causes of neonatal morbidity and mortality in developing countries. It is estimated to affect more than 30 million people worldwide annually, potentially leading to 6 million deaths.The objective of the study was to determine the prevalence, bacteriological profile, antibiotic susceptibility and factors associated with neonatal septicaemia among neonates suspected to sepsis at Kilembe mines hospital. We conducted a descriptive cross-sectional study, where purposive sampling technique was used and blood was drawn from 122 neonates suspected to sepsis attending Kilembe Mines Hospital during the period (July to November 2020). Specimens were inoculated in Brain heart infusion broth, transported to Fortportal Regional Referral Hospital, plated daily up to 7 days on blood, chocolate, MacConkey agar and incubated in aerobic and 5% carbondioxide. Pure colonies were identified by Gram stain, biochemical tests and antibiotic sensitivities obtained by Kirby Bauer disc diffusion method. Associations were tested using Chi square with Fisher’s exact or Yates correction tests where necessary and statistical significance was set at P < 0.05. Stata (version 14) used for statistical analysis. Blood cultures were positive in 59.0% cases with 55.5% male and 44.4% female. EOS was present in 56.9% and LOS 43.1% of the cases. Gram negative (56.9%) organisms were most implicated with neonatal septicaemia than Gram positives ones (43.1%). Gram positive organisms exhibited better susceptibility to amikacin, linezolid and vancomycin but more resistant to ampicillin and gentamicin. Of the aminoglycosides, amikacin exhibited a verge over netilmicin and gentamicin against Gram negative isolates. Risk factors of neonatal septicaemia were mother’s age of ≥25 years, employed mothers, tertiary-level of education, SVD, ANC attendance of ≥4 times, UTI during pregnancy, PROMS, foul Smelling liquor, urban residence, neonatal birth weight of ≥2500 g, Apgar score 1st and 5th min ≥6 and resuscitation.
Birth intervals and associated factors among women attending young child clinic in Yumbe hospital , Uganda.
(International Journal of Reproductive Medicine, 2020-01-04) Aleni, Mary; Mbalinda, S. N.; Muhindo, R.
Evidence suggests that both short and long birth intervals are associated with poor maternal and child health outcomes. However, current studies suggest that a number of births still occur at short intervals. The aim of this study was to document birth intervals and associated factors among women of reproductive age in rural Uganda. Materials and Methods. This was a cross-sectional study conducted among 296 women aged 15-49 years attending young child clinic at Yumbe Hospital who had at least two successive live births. Data was collected using interviewer-administered questionnaire. Birth interval was categorized according to the WHO-recommended birth interval of ≥24 months and <24 months. Results. Of the 296 participants, 86.6% desired a birth interval ≥ 24 months with a desired median birth interval of 36 months. The actual median birth interval was 22 months. Slightly more than half of the women (52.4%) had short birth intervals. Factors which were likely to be associated with short birth intervals included being younger (15-24 years) (AOR = 4:39, 95%CI = 1:49‐12:93, P = 0:007), not planning to have another pregnancy (AOR = 0:33, 95%CI = 0:18‐0:58, P = 0:001), not deciding together with husband when to have the next child (AOR = 3:10, 95%CI = 1:53‐6:28, P = 0:002), not always using contraceptives before the next pregnancy (AOR = 0:28, 95%CI = 0:12‐0:64, P = 0:003), and lack of influence of husband on when to have the next child (AOR = 2:59, 95% CI = 1:44 – 4:64, P = 0:001). Conclusion. Prevalence of short birth intervals is still high in rural Uganda (52.4%), although majority (86.6%) of the women desire optimal birth intervals. Factors which were likely to be associated with short birth intervals included young maternal age, not using contraceptives, and lack of male involvement in child spacing activities. Therefore, to optimize birth intervals, focused child spacing strategies targeting young women and men are needed
Clinical teaching of university-degree nursing students: are the nurses in practice in Uganda ready?
(BMC Nursing, 2021-01-04) Drasiku, Amos; Gross, Janet L.; Jones, Casey; Nyoni, Champion N.
