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Item In vivo aphrodisiac efficacy of aqueous and hydroalcoholic extracts of the leaf and root bark of Citropsis articulata (Willd. ex Spreng.) Swingle & M. Kellerm. in male Wistar rats(Elsevier, 2025-11-13) Amaza, Ronald Anyase; Amutuhaire, Treasure Angie; Tusiimire, Jonans; Amito, Vivian Sharon; Ajayi, Clement Olusoji; Angupale, Jimmy Ronald; Abdelgadir, Abdelgadir Alamin; Ogwang, Patrick Engeu; Anywar, GodwinEthnopharmacological relevance: Citropsis articulata (Willd. ex Spreng.) Swingle & M.Kellerm (Rutaceae), commonly known as the African cherry orange, is traditionally used to enhance male sexual performance and manage erectile dysfunction in various African communities. Aim of the study: This study aimed to evaluate the aphrodisiac efficacy of the aqueous and hydroalcoholic extracts of C. articulata leaf and root bark in male Wistar rats. Materials and methods: Aqueous extracts (decoctions) were prepared by boiling 500 g of dried herbal powder in 4 L of distilled water for 60 min. Hydroalcoholic extracts were obtained by Soxhlet extraction, where 500 g of the powder was continuously percolated with 2.5 L of 70 % ethanol. Male Wistar rats (n = 6 per group) were administered the extracts at doses of 100, 500, and 1000 mg/kg daily for 28 days. Control groups included two negative controls (distilled water and 10% DMSO + 0.1% gum arabic) and a positive control (sildenafil citrate, 5 mg/kg). Sexual behaviour parameters—including attraction to the female, penile erection, mount frequency, and mount latency—were assessed on days 0, 3, 7, 14, 21, and 28. At day 28, three animals per group were sacrificed for evaluation of testosterone levels, sexual organ weights, and histological analysis. The remaining three animals in each group were observed without further dosing for an additional 14 days, with behavioural assessments on days 35 and 42, before being sacrificed for post-treatment evaluation of sustained or delayed effects. Results: Both the root bark and leaf extracts of C. articulata significantly enhanced attraction towards the female, penile erection, and mount frequency, while reducing mount latency in male Wistar rats. The leaf extracts exhibited a slightly stronger aphrodisiac effect compared to the root bark, especially at the 500 mg/kg dose, where the leaf decoction produced a greater increase in testosterone levels and more pronounced improvements in sexual behaviour. Notably, administration of the leaf decoction at 500 mg/kg resulted in a significantly higher testosterone level (14.50 ± 2.53 ng/ml) compared to the positive control (sildenafil citrate, 4.00 ± 2.70 ng/ml; p = 0.021, 95 % CI: −19.45 to −1.533). After 28 days of treatment, testosterone levels were elevated across all extract-treated groups but declined markedly in animals monitored for an additional 14 days without dosing. Histological analysis showed active spermatogenesis during treatment, which diminished following cessation of extract administration. Conclusion: This study revealed that both the root bark and leaf of C. articulata have aphrodisiac efficacy in male Wistar rats in vivo.Item 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 ObadoIntroduction 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.Item Implementing a rapid cascade training model to enhance laboratory response during the Sudan virus disease outbreak in Uganda, 2022(African Field Epidemiology Network (AFENET), 2025-07-28) Eilu, Roggers Michael; Otita, Morgan; Kiiza, Daniel; Musinguzi, Benson; Aluma, Gerald; Ocatre, Ronald; Nankoma, Claire; Kwiringira, Andrew; Tukamuhebwa, Paddy Mutungi; Byonanebye, Dathan; Kesande, Maureen; Kawere, Boneventure Brian; Mugerwa, Ibrahim; Namusoosa, Ritah; Kagirita, Atek; Nsibambi, Thomas; Nanyondo, Judith; Boore, Amy; Nabadda, Suzan; Kakooza, Francis; Lamorde, MohammedIntroduction: In September 2022, Uganda experienced an outbreak of Sudan Virus Disease. We describe the roll-out of a rapid cascade training model which was implemented to enhance the capacity of laboratory response teams in managing samples at both national and subnational levels. Method: A training package was developed, reviewed by laboratory pillar members and approved by the Ministry of Health. The laboratory pillar team facilitated a national training program for trainers from national and specialized referral laboratories. Officers trained at the national level