Browsing by Author "Kiguli, Sarah"

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    Changes in haematological indices among children with sickle cell disease on hydroxyurea treatment for at least 1 year : a cohort study.
    (PLOS One, 2025) Emuli, Stephen; Tegu, Crispus; Oguttu, Faith; Nantale, Ritah; Ochieng, Paul; Paasi, George; Abeso, Julian; Wamulugwa, Joan; Musaba, Milton W.; Namazi, Ruth; Kiguli, Sarah; Mukunya, David
    Background Sickle cell disease is the 12th cause of under-five mortality in Africa, with over 81,000 deaths attributed to sickle cell disease annually. Hydroxyurea is one of the few disease-modifying therapies available for the management of sickle cell disease. This study aimed to assess changes in haematological indices among children who had been initiated on hydroxyurea for at least one year in a non-trial setting at a regional referral hospital in Eastern Uganda. Methods We conducted a cohort study, which included children who attended the sickle cell clinic from 21/Aug/2024 to 30/Oct/2024. Data were analyzed using Stata version 18.0. We conducted a paired sample t-test comparing the haematological indices of children with sickle cell disease at baseline and at least one year later. Results We included 324 children. Nearly half 155/324 (47.8%) of the participants had good monthly adherence to hydroxyurea. The mean haemoglobin level at follow-up increased by 0.77g/dl (p <0.001) from 7.07g/dl (SD 0.10) at baseline to 7.84g/dl (SD 0.09). There was an increase in the mean corpuscular volume [0.97fl (p=0.645)] and mean corpuscular haemoglobin [0.58pg (p=0.120)]. The white blood cell count decreased by 6.17x103/µl (p<0.001) from 20.77x103/µl (SD ± 0.806) at baseline to 14.60x103/µl (SD ± 0.613) at follow-up. The differential white cell counts of neutrophils, lymphocytes, monocytes, and basophils also decreased. Conclusion Hydroxyurea resulted in an increase in mean haemoglobin level and a decrease in absolute and differential white blood cell count. The benefit was more pronounced among children with good adherence to hydroxyurea. We add our voice to calls for continued advocacy for the availability of hydroxyurea for use by children with sickle cell disease in low-resource settings. We also recommend a routine complete blood count to monitor response to treatment and also guide patient management among children with sickle cell disease initiated on hydroxyurea.
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    Early weaning from oxygen therapy in African children with severe pneumonia.
    (BMC Medicine, 2025) Maitland, Kathryn; Giallongo, Elisa; Hamaluba, Mainga; Alaroker, Florence; Opoka, O. Robert; Tagoola, Abner; Nalwanga, Damalie; Nabawanuka, Eva; Okiror, William; Nakuya, Margaret; Aromut, Denis; Williams, N. Thomas; Thomas, Karen; Harrison, A. David; Mouncey, Paul; Bush, Andrew; Fraser, F. J.; Rowan, Kathy; Olupot‑Olupot, Peter; Kiguli, Sarah
    Background: In Africa, severe pneumonia remains the major cause of paediatric hospitalisation, resulting in high requirements for oxygen therapy. Adequate supplies of oxygen are key challenges for many low-resource hospitals. The World Health Organization manual for oxygen therapy advises 2–3 days of oxygen therapy for pneumonia and recommends against early weaning, even in the absence of hypoxaemia. Few data support this recommendation. We describe the oxygen use and timing of weaning in the COAST trial of oxygen therapy (ISRCTN15622505). Methods: Children aged 28 days to 12 years presenting to 6 hospitals in Uganda and Kenya with severe pneumonia and hypoxaemia (saturations<92% on pulse oximetry (SpO2) were eligible for the trial. Children in two strata (a) severe hypoxaemia (SpO2<80%) and (b) moderate hypoxaemia (SpO2 80–91%) were allocated to receive high flow nasal therapy (HFNT), low flow oxygen delivery (LFO) or control (no immediate oxygen (moderate hypoxaemia stratum only)). Children were closely monitored over 48 h by pulse oximetry and weaned off oxygen once ­SpO2>92%. We describe the oxygen use and proportion requiring respiratory support over time by intervention strategy. Results: Of the 1842 children enroled the majority, 1454 (79%) had moderate hypoxaemia. In this stratum, by 2 and 8 h, 148 (41%) and 200/360 (55.6%) in the LFO arm had been weaned; in the HFNT arm, 213/362 (59%) were receiving respiratory support at 2 h in room alone, and by 8 h, 164/362 (45%) had been weaned. At 48 h, in the respective strata, 77–80% and 53–63% still had respiratory distress but without hypoxaemia and were thus not receiving oxygen. Median oxygen use at 48 h in the moderate hypoxaemia group was highest in LFO am 480L (IQR 236.2, 2132.2) compared to 113.4 L (IQR 0.0, 1453.9) in the HFNT and 0 L (IQR 0.0) in the control arms. Children requiring oxygen beyond 48 h, 17/33 (51.1%) and 9/46 (19.5%) in the respective strata, had additional cardiac conditions. Conclusions: Closely monitoring SpO2 resulted in early weaning and reduced the use of and exposure to oxygen. Where oxygen supplies are at a premium, this approach may improve equitable access for children with severe pneumonia. Keywords Severe pneumonia, African children, Oxygen therapy, High flow nasal therapy