Background: Nurses with degree qualifications offer better nursing care compared to nurses prepared at lower levels. University based nursing degrees have been sanctioned as entry into professional nursing and several lowresource states have introduced university based nursing degrees. The clinical teaching of students enrolled in such degrees is challenged, as most nurses in practice do not have university degrees and may not have the necessary skills to facilitate clinical learning as expected at degree level. A university in Uganda established a bachelor’s degree in Nursing program and was expecting to use nurses in practice at a teaching hospital for the clinical teaching of university-degree nursing students. This study reports on the perceptions of the nurses in practice regarding their readiness for the clinical teaching of undergraduate nursing students. Methods: A qualitative descriptive research study was conducted among 33 conveniently sampled nurses from Arua Regional Referral Hospital (ARRH) who had been supervising Diploma and/or Certificate in Nursing students. Five focus group discussions and three informant interviews were used to generate the data. Data were transcribed verbatim and analysed using an inductive approach through thematic analysis. Results: The nurses in practice perceived themselves as ready for clinical teaching of undergraduate nursing students. Three themes emerged namely; “Willingness to teach undergraduate students” “Perceived attributes of undergraduate students”, and “The clinical practice environment”. Conclusion: The nurses in practice need support in the execution of the clinical teaching role of university-degree nursing students. The nature of supports would include, continuing professional development specific to clinical teaching, engaging the educators in the clinical environment, positively engaging power gradients and address insecurities among the nurses and the students. Students in these programmes should be exposed to the clinical environment earlier within the programme, and be exposed to interprofessional and trans-professional education.
Detection of filarial IgG and IgM antibodies among individuals with lymphedema in the Kamwenge District, Western Uganda
(Springer Nature, 2025-07-08) Mwesigye, Vicent; Tebulwa, Joanita Berytah; Musinguzi, Benson; Agaba, Bosco Bekita; Bagenda, Charlse Nkubi; Bajunirwe, Francis; Bazira, Joel; Mulogo, Edgar; Herbert, Itabangi; Byarugaba, Frederick
Filarial infections trigger a complex immune response characterized by the production of different antibodies, particularly immunoglobulin G (IgG) and immunoglobulin M (IgM). These immunoglobulins play a key role in diagnosing the disease, with IgM typically indicating recent infection and IgG reflecting past or ongoing exposure. Assessing their presence provides valuable insight into an individual's immune response and infection history. This study examined the levels of IgG and IgM in people living with lymphedema in the Kamwenge district, Western Uganda, to better understand their immunological status in relation to filarial infection. This cross-sectional study, conducted in the Kamwenge district, aimed to assess the presence of anti-filarial antibodies among lymphedema patients. A total of 154 participants, predominantly female (71.4%), with a mean age of 54.7 years, were selected through simple random sampling. Serological testing using the Abbexa Filariasis IgG/IgM Rapid Test revealed that 10.4% tested positive for IgG, and 1.9% for IgM antibodies. We enrolled a total of 154 participants, the majority of whom were female 110 (71.4%) while 44 (28.6%) were male. The participants had a mean age of 54.7 years, with a standard deviation of 15.6 years. Overall, 10.4% (n=16) tested positive for filarial antibodies. Specifically, 10.4% (n=16) were positive for filarial IgG, while 1.9% (n=3) tested positive for IgM antibodies. The serological findings demonstrated a low prevalence of recent filarial infections, with a higher occurrence of past or chronic exposure among participants. This suggests that while active transmission may be limited, lymphatic filariasis remains an ongoing public health concern in the Kamwenge district. These results emphasize the need for continued surveillance, early detection, and targeted interventions to effectively manage and mitigate the burden of filarial-related lymphedema in the region.
