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Item Awareness of antimicrobial resistance among primary health care workers in Buyende district, rural Eastern Uganda.(Microbiology Research Journal International, 2018-02-03) Ahebwa, Amelia; Akol, Walter; Achong, Emmanuel; Mugerwa, Timothy; Nakayenga, Aminah; Omega, Phillip; Nekaka, Rebecca; Iramiot, Jacob StanleyAim: The aim of this study was to assess the awareness of antimicrobial resistance among Primary Health Care Workers in Buyende district. Methods: This was a cross sectional study employing qualitative and quantitative methods. Administration of a questionnaire evaluating knowledge and practices of health workers in Buyende community was conducted. The study was designed to cover all health workers involved in prescribing and dispensing drugs in selected health facilities of Buyende district. The participants were from four health facilities (Kidera Health Center IV, Nkondo Health Center III, Buyende Health Centre III and Miseru Health Center III) and ten private community drug shops. Health care workers were assigned to different cords for the data collection process. One hundred twenty-four (124) respondents participated in the survey, representing a majority of the health workers in Buyende district. Results: Most respondents (75%) reported receiving information about antibiotic resistance with medical training school (67.2%) being the main source of information. Sixty-six percent (66%) of the participants believed that the widespread use of antibiotics is an important cause of resistance, while 60% attribute antimicrobial resistance to inadequate restrictions on antibiotic prescription due to advertising and promotion by pharmaceutical companies. Guidelines for the use of antibiotics against common infections and regular microbiological consultations/ward rounds were reported as crucial in controlling the problem of anti-microbial resistance. Though most health workers reported following clinical guidelines when prescribing antibiotics (79%), a substantial proportion still prescribed use of antibiotics for the treatment against common cold/cough (64%) and viral infections (44%). Conclusion: The awareness of anti-microbial resistance is a public health problem in rural Eastern Uganda. Campaigns for appropriate prescription and awareness of anti-microbial resistance should include educating the public and rural health care workers with the aim of decreasing the emergence antibiotic resistant microbes. Keywords: Antimicrobial resistance; awareness; primary health care workers.Item Prevalence of anaemia and associated factors among children in North-western Uganda : a cross sectional study.(BMC Hematology, 2017) Legason, Ismail Dragon; Atiku, Alex; Ssenyonga, Ronald; Olupot-Olupot, Peter; Barugahare, John BansonBackground: Despite the public health significance of anaemia in African children, its broader and often preventable risk factors remain largely under described. This study investigated, for the first time, the prevalence of childhood anaemia and its risk factors in an urban setting in Uganda. Methods: A total of 342 children were enrolled. Venous blood samples were collected in EDTA tubes and analyzed using Symex 500i (Symex Corp. Japan). Stool and urine samples were analyzed according to established standard methods. Anthropometric indicators were calculated according to the CDC/WHO 1978 references. Ethical approval was granted. Results: Categorically, the prevalence of anaemia was; 37.2, 33.3 and 11.8% among children aged 1–5years,6–11 years and 12–14 years respectively. Overall anaemia prevalence was 34.4%. The risk of anaemia was higher among males than females [(OR = 1.3, 95% CI = 0.8, 2.1), P = .22]. Malaria was associated with a 1.5 times risk of anaemia though not statistically significant in the multivariate analysis (P=.19). Maternal parity <5 (P = .002), and stunting [(OR = 2.5, 95% CI = 1.3, 4.7), P = .004] were positively associated with anaemia. There was a positive correlation between household size and income (Pearson X 2 = 22.96; P = .001), implying that large families were of higher socioeconomic status. Conclusions: This study demonstrates that anaemia is more prevalent in the under-5 age. The risk factors are stunting and low maternal parity. Interventions that address nutritional deficiencies in both preschool and school children arerecommended. Malaria and helminthiasis control measures counter the risk of anaemia. Further studies are required to investigate the association between maternal parity and anaemia found in this study. Keywords: Prevalence, Anaemia, Riskfactors, Children, North-western, Uganda.Item NITEO : a qualitative study of a supported education program for students experiencing disruptions to their college education because of a mental health condition.