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    Effect of nutritional supplementation with lipid-based therapeutic food on body composition of non-severely malnourished African children aged 6–59 months hospitalized with severe pneumonia
    (Oxford University Press, 2025) Nalwanga, Damalie; Musiime, Victor; Kiguli, Sarah; Olupot-Olupot, Peter; Alaroker, Florence; Opoka, Robert; Tagoola, Abner; Mnjala, Hellen; Mogaka, Christabel; Nabawanuka, Eva; Giallongo, Elisa; Karamagi, Charles; Briend, Andr’e; Maitland, Kathryn
    Pneumonia remains an important cause of morbidity and mortality among children in low- and middle-income countries. Poor outcomes are associated with undernutrition. Nutritional supplementation may be beneficial. We examined the effect of supplementation with lipid-based ready-to-use therapeutic food (RUTF) on the body composition of children with severe pneumonia. Non-severely malnourished children (6–59 months) with severe pneumonia enrolled into the Children’s Oxygen Administration Strategies and Nutrition trial in Uganda and Kenya and randomized to receive a diet supplemented with RUTF (500 Kcal/day) for 56 days versus usual diet alone (control) were included. We assessed arm anthropometry and bioimpedance analysis at admission and days 28, 90, and 180 of follow-up. We used mixed effects linear regression to compare body composition between groups. We included 737 participants (369 in intervention; 368 in control group). The median age was 16 months (IQR; 9, 26), and 58.1% were male. Overall, baseline mean arm fat area (AFA), arm muscle area and arm muscle circumference were 5.8 ± 1.8 cm2, 11.6 ± 2.3 cm2, and 12.3 ± 1.2 cm2, respectively. The mean fat mass and fat-free mass calculated in 116 participants were 5.5 ± 1.5 kg and 5.5 ± 1.5 kg, respectively. There were modest increases in most body composition parameters. RUTF significantly increased AFA at days 28 and 90 but not at day 180 (P-value ¼ .03, .02, and .99, respectively). RUTF did not change other body composition parameters. Despite initial increases in AFA, RUTF did not change the body composition of children with severe pneumonia. KEYWORDS: bio-impedance analysis; body composition; children; fat-free-mass fat-mass; malnutrition; pneumonia; ready-to-use therapeutic food
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    Epidemiological dynamics of influenza B virus across multiple seasons in Kenya and Uganda inferred from sequence data, 2010–2021.
    (BMC Infectious Diseases, 2025) Nyarango, K. Brenda; Owuor, Collins D.; Isoe, Everlyne; Mutunga, Martin; Cheruiyot, Robinson; Katama, N. Esther; Makori, Timothy; Lambisia, Arnold; Nyiro, Joyce; Githinji, George; Kiguli, Sarah; Olupot-Olupot, Peter; Maitland, Kathryn; Agoti, N. Charles
    Background: Influenza B virus (IBV) contributes significantly to morbidity and mortality during Influenza seasons annually. However, IBV genomic surveillance occurs unevenly across the globe, particularly within the African region, obscuring its epidemiology. This study aims to elucidate the epidemiological dynamics of IBV in Kenya and Uganda between 2010 and 2022. Methods: In this study, 83 near complete IBV genomes circulating in Kenya and Uganda between 2010 and 2022 were generated through Oxford Nanopore Technologies sequencing (ONT). Publicly available IBV datasets were incorporated to evaluate the public context of these genomes. Further evolutionary dynamics analysis investigated the antigenic mutation, reassortment and glycosylation patterns of IBVs circulating in Kenya and Uganda within this period. Results: Alternating IBV lineage predominance and clade turnover was observed consistent with global patterns. No B/Yamagata strains were detected at the study sites after 2019. Multiple B/Victoria clade/subclades (V1A, V1A.3, V1A.3a, V1A.3a.2) and B/Yamagata clades (Y2 and Y3) were identified with no inter-lineage reassortments observed. Over time, the clades/subclades appeared to diversify through the accumulation of amino acid changes along the hemagglutinin (HA) segment backbone, especially within the known antigenic sites. Local outbreak strains appeared to be putatively introduced from both within and outside Africa. Conclusions: The congruence of local and global strains in circulating lineages and amino acid changes suggests potential effectiveness of vaccines recommended for the Northern and Southern Hemispheres in East Africa. Keywords: IBV, B/Victoria, B/Yamagata
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    “I can no longer give take-home exams”: health professionals educators’ experiences and perceptions regarding the use of artificial intelligence in health professions education in Uganda.