Distribution and antifungal susceptibility profile of oropharyngeal Candida species isolated from people living with HIV in the era of universal test and treat policy in Uganda
(Sage Publishing, 2024-04-30) Musinguzi, Benson; Turyamuhika, Laban; Mwesigwa, Alex; Nalumaga, Pauline Petra; Kabajulizi, Immaculate; Njovu, Israel Kiiza; Mwebesa, Edson; Luggya, Tonny; Ocheng, Francis; Kateete, David Patrick; Itabangi, Herbert; Mboowa, Gerald; Sande, Obondo James; Achan, Beatrice
Despite the increased frequency of oropharyngeal candidiasis among people living with human immunodeficiency virus (HIV), its management is no longer effective due to empirical treatment and emergence of antifungal resistance (AFR). This study sought to investigate the prevalence of oropharyngeal candidiasis and assess the antifungal susceptibility profile of oropharyngeal Candida species isolated from people living with human immunodeficiency virus. Additionally, we evaluated the correlation between oropharyngeal candidiasis and CD4 T cell as well as viral load counts. A descriptive cross-sectional study was carried out from April to October 2023 in which 384 people living with HIV underwent clinical examination for oral lesions. Oropharyngeal swabs were collected and cultured on Sabouraud Dextrose agar to isolate Candida species which were identified using the matrix assisted laser desorption ionization time of flight mass spectrometry. Additionally, the antifungal susceptibility profile of Candida isolates to six antifungal drugs was determined using VITEK® (Marcy-l’Étoile, France) compact system. Data on viral load were retrieved from records, and CD4 T cell count test was performed using Becton Dickinson Biosciences fluorescent antibody cell sorter presto. The prevalence of oropharyngeal candidiasis was 7.6%. Oropharyngeal candidiasis was significantly associated with low CD4 T cell count and high viral load. A total of 35 isolates were obtained out of which Candida albicans comprised of 20 (57.1%) while C. tropicalis and C. glabrata comprised 4 (11.4%) each. C. parapsilosis, C. dubliniensis and C. krusei accounted for 2 (5.7%) each. Additionally, 7 (20%) isolates were resistant to fluconazole, 1 (2.9%) to flucytocine and 0.2 (5.7%) isolates were intermediate to caspofungin. However, specific specie isolates like C. albicans showed 20% (4/20), C. glabrata 50% (2/4) and C. krusei 50% (1/2) resistance to fluconazole. Additionally, C. krusei showed 50% resistance to flucytosine. The prevalence of oropharyngeal candidiasis (OPC) among people living with HIV was low, and there was a significant association between OPC and CD4 T cell count as well as viral load. C. albicans was the most frequently isolated oropharyngeal Candida species. C. glabrata and C. krusei exhibited the highest AFR among the non-albicans Candida species. The highest resistance was demonstrated to fluconazole.
Distribution of Candida species isolated from people living with human immunodeficiency virus with oropharyngeal and oral candidiasis in Africa in the era of universal test and treat policy: a systematic review and meta‑analysis
(Springer Nature, 2024-11-27) Musinguzi, Benson; Obuku, Ekwaro A.; Mwesigwa, Alex; Migisha, Richard; Kinengyere, Alison Annet; Ndagire, Regina; Baguma, Andrew; Okek, Erick Jacob; Olum, Ronald; Itabangi, Herbert; Mboowa, Gerald; Sande, Obondo James; Achan, Beatrice
Background: The introduction of antiretroviral therapy (ART) and the implementation of the human immunodeficiency virus (HIV) universal test and treat (UTT) policy have led to a decline in the incidence of opportunistic infections. However, oropharyngeal and oral candidiasis remain prevalent and continue to pose challenges among people living with human immunodeficiency virus (PLHIV) in Africa, indicating the need for a better understanding of the distribution of Candida species responsible for these infections. This systematic review and meta-analysis aimed to determine the distribution of Candida species isolated from PLHIV with oropharyngeal and oral candidiasis in Africa in the era of UTT policy. Methods: The review followed the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. A comprehensive search was conducted to identify eligible studies to be included in the meta-analysis and analysed using a random effects model in STATA version 17. The risk of bias was assessed using the Joanna Briggs Institute quality assessment tool. Results: Fourteen studies with 4281 participants were included in the review. Overall, 2095 Candida isolates were reported, 78.7% (1650/2095) of which were C. albicans, 19.6% (410/2095), non-albicans Candida (NAC), and 1.7% (35/2095) could not be identified to the Candida specific species level. The most prevalent NAC species were C. glabrata (26.3%), followed by C. tropicalis (24.9%), C. krusei (15.6%), C. parapsilosis (11%), and C. dubliniensis (6.3%). The pooled prevalence of oropharyngeal and oral candidiasis was 48% (95% CI 34–62%). The prevalence of oropharyngeal candidiasis was higher in the pre-UTT era, at 56% (95% CI 40–72%, p < 0.001), than in the post-UTT era, at 34% (95% CI 10–67%, p < 0.001). The risk of bias assessment revealed that 71.4% (10/14) of the included studies had a low risk of bias and that 28.6% (4/14) had a moderate risk of bias. Conclusions: While C. albicans remain, the predominant species causing oropharyngeal and oral candidiasis among PLHIV in Africa, NAC species also contribute significantly to the infection burden. Despite ART and UTT policies, oropharyngeal candidiasis remains prevalent, emphasizing the need for targeted interventions.