(American Psychological Association, 2025) Rogers, E. Sally; Braverman, David; Joly-Lowdermilk, Courtney; Augustine, Lisa; Rothpletz-Puglia, PamelaObjective: The rates and severity of mental health conditions among young adults are troublesome. Mental health conditions among college students impact educational attainment, future employment and earnings, as well as quality of life. Our objective was to assess students’ experience and perceptions of the core components of NITEO, a college reentry program designed to assist young adults who have dropped out of or taken a leave of absence from college. Methods: We conducted a qualitative study of the core components of NITEO, employing an applied interpretive approach and conducting semi structured interviews with 31 former NITEO students. Data were examined using thematic analysis. Results: Analyses revealed four themes: (a) NITEO catalyzes personal growth and connection, (b) coaching builds skills and promotes accountability, (c) peer mentors are supportive role models, and (d) other students in the program impact the program experience. These findings suggest that the different components of NITEO foster skills and resilience while providing a supportive community. Conclusions and Implications for Practice: Our study illuminates the potential of programs such as NITEO to facilitate recovery and return to college for students on leave or who have dropped out due to mental health conditions. Keywords: college mental health, college dropout, college leave of absence, mental health, young adultsItem Potential health risks from contaminated fish in Lake Victoria : a 25-year systematic review of pollutants and management challenges.(Elsevier Ltd, 2025) Mwebesa, Nelson; Oyege, Ivan; Ssekimpi, Dennis; Ndolo, Jackson Kisingu; Egor, MosesLake Victoria is the largest freshwater lake in East Africa, sustaining the livelihoods of over 40 million people. However, its fisheries face increasing threats from contamination by potentially toxic elements (heavy metals), persistent organic pollutants, and emerging contaminants. This systematic review integrates 25 years (2000–2025) of research, analyzing primary studies on fish contamination across Uganda, Kenya, and Tanzania. The review assessed the occurrence, bioaccumulation, and toxicology of pollutants, as well as their health implications and management strategies. Mercury was the dominant pollutant of concern, with concentrations ranging from 3.4 ng/g wet weight in Nile tilapia (Oreochromis niloticus) to very high values of 335,000 ng/g dry weight in silver fish from mining regions, exceeding international safety limits. Other detected contaminants included organochlorine pesticides, polychlorinated biphenyls, endosulfan, polybrominated diphenyl ethers, polychlorinated dibenzo-p-dioxins and furans, per- and polyfluoroalkyl substances, and microplastics. Bioaccumulation patterns revealed higher contaminant loads in the liver tissues of all fish, particularly in Nile perch (Lates niloticus). The health risks associated with these pollutants include neurotoxicity, carcinogenicity, endocrine disruption, and ecosystem-level impacts. However, significant knowledge gaps remain for newer pollutants, including pharmaceutical and personal care products, plasticizers, and modern pesticides, which have not been assessed in Lake Victoria fish. Furthermore, spatial coverage is uneven, with most islands and some inshore fishing zones lacking data. This review presents the first comprehensive synthesis of fish contamination data in Lake Victoria, providing a foundation for future scientific research, policy, and transboundary management, while also offering a transferable framework for addressing similar pollution challenges in tropical inland waters globally.Item 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, SarahBackground 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 educationItem 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, SarahBackground 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.Item Factors affecting lifestyle modification among adults with type II diabetes mellitus attending care at Mbale regional referral hospital in Mbale city, Eastern Uganda: a mixed methods study.(Sage, 2025) Gidudu, Mariam; Nandutu, Lornah; Ankunda, Ronnet; Epuitai, Joshua; Lulenzi, Jalia; Ssenyonga, Lydia V. N.; Gavamukulya, Yahaya; Nabirye, Rose ChaloBackground: Globally diabetes affects over 530million adults with Type II Diabetes (T2DM) accounting for approximately 98% of patients. T2DM is preventable, and its onset can be markedly postponed by increasing physical activity, reducing weight, and changing dietary habits, poor adherence to lifestyle modification was attributed to a number of factors such as poverty, and diet education. The main objective of this study was to explore factors affecting lifestyle modification among adults with type II diabetes mellitus at Mbale Regional Referral Hospital (MRRH)-Mbale City, Eastern Uganda. Design and methods: A descriptive cross-sectional study involving 262 participants was conducted in MRRH among T2DM patients attending the diabetic clinic. Quantitative data was collected through structured administered questionnaires. Simple random sampling was used to recruit respondents for the study. Quantitative data was analyzed at univariate, and bivariate levels using SPSS version 25. Qualitative data was analyzed using thematic analysis. Statistical significance was set at p-value of <0.05. Results: About 70.1% of the participants were females, 63.4% were above 50years, and 29.7% of participants had high knowledge on T2DM. Most participants engaged in health practices like recommended diet, regular physical activity, body weight monitoring, blood sugar monitoring, and health checkups. Gender, religion, occupation, physical exercise, smoking, and weight management significantly affected lifestyle modifications. Qualitative results revealed three main themes namely, social support, health education, and having a conducive environment as promoters to lifestyle modification, while