then trained regional laboratory officers, who trained district-level trainers and personnel from health facilities. The mean pre-test and post-test scores were compared using the paired t-test to evaluate knowledge improvement among participants. The turnaround time for laboratory results before and after training was monitored using the national results dispatch system. Results: Within two weeks of the development of the training package, 89 national and 133 regional trainers were trained, alongside 685 district laboratory response teams, 60 hub riders and drivers, and 86 mortuary attendants. There was a marked improvement in post-test knowledge assessments versus pre-test scores at both national and sub-national levels, as well as across all targeted health worker cadres from 59% to 87% (p<0.001). The swift increase in the number of personnel available to collect and refer samples post-training contributed to a rise in the number of samples collected, from 315 in the initial two weeks of response prior to the training, to a cumulative total of 4,430 by the conclusion of the outbreak. Additionally, the turnaround time was reduced from 144 hours before training to 24 hours after training. Conclusion: Implementing rapid cascade training during an outbreak response is both practical and advantageous. It boosts laboratory personnel’s confidence in handling high-risk pathogen samples and enhances sample quality. The quick increase in trained laboratory staff in the intervention areas led to more personnel available for quality sample management, reduced fatigue among the initially small team, and consequently, a shorter turnaround time.Item 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 MugemaBackground 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.Item 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, MunirBackground: 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.Item Prevalence and factors associated with neonatal hypothermia: a cross-sectional study among healthy term neonates in a peri-urban hospital in Northern Ugand(Springer Nature, 2025-10-08) Akao, Mary Grace; Nalwadda, Gorrette; Epuitai, Joshua; Ayebare, Elizabeth; Ndeezi, Grace; Ratib, Dricile; Tumwine, James KBackground Neonatal hypothermia is highly prevalent even in warm tropical countries. Neonatal hypothermia increases the risk of morbidity and mortality. In Uganda, the prevalence of hypothermia is not known among healthy term neonates. Objective To determine the prevalence of neonatal hypothermia and the associated factors in Lira Regional Referral Hospital. Methods Hospital-based cross-sectional study was conducted in Northern Uganda. The interviewer-administered questionnaires and direct observations used to determine the initiation of warm-chain practices after delivery for 271 newborns. The axillary temperature of neonates was measured at intervals of 10 min, 30 min, one hour, and 2 h after birth. The multivariate binary logistic regression was done. The 95% confidence interval (CI) and p-value < 0.05 used to identify factors significantly associated with neonatal hypothermia. Results Neonatal hypothermia was 67.6% during the first two hours postnatal. Neonatal hypothermia was 64.5% at 10 min, 81% at 30 min, 76% at one hour and 49% at two hours postnatal. Hypothermia was significantly associated with low birth weight (Adjusted odds ratio (AOR) = 2.78; 95% CI: 1.01–7.62); male sex (AOR = 1.69; 95% CI: 1.04–3.33), not drying the newborn (AOR = 3.06, 95% CI: 1.64–5.72); no skin to skin contact within five minutes postnatal (AOR = 2.17, 95% CI: 1.15–4.10); and low maternal body temperature (AOR = 2.70, 95% CI: 1.49–4.76). Conclusions The prevalence of neonatal hypothermia was high in the first two hours. Neonates who were more likely to have hypothermia were male, not dried properly, low birth weight, no skin-to-skin contacts, and low maternal body temperature. Proper drying of the newborn and skin-to-skin contact can reduce the burden of neonatal hypothermia. There is a need to train the midwives on proper drying of the newborn, keeping the mother warm, and the importance of skin-to-skin contact in prevention of neonatal hypothermia among male and low birth neonates.Item Prevalence of malaria among individuals living with lymphedema in Kamwenge District, Western Uganda(Springer Nature, 2025-10-02) Mwesigye, Vicent; Tebulwa, Joanita Berytah; Musinguzi, Benson; Muzafaru, Twinomujuni; Zamarano, Henry; Bagenda, Charles