    (BMC, 2025) Mukunya, David; Nantale, Ritah; Paungholi, Kennedy; Epuitai, Joshua; Kayemba, Frank; Jemba, Brian; Ajalo, Elizabeth; Afodun, Adam; Musaba, Milton W.; Munabi, Ian G.; Kiguli, Sarah; Mubuuke, A. G.
    Introduction: Artificial intelligence (AI) tools offer immense opportunities and challenges for medical education. However, there is limited information about the use of AI among health professional educators, particularly in low and middle-income countries. We aimed to explore the experiences and perceptions regarding AI use in health professional education. Methods and materials: We collected qualitative data using in-depth interviews with 19 health professional educators. The interviews were audio-recorded and transcribed verbatim. We used Atlas Ti version 9.1 to organise the data. We used Braun and Clarke’s six-step thematic analysis for data analysis. The study was approved by the Busitema University Research and Ethics Committee (BUFHS-2023-79). Results: Three major themes were identified from the data: uptake and use of AI, perceived benefits of AI in health professional education, and concerns regarding AI use. We noted initial reluctance to support AI use, while its use varied from no or infrequent use to frequent use. Health professional educators used AI for various reasons, such as for teaching, student assessment, research, and personal work. AI was perceived to be beneficial in improving the clarity of writing, providing access to individual-tailored information, teaching, learning, and assessment, and research purposes. The barriers to AI use included a lack of institutional policies to guide AI use, limited capacity to afford paid AI versions, and reluctance to use AI. AI was seen to have inherent limitations, which included inaccurate information and a lack of contextual information for resource-limited settings. The fears of AI use included the risk of over-reliance on AI, academic misconduct, examination malpractice, ethical conflicts, and integrity. Conclusion: AI use in health professional education was perceived to have some benefits, amidst concerns that may derail its use in health professional education. The lack of policy and guidelines to govern the use of AI in health professions education underscores the need to develop policies and guidelines that safeguard and promote responsible and ethical use of AI. Keywords Health professional education, Artificial intelligence, Educators, Uganda
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    Nasopharyngeal Microbiome Composition and its Clinical Correlates in Children Hospitalized with Severe Pneumonia in East Africa
    (Oxford University Press, 2026) Makori, O. Timothy; Gicheru, T. Elijah; Mburu, W. Maureen; Sada, S. Mercy; Nyawa, Omar; Mutunga, Martin; Lewa, Clement; Cheruiyot, Robinson; Kiguli, Sarah; Olupot-Olupot, Peter; Muhindo, Rita; Mogaka, Christabel; Williams, N. Thomas; Agoti, N. Charles; Maitland, Kathryn; Sande, J. Charles
    Background: Pneumonia remains the leading cause of infectious mortality in children under 5, with the highest burden in sub-Saharan Africa. Dysbiosis in nasopharyngeal (NP) microbiota may influence pneumonia susceptibility and progression, but little is known about its composition or clinical relevance in low- and middle-income countries. We characterized the NP microbiota of children hospitalized with severe pneumonia in East Africa and investigated associations with clinical outcomes. Methods: We performed 16S rRNA partial gene sequencing of NP swabs collected at hospital admission from 876 children enrolled in the COAST trial across 5 sites in Kenya and Uganda. Clinical, demographic, and virological data were prospectively collected. Microbial profiles were analyzed using hierarchical clustering, nonmetric multidimensional scaling, and multivariable regression to assess associations with respiratory viral infections, sepsis, cyanosis, bacteremia, coma, HIV status, malnutrition, sickle cell disease, malaria, and mortality. Results: The NP microbiome was structured in 6 distinct clusters, each dominated by different genera, including Staphylococcus, Streptococcus, Haemophilus, Dolosigranulum, Corynebacterium, and Moraxella. Multivariable models adjusting for study site and age showed a positive association between Corynebacterium and early mortality. Temporal analysis showed elevated Corynebacterium abundance in children who died within 48 hours of admission, then declined over longer 56 survival intervals, approaching levels observed in survivors. However, time-continuous models did not support this persistent association, suggesting a subgroup effect. Conclusions: We provide one of the largest high-resolution surveys of the pediatric upper airway microbiome in Africa, identifying microbial patterns associated with viral infection, HIV status, early death, and bacteremia. Keywords: 16 seconds rRNA sequencing; nasopharyngeal microbiome; pediatric pneumonia.