Dyslipidemia and associated factors among people living with HIV on dolutegravir-based antiretroviral therapy in central Uganda
(SAGE Publications, 2025-10-23) Timbigamba, Flavia; Bagenda, Charles Nkubi; Sembogga, Hendry; Wasswa, Timothy; Bazibu, Faizo; Ssali, Joseph; Ssemwanga, Elastus; Mugisa, Michael Junior; Nuwagaba, Edwin; Ojuko, Samuel; Nantongo, Carol; Wafwoyo, Jesca Akoth; Musinguzi, Benson; Akiteng, Winnie; Osuwat, Lawrence Obado
Introduction Dolutegravir (DTG)-based antiretroviral therapy (ART) use has been associated with excessive weight gain, increasing the risk of dyslipidemias such as hypercholesterolemia. We assessed the prevalence of, and associated factors with dyslipidemia among adults on DTG-based ART. Materials and methods We conducted a cross-sectional study among 281 systematically sampled adults on DTG-based ART for ≥ 6 months at Kira Health Centre IV, Wakiso District, Central Uganda. Data were collected through structured questionnaires, medical record reviews, anthropometric measurements, and laboratory biomarker analysis. Logistic regression was used to determine associated factors, and the predictive performance of obesity indices was evaluated using receiver operating characteristic (ROC) curve analysis. Results The prevalence of dyslipidemia was 44.1% 95% CI: 38.4%–50.0%. Low high-density lipoprotein (HDL) cholesterol was the most common abnormality, affecting 39.9% of participants, followed by elevated total cholesterol at 5.7% [95% CI: 3.51–9.11] and elevated low-density lipoprotein (LDL) cholesterol at 5.0%. High waist circumference (WC) was significantly associated with dyslipidemia; (aPR: 1.93, 95% CI: 1.15–3.24, p = .013), and demonstrated a significant ability to predict dyslipidemia with area under the curve (AUC) of 0.577 [95% CI: 0.511–0.644]. The AUC for WC in predicting hypercholesterolemia, elevated LDL-C, and low HDL-C were 0.702 (95% CI: 0.547–0.857), 0.729(95% CI: 0.590–0.867), and 0.548 (95% CI: 0.481–0.616) respectively. Conclusion Dyslipidemia is prevalent among adults on DTG-based ART, and is potentially associated with high WC.
Ethnicity, gender, and migration status:
(Wolters Kluwer Health, 2022-07-29) Mangwi, Richard Ayiasi; Mangwi, Alice Jean Ochola; Young, Ruth; Orach, Christopher Garimoi; Morgan, Rosemary
Globally, 298,000 women die due to pregnancy related causes and half of this occurs in Africa. In Uganda, maternal mortality has marginally reduced from 526 to 336 per 100,000 live births between 2001 and 2016. Health facility delivery is an important factor in improving maternal and neonatal outcomes. However, the concept of using a skilled birth attendant is not popular in Uganda. An earlier intervention to mobilize communities in the Masindi region for maternal and newborn health services discovered that immigrant populations used maternal health services less compared to the indigenous populations. The aim of this qualitative study was therefore to better understand why immigrant populations were using maternal health services less and what the barriers were in order to suggest interventions that can foster equitable access to maternal health services. Five focus group discussions (FGDs) (three among women; 2 with men), 8 in-depth interviews with women, and 7 key informant interviews with health workers were used to better understand the experiences of immigrants with maternal and newborn services. Interviews and FGDs were conducted from July to September 2016. Data were analyzed using content analysis and intersectionality. Results were based on the following thematic areas: perceived discrimination based on ethnicity as a barrier to access, income, education and gender. Immigrant populations perceived they were discriminated against because they could not communicate in the local dialect, they were poor casual laborers, and/or were not well schooled. Matters of pregnancy and childbearing were considered to be matters for women only, while financial and other decisions at the households are a monopoly of men. The silent endurance of labor pains was considered a heroic action. In contrast, care-seeking early during the onset of labor pains attracted ridicule and was considered frivolous. In this context, perceived discrimination, conflicting gender roles, and societal rewards for silent endurance of labor pains intersect to create a unique state of vulnerability, causing a barrier to access to maternal and newborn care among immigrant women. We recommend platforms to demystify harmful cultural norms and training of health workers on respectful treatment based on the 12 steps to safe and respectful mother baby-family care. Abbreviations: FGDs = Focus group discussions, IDI = In-depth interviews, MNCH = maternal newborn child health, USD = United States dollars.