Nkubi; Mulogo, Edgar; Byarugaba, Frederick; Herbert, ItabangiLymphedema, also known as elephantiasis, is a long-term and often debilitating condition characterized by the progressive swelling of limbs due to poor lymphatic drainage. While lymphatic filariasis, a mosquito-borne disease, is a common infectious cause globally, non-infectious forms such as podoconiosis resulting from prolonged exposure to mineral-rich soils are also prevalent in many low-resource, endemic regions. In areas where both malaria and lymphedema occur, malaria may further affect individuals already suffering from chronic swelling. In Kamwenge District, Western Uganda, lymphedema is a recognized public health concern, yet the contributing factors remain poorly understood. This lack of clarity complicates effective diagnosis, treatment, and disease control. This study aimed to assess the presence of malaria among individuals living with lymphedema in this setting. A cross-sectional study was conducted among 154 individuals with clinically confirmed lymphedema, recruited through purposive sampling from Rukunyu Hospital and surrounding communities. Data collection involved structured interviews, physical examinations, and venous blood sampling. Malaria infection was determined through microscopic examination of blood smears. Of the 154 participants, 71.4% were female, with an average age of 54.7 years. Plasmodium falciparum was detected in 3.3% (n=5) of the individuals. The majority (96.8%) had bilateral lower limb lymphedema and resided in rural areas, primarily engaged in subsistence farming. The presence of malaria among individuals with lymphedema highlights the need for integrated healthcare approaches in areas where multiple parasitic diseases are endemic. Although malaria was detected in a small portion of participants, its occurrence alongside lymphedema underscores the importance of continued disease surveillance, targeted interventions, and community education to support affected populations.Item 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, JonathanBackground 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.Item 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, DeusdeditObjectives: 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.Item 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 EdwardUnintended 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.Item One-year follow-up effects of the informed health choices secondary school intervention on students’ ability to think critically about health in Uganda: a cluster randomized trial(Springer Nature, 2025-02-26) Ssenyonga, Ronald; Oxman, Andrew D.; Nakyejwe, Esther; Chesire, Faith; Mugisha, Michael; Nsangi, Allen; Oxman, Matt; Rose, Christopher James; Rosenbaum, Sarah E.; Moberg, Jenny; Kaseje, Margaret; Nyirazinyoye, Laetitia; Dahlgren, Astrid; Lewin, Simon; Sewankambo, Nelson K.Introduction We assessed the effects of the Informed Health Choices (IHC) secondary school intervention on students’ ability to think critically about choices 1 year after the intervention. Methods We randomized eighty secondary schools to the intervention or control (usual curriculum). The schools were randomly selected from the central region of Uganda and included rural and urban, government, and privately-owned schools. One randomly selected class of year-2 students (ages 14–17) from each school participated in the trial. The intervention included a 2-day teacher training workshop, 10 lessons accessed online by teachers and delivered in classrooms during one school term (May–August 2022). The lessons addressed nine prioritized IHC concepts. We used two multiple-choice questions for each concept to evaluate the students’ ability to think critically about choices at both the end of the school term and again after 1 year. The primary outcome was the proportion of students with a passing score (≥ 9 of 18 questions answered correctly) on the “Critical Thinking about Health” (CTH) test. Results After 1-year, 71% (1749/2477) of the students in the intervention schools and 71% (1684/2376) of the students in the control schools completed the CTH test. In the intervention schools, 53% (934/1749) of students who completed the test had a passing score compared to 33% (557/1684) of students in the control schools (adjusted difference 22%, 95% CI 16–28). Conclusions The effect of the IHC secondary school