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    Specialty career preferences among final year medical students at Makerere University College of health sciences, Uganda :
    (BMC, 2021) Kuteesa, Job; Musiime, Victor; Munabi, Ian G.; Mubuuke, Aloysius G.; Opoka, Robert; Mukunya, David; Kiguli, Sarah
    Background: Uganda has an imbalanced distribution of the health workforce, which may be influenced by the specialty career preferences of medical students. In spite of this, there is inadequate literature concerning the factors influencing specialty career preferences. We aimed to determine the specialty career preferences and the factors influencing the preferences among fifth year medical students in the School of Medicine, Makerere University College of Health Sciences (MakCHS). Methods: A sequential explanatory mixed methods study design with a descriptive cross-sectional study followed by a qualitative study was used. A total of 135 final year medical students in MakCHS were recruited using consecutive sampling. Self-administered questionnaires and three focus group discussions were conducted. Quantitative data was analysed in STATA version 13 (StataCorp, College Station, Tx, USA) using descriptive statistics, chi-square tests and logistic regression. Qualitative data was analysed in NVIVO version 12 (QRS International, Cambridge, MA) using content analysis. Results: Of 135 students 91 (67.4%) were male and their median age was 24 years (IQR: 24, 26). As a first choice, the most preferred specialty career was obstetrics and gynecology (34/135, 25.2%), followed by surgery (27/135, 20.0%), pediatrics (18/135, 13.3%) and internal medicine (17/135, 12.6%). Non-established specialties such as anesthesia and Ear Nose and Throat (ENT) were not selected as a first choice by any student. Female students had 63% less odds of selecting surgical related specialties compared to males (aOR = 0.37, 95%CI: 0.17–0.84). The focus group discussions highlighted controlled lifestyle, assurance of a good life through better financial remuneration and inspirational specialists as facilitators for specialty preference. Bad experience during the clinical rotations, lack of career guidance plus perceived poor and miserable specialists were highlighted as barriers to specialty preference. Conclusion: Obstetrics and Gynecology, Surgery, Pediatrics and Internal Medicine are well-established disciplines, which were dominantly preferred. Females were less likely to select surgical disciplines as a career choice. Therefore, there is a need to implement or establish career guidance and mentorship programs to attract students to the neglected disciplines. Keywords: Career, Medical, Preferences, Specialty, Student
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    Supplementation with ready-to-use therapeutic food has no effect on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia.
    (Frontiers, 2025) Nalwanga, Damalie; Giallongo, Elisa; Musiime, Victor; Kiguli, Sarah; Olupot Olupot, Peter; Alaroker, Florence; Opoka, Robert; Tagoola, Abner; Hamaluba, Mainga; Mogaka, Christabel; Nabawanuka, Eva; Karamagi, Charles; Briend, André; Maitland, Kathryn
    Objectives: To investigate the effect of supplementation with ready-to-use therapeutic food (RUTF) on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia. Methods: This secondary analysis of the COAST-Nutrition (ISRCTN10829073) included children hospitalized for severe pneumonia in Uganda and Kenya. Undernutrition was defined as having either a weight-for-age z score, heightfor-age z score, or weight for-height/length z score below the median of the WHO reference population (< 0) or mid-upper arm circumference (MUAC) below 13.5 cm. Participants were randomized to receive 1 sachet of RUTF daily for 8 weeks in addition to the usual diet (intervention) or usual diet alone (control). The primary composite outcome for adverse events was any one of mortality, re-admission, or deterioration of nutritional status by day 90 of follow-up. Results: Of 846 main trial participants, 741 (88%) met the inclusion criteria (intervention: 374 versus control: 367). Of 687 (93%) participants in whom the primary outcome was assessed, 370 (54%) experienced an adverse event, [intervention: 184/348 (53%) versus control: 186/339(54%)]. There was no difference in the primary outcome between groups, aOR 0.92 (95% CI 0.68, 1.24), p = 0.572. Adverse outcome risk reduced with increasing age, aOR 0.53, (95% CI 0.45, 0.62), p < 0.001. Conclusion: RUTF supplementation did not reduce the high frequency of adverse outcomes in children aged 6–59 months following hospital admission with severe pneumonia. Nutritional support directly targeting metabolic needs post-pneumonia should be considered in the future.
