Muni Repository (MR)
This repository contains open access publications of Muni University Library.
Objectives:
- To digitally collect, preserve and provide electronic access to scholarly works and research output of Muni University.
- Increase the visibility and impact of our research, making it easy for researchers, students, policymakers and journalists to reference, replicate, and re-use the work.
- Issue permanent, unique and trustworthy identifiers when creating URLs to access the resource without concern that the location of the resource may change.
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- Contact the library through email: libsupport@muni.ac.ug
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Recent Submissions
Modeling aflatoxin risk dynamics in Uganda’s groundnut value chain: A System dynamics decision support approach
(PT. Teknologi Futuristik Indonesia, 2026-06-15) Nansukusa, Yudaya; Asikuru, Salama; Kalyankolo, Umaru; Nafuna, Ritah
Aflatoxin contamination remains a persistent threat to food safety, public health, and trade in Uganda’s groundnut value chain, where a large share of household and market samples exceed national and international safety limits. Despite sustained investment in awareness campaigns, improved storage, and biocontrol products, contamination remains high and unevenly controlled, in part because interventions are typically evaluated in isolation and are rarely supported by dynamic tools that capture the feedback, delays, and trade-offs linking climate, farmer behaviour, institutional support, and markets. This study develops and analyses a System Dynamics (SD) decision-support model of aflatoxin risk in the groundnut value chain, framed within an Information Systems view of simulation-based decision support. Causal loop diagrams constructed in Vensim PLE and a stock-and-flow model implemented in STELLA Architect represent the reinforcing and balancing feedback structures governing contamination, including the “Shifting the Burden” archetype. Scenario simulations and a one-at-a-time sensitivity analysis show that symptomatic measures such as awareness campaigns deliver only temporary relief, whereas post-harvest practice quality emerges as the highest-leverage parameter; a realistic mixed-policy scenario that combines moderate investment across practices, awareness, and storage technology drives contamination below regulatory thresholds within the simulated horizon. These findings indicate that durable mitigation in low-resource settings depends on sustained structural investment rather than reactive fixes, and they demonstrate how SD modelling can guide adaptive, evidence-based food-safety policy.
Burden of extended-spectrum beta-lactamase- producing Enterobacteriaceae among cancer patients in Africa: a systematic review and meta-analysis
(Microbiology Society, 2026-06-12) Zamarano, Henry; Musinguzi, Benson; Twinomujuni, Muzafaru; Khakasa, Catherine; Mwesigye, Vicent; Muhwezi, Ivan; Mulogo, Edgar Mugema; Natumanya, Deborah; Kawuma, Simon; Orikiriza, Patrick; Iramiot, Jacob Stanley
Background. Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) exacerbate infections in cancer patients in settings where antimicrobial resistance threatens health outcomes. This study estimated the prevalence of ESBL-PE among cancer patients in Africa from 1 January 2010 to 31 December 2024.
Methods. We searched PubMed, Embase, Web of Science, CINAHL and Global Health for observational studies reporting ESBL-PE prevalence in cancer patients. Studies published in English from 1 January 2010 to 31 December 2024 were included. Two reviewers independently screened studies, extracted data using standardized forms and assessed the quality of articles using the Newcastle–Ottawa Scale. Pooled prevalence was calculated using a random-effects model in RStudio v4.4.2, with heterogeneity assessed with the I² statistic and publication bias assessed with funnel plots and Egger’s test.
Results. Twelve studies from 9 African countries, involving a total of 1,252 cancer patients and 643 identified events, were included. The pooled prevalence of ESBL-PE was 49.4% (95% CI: 36.0–62.9%, I²=88.3%, P<0.001). Escherichia coli and Klebsiella pneumoniae predominated. There was no evidence of publication bias based on funnel plot symmetry, Egger’s test (t=−0.35, P=0.73) and trim-and-fill analysis (no studies imputed; adjusted estimate unchanged). Heterogeneity was substantial (I²=88.3%) with a wide 95% prediction interval (22.7–76.5%). Leave-one-out sensitivity analysis confirmed estimate stability (~49%) with persistently high heterogeneity (I² range: 81.4–89.4%).
Conclusions. The high ESBL-PE prevalence in African cancer patients signals a critical public health issue, necessitating enhanced surveillance, antimicrobial stewardship and intentional infection control measures.