Evaluating psychometric properties of three mentoring scales among nurses and midwives in hospital settings: A methodological study
(Wiley, 2023-10-11) Kakyo, Tracy Alexis; Xiao, Lily Dongxia; Chamberlain, Diane
Scales used to evaluate nurses’ perspectives of mentoring programmes are mainly designed in developed countries, making them unsuitable for nurses and midwives working in resource-poor developing countries. To explore the psychometric properties of the perceived cost of mentoring (PCM) scale, negative mentoring experiences (NME) scale and relational mentoring index (RMI) for adaptation in hospital settings in Uganda. A cross-sectional study design was used. In total, 303 hospital nurses/midwives in Ugandan participated in the study to evaluate the psychometric properties of the three mentoring scales. Revisions based on word choice were made in adapting the scales to the Ugandan context. The PCM showed three factors (risk to reputation, mentoring effort and nepotism) and had an intra-class correlation (ICC) of 0.609 (95% CI, 0.324–0.793) and Cronbach's alpha of 0.705. The NME scale had two factors (lack of mentor expertise and mismatch between the dyad) consistent with the original scale with an ICC of 0.568 (95% CI, 0.271–0.767) and Cronbach's alpha of 0.841. The RMI showed two factors (individual influence and relational quality) with an ICC of 0.664 (95% CI, 0.410–0.824) and Cronbach's alpha of 0.933.The initial psychometric assessment indicates satisfactory validity and reliability of the scales for implementation among nurses and midwives within Ugandan hospital contexts. Subsequent research is warranted to validate the factor structures of the scales on a different sample. In using mentoring programmes to develop the hospital workforce, nurse and midwifery policymakers need to use culturally adapted and validated PCM, NME, and RMI scales to evaluate the quality of these mentoring programmes to maximise the benefits while avoiding unintended consequences.
Exploring the dark side of informal mentoring: Experiences of nurses and midwives working in hospital settings in Uganda
(Wiley, 2024-04-12) Kakyo, Tracy Alexis; Xiao, Lily Dongxia; Chamberlain, Diane
Mentoring literature explores the dark side of mentoring as factors such as gender and race and how they affect the overall mentoring experience. The sociocultural context of the nursing and midwifery professions presents unique characteristics warranting a qualitative exploration of negative mentoring experiences. We aimed to characterise the dark side of mentoring based on informal mentoring relationships occurring among nurses and midwives working in hospitals. Utilising semistructured interviews in a qualitative descriptive design and reflexive thematic analysis, we examined the perceptions of 35 nurses and midwives from three public hospitals located in the Western, Northern and North-western regions of Uganda. Findings emerged in four overarching themes mentoring process deficits, mentoring relational problems, organisational challenges in mentoring and implications of negative mentoring experiences. Our study findings underscore that, while mentoring is frequently beneficial, it can also be interspersed with negative experiences arising from relational dynamics, particular mentoring processes and the overarching hospital environment. Notably, nurses and midwives actively transformed these challenges into opportunities for growth and self-improvement, while introspectively examining their roles in contributing to these negative experiences. Such a proactive approach highlights their resilience and steadfast commitment to professional development, even in the face of adversity.

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