intervention on students’ ability to assess health-related claims was largely sustained for at least 1 year. Trial registration Pan African Clinical Trial Registry PACTR202204861458660. Registered on 4 April 2022.Item 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, RonaldBackground 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.Item Total cholesterol/high-density lipoprotein cholesterol ratio is a significant predictor of metabolic syndrome among people on dolutegravir-based antiretroviral therapy: A cross-sectional study in southwestern Uganda(Sage, 2025-08-29) Bagenda, Charles Nkubi; Nantongo, Carol; Ssemwanga, Elastus; Mugisa, Michael Junior; Ojuko, Samuel; Sempijja, Fred; Nzaramba, Daniel; Kiconco, Ritah; Ssedyabane, Frank; Musinguzi, Benson; Akiteng, Winnie; Tusubira, Deusdedit; Osuwat, Lawrence Obado; Rugera, Simon PeterObjective: The total cholesterol/high-density lipoprotein cholesterol ratio is a predictor of nonalcoholic fatty liver disease—a hepatic manifestation of metabolic syndrome. This study investigated the association between total cholesterol/high-density lipoprotein cholesterol ratio and metabolic syndrome among people living with human immunodeficiency virus on dolutegravir-based antiretroviral therapy in southwestern Uganda. Methods: We conducted a secondary analysis of data obtained from a cross-sectional study of 377 adults who had been on dolutegravir-based antiretroviral therapy for at least 1 year at Ruhoko Health Centre IV, southwestern Uganda. Results: The median total cholesterol/high-density lipoprotein cholesterol ratio was significantly higher in individuals with metabolic syndrome (3.92) than in those without (2.96, p < 0.001). A statistically significant association was observed between high total cholesterol/high-density lipoprotein cholesterol ratio and metabolic syndrome (adjusted odds ratios: 2.06, 95% confidence interval: 1.08–3.91, p 1⁄4 0.028). The total cholesterol/high-density lipoprotein cholesterol ratio at an optimal cutoff of 3.30 had a significant ability (area under the curve 1⁄4 0.696, 95% confidence interval: 0.642–0.750) to differentiate participants with metabolic syndrome from those without at a sensitivity of 73% and specificity of 60%. Conclusion: The total cholesterol/high-density lipoprotein cholesterol ratio is a significant pre-dictor of metabolic syndrome and serves as a potential blood-based biomarker.Item 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, FrederickFilarial 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.Item Pou2f3 modulates mosquito host-seeking behavior by regulating skin microbiota and their production of volatiles: Implications for eco-friendly pest control strategies(ACS Publications, 2025-06-26) Wang, Hui; Ruixi, Qian; Wang, Yuxiang; Li, Lanxi; Wu, Wenxuan; Chen, Yunxuan; Li, Wenqing; Wijewardana, Chanuka Nisalanka; Zhou, Yinghui; Padde, John Roberts; Wang, Yuxiang; Hou, Min; Xu, Zhipeng; Ji, MinJun; Chen, Lu; Chen, LinSkin microbiota-derived volatile metabolites are critical for mosquito host-seeking and disease transmission. Similar volatile organic compounds (VOCs)-mediated mechanisms may apply to agricultural pests (e.g., aphids, whiteflies). We demonstrate that Pou2f3, a skin-enriched transcription factor, regulates β-defensin1 expression, shaping microbiota composition and volatile production. Pou2f3-deficient mice exhibited increased Staphylococcus abundance and elevated 1-methoxy-2-propanol levels, enhancing attraction in Culex and Aedes mosquitoes. This VOC, alongside other microbiota-derived compounds, could inspire targeted attractants for eco-friendly pest control via species-specific lures in integrated pest management (IPM). By bridging medical entomology and agricultural chemistry, this work advances sustainable solutions against vector-borne diseases and agricultural pests through precision chemical ecology strategies.Item Prevalence of malaria and associated risk factors among febrile under-five refugee children attending Panyadoli Health Centre III, Kiryandongo District, Mid-western Uganda(Springer Nature, 2025-05-25) Acan, Dorcus; Opiro, Robert; Musinguzi, Benson; Agaba, Bosco B.; Alarakol, Simon PeterBackground: Malaria presents a big threat to the health of refugees, internally displaced persons, returnees and other such persons affected by humanitarian emergencies, with almost two thirds of these groups of persons living in malaria endemic