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    The resurgence of blackwater fever among children in sub-Saharan Africa : a scoping review.
    (Research Square, 2025) Paasi, George; Namazi, Ruth; Malaika, Nancy; Namayanja, Cate; Ongodia, Paul; Okalebo, Benard Charles; Amorut, Denis; Asiimwe, Glorias; Okello, Francis; Mukunya, David; Munabi, Guyton Ian; Kiguli, Sarah; Idro, Richard; Olupot-Olupot, Peter
    Background: Blackwater fever (BWF), a life-threatening complication of Plasmodium falciparum malaria, has reemerged as a significant health concern among children in sub-Saharan Africa (SSA). Characterized by acute intravascular hemolysis, hemoglobinuria, and severe anemia, BWF necessitates urgent medical intervention. Despite its clinical severity, data on its burden, risk factors, and management remain fragmented. Therefore, this scoping review aimed to systematically map the existing literature on BWF in SSA, focusing on its epidemiology, clinical presentation, risk factors, management strategies, and outcomes among children in SSA. Methods: Following the Arksey and O’Malley framework, a comprehensive search was conducted across six databases (PubMed, Embase, Cochrane Library, CINAHL, PsycINFO, web of science) and grey literature sources including preprint servers, conference proceedings, theses, dissertations, WHO reports and clinical trials registries (PACTR, clinicaltrials.gov). Studies published from inception to December 2024 were included. Data were extracted and synthesized narratively, with findings categorized thematically by epidemiology, clinical features, risk factors, management, and outcomes. Results: BWF was geographical clustered in East and Central Africa, particularly Uganda (53.8%) and the DRC (26.9%). Prevalence ranged from 4.4% to 52.7%, with higher incidence during rainy seasons. MBL2 AA polymorphisms, elevated IgG1 and quinine exposure (aOR 50.19-57.33) were significant contributors while G6PD deficiency (G6PDd) had conflicting associations. Clinical hallmarks were dark urine (100% of cases), jaundice (22.7-100%), and severe anemia (23.7-77%) aligning with the “hemolytic triad” reported in BWF. Acute kidney injury (AKI) (16.2-90.6% of cases) and recurrent episodes (50-68% readmission rates) exacerbated morbidity. Diagnosis relied on clinical criteria, with limited laboratory confirmation, while management emphasized artemisinin-based therapies and supportive care. Delays in blood transfusions and renal replacement therapy contributed to poor outcomes. Conclusion: BWF resurgence in SSA highlights critical gaps in diagnostics, equitable care, and adherence to artemisinin-based treatments. Targeted surveillance during malaria peaks, standardized diagnostic protocols, and improved access to supportive therapies are urgently needed to mitigate BWF-associated mortality and morbidity in high-burden regions.
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    Utilisation of ChatGPT and other Artificial Intelligence tools among medical faculty in Uganda : a cross-sectional study.