two main themes namely lack of social support and religious and cultural beliefs were the main barriers. Conclusion: Generally, participants had good knowledge on the lifestyle modifications of T2DM. Gender, religion, occupation, physical exercise, smoking, and weight management significantly affected lifestyle modifications. Social support, health education, and having a conducive environment were reported as promoters to lifestyle modification, while lack of social support and religious and cultural beliefs were the main barriers. It is recommended that health care workers should continuously educate the patients on the lifestyle modifications considering their financial status, and all other limiting factors. A holistic approach to lifestyle modifications needs to be taken in order to help reduce the complications associated with the condition. Keywords: type II diabetes mellitus (T2DM), glycemic control, dietary management, physical exercise, social support, health educationItem Validation of triple pass 24-hour dietary recall in Ugandan children by simultaneous weighed food assessment.(BioMed Central, 2016) Nightingale, Helen; Walsh, Kevin J; Olupot-Olupot, Peter; Engoru, Charles; Ssenyondo, Tonny; Nteziyaremye, Julius; Amorut, Denis; Nakuya, Margaret; Arimi, Margaret; Frost, Gary; Maitland, KathrynBackground: Undernutrition remains highly prevalent in African children, highlighting the need for accurately assessing dietary intake. In order to do so, the assessment method must be validated in the target population. A triple pass 24 h dietary recall with volumetric portion size estimation has been described but not previously validated in African children. This study aimed to establish the relative validity of 24-h dietary recalls of daily food consumption in healthy African children living in Mbale and Soroti, eastern Uganda compared to simultaneous weighed food records. Methods: Quantitative assessment of daily food consumption by weighed food records followed by two independent assessments using triple pass 24-h dietary recall on the following day. In conjunction with household measures and standard food sizes, volumes of liquid, dry rice, or play dough were used to aid portion size estimation. Inter-assessor agreement, and agreement with weighed food records was conducted primarily by Bland-Altman analysis and secondly by intraclass correlation coefficients and quartile cross-classification. Results: Nineteen healthy children aged 6 months to 12 years were included in the study. Bland-Altman analysis showed 24-h recall only marginally under-estimated energy (mean difference of 149 kJ or 2.8 %; limits of agreement −1618 to 1321 kJ), protein (2.9 g or 9.4 %; −12.6 to 6.7 g), and iron (0.43 mg or 8.3 %; −3.1 to 2.3 mg). Quartile cross-classification was correct in 79 % of cases for energy intake, and 89 % for both protein and iron. The intraclass correlation coefficient between the separate dietary recalls for energy was 0. 801 (95 % CI, 0.429–0.933), indicating acceptable inter-observer agreement. Conclusions: Dietary assessment using 24-h dietary recall with volumetric portion size estimation resulted in similar and acceptable estimates of dietary intake compared with weighed food records and thus is considered a valid method for daily dietary intake assessment of children in communities with similar diets. The method will be utilised in a sub-study of a large randomised controlled trial addressing treatment in severe childhood anaemia. Trial registration: This study was approved by the Mbale Research Ethics Committee (Reference: 2013–050). Transfusion and Treatment of severe Anaemia in African Children: a randomized controlled Trial (TRACT) Registration: ISRCTN84086586. Keywords: Dietary assessment, Validation, Children, Portion size estimation, Uganda, UndernutritionItem Hydroxyurea therapy for children with sickle cell anemia in Sub-Saharan Africa : rationale and design of the REACH trial.(Wiley Online Library, 2015) McGann, Patrick T; Tshilolo, leon; Santos, Brigida; Tomlinson, George A; Stuber, Susan; Latham, Teresa; Aygun, Banu; Obaro, Stephen K; Olupot-Olupot, Peter; Williams, Thomas N; Odame, Isaac; Ware, Russell EBackground: Sickle cell anemia (SCA) is an inherited hematological disorder that causes a large but neglected global health burden, particularly in Africa. Hydroxyurea represents the only available disease-modifying therapy for SCA, and has proven safety and efficacy in high-resource countries. In sub-Saharan Africa, there is minimal use of hydroxyurea, due to lack of data, absence of evidence-based guidelines, and inexperience among healthcare providers. Procedure: A partnership was established between investigators in North America and sub-Saharan Africa, to develop a prospective multicenter research protocol designed to provide data on the safety, feasibility, and benefits of hydroxyurea for children with SCA. Results: The Realizing Effectiveness Across Continents with Hydroxyurea (REACH, ClinicalTrials.gov NCT01966731) trial is a prospective, phase I/II open-label dose escalation study of hydroxyurea that will treat a total of 600 children age 1–10 years with SCA: 150 at each of four different clinical sites within sub-Saharan Africa (Angola, Democratic Republic of Congo, Kenya, and Uganda). The primary study endpoint will be severe hematological toxicities that occur during the fixed-dose treatment phase. REACH has an adaptive statistical design that allows for careful assessment of toxicities to accurately identify a safe hydroxyurea dose. Conclusions: REACH will provide data that address critical gaps in knowledge for the treatment of SCA in sub-Saharan Africa. Keywords: Africa; hydroxyurea; sickle cell anemiaItem Sacred birth, clean hands : infection prevention as ritual and practice among traditional birth attendants in Mayuge district, east central Uganda.