regions. The aim of this study was to determine the prevalence of malaria and associated risk factors among refugee children < 5 years attending a Health Centre in Panyadoli Refugee Settlement Camp, Kiryandongo District, Uganda. Methods: A cross-sectional survey was done between February to April 2022, targeting refugee children < 5 years old seeking healthcare at Panyadoli Health Centre III in Kiryandongo District. Simple random sampling was employed to select 380 participants, who were then tested for the presence of malaria parasites using malaria rapid diagnostic tests and microscopy techniques. Data on risk factors of malaria was collected using a pre-tested and standardized semi-structured questionnaire. Bivariate and multivariate logistic regression analyses was used to identify the risk factors for malaria infections, at 95% confidence interval and p < 0.05. Results: Malaria prevalence among the refugee children < 5 years attending Panyadoli HCIII was 12.6% [95% CI: 8.7–18.0]. The associated risk factors for malaria infection included: non-application of indoor residual spraying over the last 12 months [AOR = 4.323; 95% CI 1.231–7.212], history of malaria in children (AOR = 5.861; 95% CI 1.562—8.433], and not sleeping under insecticide-treated nets (AOR = 3.141; 95% CI 0.865—5.221). Conclusion: Malaria remains a threat to refugee children < 5 years old at Panyadoli Refugee Settlement Camp. Sustained implementation of IRS should be pursued through expanded geographic coverage and increased application frequency, in conjunction with complementary malaria control measures such as enhanced ITN distribution and IPT for pregnant women, to support long-term malaria reduction.Item Factors associated with completion of maternal health services, a cross-sectional study among women at an outpatient facility in Northern Uganda(Springer Nature, 2025-05-15) Acirucan, Polline; Nankumbi, Joyce; Ngabirano, Tom Dennis; Muwanguzi, PatienceItem 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, RonaldBackground: 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.Item One‑year follow‑up effects of the informed health choices secondary school intervention on students’ ability to think critically about health in Uganda: a cluster randomized trial(Springer Nature, 2025-02-26) Ssenyonga, Ronald; Oxman, Andrew D.; Nakyejwe, Esther; Chesire, Faith; Mugisha, Michael; Nsangi, Allen; Oxman, Matt; Rose, Christopher James; Rosenbaum, Sarah E.; Moberg, Jenny; Kaseje, Margaret; Nyirazinyoye, Laetitia; Dahlgren, Astrid; Lewin, Simon; Sewankambo, Nelson K.Introduction: We assessed the effects of the Informed Health Choices (IHC) secondary school intervention on students’ ability to think critically about choices 1 year after the intervention. Methods: We randomized eighty secondary schools to the intervention or control (usual curriculum). The schools were randomly selected from the central region of Uganda and included rural and urban, government, and privately-owned schools. One randomly selected class of year-2 students (ages 14–17) from each school participated in the trial. The intervention included a 2-day teacher training workshop, 10 lessons accessed online by teachers and delivered in classrooms during one school term (May–August 2022). The lessons addressed nine prioritized IHC concepts. We used two multiple-choice questions for each concept to evaluate the students’ ability to think critically about choices at both the end of the school term and again after 1 year. The primary outcome was the proportion of students with a passing score (≥ 9 of 18 questions answered correctly) on the “Critical Thinking about Health” (CTH) test. Results: After 1-year, 71% (1749/2477) of the students in the intervention schools and 71% (1684/2376) of the students in the control schools completed the CTH test. In the intervention schools, 53% (934/1749) of students who completed the test had a passing score compared to 33% (557/1684) of students in the control schools (adjusted difference 22%, 95% CI 16–28). Conclusions: The effect of the IHC secondary school intervention on students’ ability to assess health-related claims was largely sustained for at least 1 year. Trial registration: Pan African Clinical Trial Registry PACTR202204861458660. Registered on 4 April 2022.Item 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, PaulineAntimalarial 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.