Smart grid design and simulation for Goma TMK substation regulation
(Lamintang Education and Training Centre, 2026-04-10) Kalyankolo, Umaru; Magana, Ajabu Elie
Power distribution networks in places like Goma, Democratic Republic of Congo, face the challenges of voltage control, energy loss, and power quality because they depend mainly on manual control provided at substations such as TMK. This study proposes a smart grid solution for automated voltage regulation through On-Load Tap Changer (OLTC) control for inefficiencies stemming from the above challenges using a Programmable Logic Controller (PLC). The system utilizes real-time electrical parameters monitoring, thereby employing dynamic adjustment processes to ensure voltage levels are kept at their optimum, as well as limiting overcurrent and improving thermal stability. The hybrid simulation approach uses Siemens TIA Portal for PLC logic and MATLAB Simulink to check the system's dynamic analysis under varied loads and faults. The results proved to enhance voltage stability and operational efficiency, and robustness while minimizing human intervention. The architecture is amenable to SCADA integration and distributed energy resources for future incorporation, thus providing a scalable solution to aging grids in resource-poor settings.
Barriers and facilitators to community-based, peer-led sexual and reproductive health intervention for adolescent girls and young women in northeastern Uganda: A qualitative study
(PLOS (Public Library of Science), 2026-06-11) Komuhangi, Alimah; Kajabwangu, Rogers; Izudi, Jonathan
Peer-led interventions can effectively improve sexual and reproductive health (SRH) knowledge, promote safer sexual behaviors among adolescents and young people, especially where health system capacity is limited. To inform a planned pre-post study, we explored the barriers and facilitators to the implementation of a community-based, peer-led SRH intervention for adolescent girls and young women (AGYW) aged 15–24 years in northeastern Uganda. We designed a qualitative case study and collected data through focus group discussions across AGYW in six categories: in-school, out-of-school, ever given birth, and never given birth, aged 15–17 years, and aged ≥18 years. We also conducted key informant interviews with SRH officials in the district and at two health facilities. Data collection was guided by the socioecological model. We performed thematic analysis and reported findings using themes along with the participants’ quotes mapped onto the socioecological model. A total of 51 adolescent girls and young women, and five key informant interviews with the district and health facility level officials were conducted. Findings show that the anticipated barriers and facilitators to implementation occur across socioecological levels. At the individual level, stigma and fear of judgment hindered participation, whereas trust in peers supported engagement. Limited autonomy hindered access at the interpersonal level, but support from family and friends helped. Institutional barriers included judgmental provider attitudes and confidentiality concerns; existing youth-friendly services and school clubs were facilitators. At the community level, myths, misconceptions, and restrictive cultural norms posed challenges, while community dialogues and champions encouraged acceptance. No major policy barriers were noted; however, supportive SRH policies and existing partnerships were facilitators. The implementation of the intervention may be influenced by several factors across individual, interpersonal, institutional, community, and policy levels. Future implementation should consider addressing the barriers while leveraging the facilitators to enhance implementation outcomes among AGYW
Effect of prior TB preventive therapy on allcause mortality during TB treatment among people with HIV/TB in rural eastern Uganda: an observational causal analysis
(Springer Nature, 2026-06-08) Izudi, Jonathan; Bajunirwe, Francis; Ssentongo, Saadick Mugerwa; Appeli, Saidi; Cattamanchi, Adithya
Background
Tuberculosis preventive therapy (TPT) is the cornerstone for preventing TB disease. However, it is uncertain whether prior TPT completion improves survival once TB disease develops in people with human immunodeficiency virus (PWH) while on anti-retroviral therapy (ART). We evaluated the effect of prior TPT completion on all-cause mortality during TB treatment among PWH who developed TB disease while on ART in rural eastern Uganda. Prior TPT completion served as a marker of sustained engagement in HIV care.
Methods
We applied inverse probability of treatment weighting using propensity scores, a causal inference analysis approach, to mimic a randomized controlled trial using real-world retrospective cohort data. Inverse probability of treatment weighting addresses design flaws in observational studies, such as selection and confounding biases, providing less biased causal effect estimates. Individuals who had completed a full course of TPT before the start of the index TB treatment episode formed the intervention group, while the control group comprised those with no history of TPT before the index TB treatment initiation. Inverse probability of treatment weighting ensured balanced baseline covariates between the exposure groups. We estimated all-cause mortality rates using person-time methods and Kaplan-Meier curves and performed propensity-score weighted Cox proportional hazards analysis for cause-effect estimation. We reported adjusted hazard ratios (aHR) with 95% confidence intervals (CI).
Results
Of 719 participants, 296 (41.2%) had completed a full course of TPT before the start of the index TB treatment episode, and 83 (11.5%) had died. The mortality rate was 7.13 per 10,000 person-days, higher among participants without prior TPT than those with prior TPT completion (18.0% vs. 2.4%, log-rank χ²(1) = 35.3, p < 0.001). Median survival was 277 days (95% CI: 213–689). Prior TPT completion was associated with an 87% lower hazard of all-cause mortality (aHR 0.13, 95% CI: 0.06–0.29).
Conclusion
Prior TPT completion substantially reduced all-cause mortality among PWH who developed drug-susceptible TB disease while on ART. Therefore, there is a need to strengthen TPT completion and engagement in HIV care across HIV programs to lower all-cause mortality among PWH.