    (MedEdPublish, 2025) Mukunya, David; Nantale, Ritah; Kayemba, Frank; Ajalo, Elizabeth; Pangholi, Kennedy; Babuya, Jonathan; Akuu, Suzan Langoya; Namiiro, Amelia Margaret; Tweheyo, Ronald; Ekak, Steven; Nakitto, Brenda; Nantongo, Kirsten; Mpagi, Joseph Luwaga; Musaba, Milton W.; Oguttu, Faith; Kuteesa, Job; Mubuuke, Aloysius Gonzaga; Munabi, Ian Guyton; Kiguli, Sarah
    Background ChatGPT is a large language model that uses deep learning techniques to generate human-like texts. ChatGPT has the potential to revolutionize medical education as it acts as an interactive virtual tutor and personalized learning assistant. We assessed the use of ChatGPT and other Artificial Intelligence (AI) tools among medical faculty in Uganda. Methods We conducted a descriptive cross-sectional study among medical faculty at four public universities in Uganda from November to December 2023. Participants were recruited consecutively. We used a semi-structured questionnaire to collect data on participants’ sociodemographics and the use of AI tools such as ChatGPT. Our outcome variable was the use of ChatGPT and other AI tools. Data were analyzed in Stata version 17.0. Results We recruited 224 medical faculty, majority [75% (167/224)] were male. The median age (interquartile range) was 41 years (34–50). Almost all medical faculty [90% (202/224)] had ever heard of AI tools such as ChatGPT. Over 63% (120/224) of faculty had ever used AI tools. The most commonly used AI tools were ChatGPT (56.3%) and Quill Bot (7.1%). Fifty-six faculty use AI tools for research writing, 37 for summarizing information, 28 for proofreading work, and 28 for setting exams or assignments. Forty faculty use AI tools for nonacademic purposes like recreation and learning new skills. Faculty older than 50 years were 40% less likely to use AI tools compared to those aged 24 to 35 years (Adjusted Prevalence Ratio (aPR):0.60; 95% Confidence Interval (CI): [0.45, 0.80]). Conclusion The use of ChatGPT and other AI tools was high among medical faculty in Uganda. Older faculty (>50 years) were less likely to use AI tools compared to younger faculty. Training on AI use in education, formal policies, and guidelines are needed to adequately prepare medical faculty for the integration of AI in medical education. Keywords ChatGPT, medical faculty, Bing, Bard, Uganda, generative AI, medical education
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    Widespread use of ChatGPT and other Artificial Intelligence tools among medical students in Uganda : a cross-sectional study.
    (PLOS One, 2025) Ajalo, Elizabeth; Mukunya, David; Nantale, Ritah; Kayemba, Frank; Pangholi, Kennedy; Babuya, Jonathan; Akuu, Suzan Langoya; Namiiro, Amelia Margaret; Nsubuga, Yakobo Baddokwaya; Mpagi, Joseph Luwaga; Musaba, Milton W.; Oguttu, Faith; Kuteesa, Job; Mubuuke, Aloysius Gonzaga; Munabi, Ian Guyton; Kiguli, Sarah
    Background Chat Generative Pre-trained Transformer (ChatGPT) is a 175-billion-parameter natural language processing model that uses deep learning algorithms trained on vast amounts of data to generate human-like texts such as essays. Consequently, it has introduced new challenges and threats to medical education. We assessed the use of ChatGPT and other AI tools among medical students in Uganda. Methods We conducted a descriptive cross-sectional study among medical students at four public universities in Uganda from 1st November 2023 to 20th December 2023. Participants were recruited by stratified random sampling. We used a semi-structured questionnaire to collect data on participants’ socio-demographics and use of AI tools such as ChatGPT. Our outcome variable was use of AI tools. Data were analyzed descriptively in Stata version 17.0. We conducted a modified Poisson regression to explore the association between use of AI tools and various exposures. Results A total of 564 students participated. Almost all (93%) had heard about AI tools and more than two-thirds (75.7%) had ever used AI tools. Regarding the AI tools used, majority (72.2%) had ever used ChatGPT, followed by SnapChat AI (14.9%), Bing AI (11.5%), and Bard AI (6.9%). Most students use AI tools to complete assignments (55.5%), preparing for tutorials (39.9%), preparing for exams (34.8%) and research writing (24.8%). Students also reported the use of AI tools for nonacademic purposes including emotional support, recreation, and spiritual growth. Older students were 31% less likely to use AI tools compared to younger ones (Adjusted Prevalence Ratio (aPR):0.69; 95% CI: [0.62, 0.76]). Students at Makerere University were 66% more likely to use AI tools compared to students in Gulu University (aPR:1.66; 95% CI:[1.64, 1.69]). Conclusion The use of ChatGPT and other AI tools was widespread among medical students in Uganda. AI tools were used for both academic and non-academic purposes. Younger students were more likely to use AI tools compared to older students. There is a need to promote AI literacy in institutions to empower older students with essential skills for the digital age. Further, educators should assume students are using AI and adjust their way of teaching and setting exams to suit this new reality. Our research adds further evidence to existing voices calling for regulatory frameworks for AI in medical education.