(Research Square, 2025) Kagoya, Enid Kawala; Auma, Proscovia; Mugabi, Joshua; Kawala, Elizabeth; Asabawebwa, Deogratias; Mugahi, Richard; Waako, Paul; Mugabe, Kenneth; Barugahare, BansonThis study explored how Traditional Birth Attendants (TBAs) in rural Uganda implement infection prevention and control (IPC) through a blend of cultural traditions and hygiene practices. Using ethnographic methods, including interviews and observations, it found that TBAs view cleanliness as both a sacred obligation and a critical part of protecting maternal health. Despite facing limited training and resources, TBAs showed a strong commitment to infection prevention, positioning them as essential yet often under-recognized actors in maternal care. Introduction The study investigated IPC practices among TBAs in rural Uganda, situating them within a broader cultural and spiritual framework. It emphasized how TBAs integrate traditional knowledge with selected biomedical practices to ensure maternal safety. This intersection of ritual and hygiene highlights the TBAs' central role in rural maternal healthcare. Objective The main objective was to explore how TBAs interpret, adapt, and implement IPC practices by drawing from both cultural beliefs and biomedical hygiene principles in the context of rural Uganda. Methods A qualitative research approach was used, involving in-depth interviews and direct observations with 15 TBAs in Mayuge District. Data collection focused on everyday IPC practices such as waste disposal, hand hygiene, and use of protective materials. Thematic analysis helped identify recurring patterns and contextual challenges in IPC implementation. Results The findings revealed that TBAs practice IPC through a hybrid model that blends ritual and hygiene. Placenta disposal, symbolic use of gloves, and improvised handwashing with soap, herbs, or oil were common. Despite limited formal training, TBAs showed innovation and commitment to safe deliveries, although resource scarcity and misalignment with formal guidelines posed challenges. Conclusion The study highlighted the creative and spiritually informed IPC strategies of TBAs in rural Uganda, showing how they skillfully navigate material shortages and cultural expectations. These frontline caregivers operate with dedication and contextual intelligence, underscoring the need for culturally sensitive training and support to enhance maternal and newborn outcomes in under-resourced settings. Keywords: Traditional Birth Attendants, Infection Prevention and Control, Maternal Health, Uganda, Ritual Hygiene, Hybrid Care Practices, Ethnography, Community Health, Safe Delivery, Cultural BeliefsItem Unraveling the therapeutic potential of tephrosia linearis : anti-inflammatory, analgesic activity, and molecular docking approaches.(Elsevier Ltd, 2025) Opio, Moses; Kiyimba, Kenedy; Nabitandikwa, Catherine; Maseruka, Richard; Wotoyitidde, Tony Lukwago; Andima, Moses; Chebijira, Mercy; Edeya, Sharon Tracy; Nabatanzi, Alice; Gavamukulya, Yahaya; Kibuule, Dan; Waako, Paul; Owor, Richard Oriko; Obakiro, Samuel BakerBackground Inflammatory diseases such as arthritis affect over 300 million people globally. The current treatment mainly involves the use of Non-Steroidal Anti-inflammatory drugs (NSAIDS) which possess several adverse drug reactions that are sometimes life threatening. This has prompted many patients to gain interest in plant-based remedies. Tephrosia linearis (Willd.) Pers (Fabaceae) is widely used in Uganda to manage symptoms of inflammation. However, there was a paucity of information concerning its analgesic and anti-inflammatory activities. This study investigated the anti-inflammatory, analgesic, and acute toxicity effects of ethanolic extracts from the aerial parts of Tephrosia linearis in Wistar albino rats. Methods Plant samples were collected from Katakwi District, Eastern Uganda and extracted using 70 % ethanol. Quantitative phytochemical analysis was conducted using UV/Vis spectroscopy. Acute toxicity was assessed using Lorke’s method, while analgesic and anti-inflammatory activities were evaluated through Complete Freud’s Adjuvant-induced arthritis model. Three doses of T. linearis (200, 400, and 800 mg/kg) were compared with a control group receiving 20 mg/kg of diclofenac. Three marker compounds were assessed using in silico modeling to predict their pharmacokinetic properties, organ toxicity, and binding energy against selected protein targets involved in inflammation. Results The ethanolic extract contained significant concentrations of flavonoids (82.9 ± 0.1 mg/g), tannins (140.2 ± 0.9 mg/g), alkaloids (93.4 ± 1.0 mg/g), and triterpenoids (76.1 ± 1.5 mg/g). No toxic effects were observed at doses below 2000 mg/kg, with an estimated LD50 of 2692 mg/kg. The extract exhibited a non-dose dependent analgesic and anti-inflammatory activities that were significantly lower than that of diclofenac (p < 0.05). Molecular docking revealed strong binding affinities for apigenin, luteolin, and velutin with COX2, PLA2, and TNFα. Conclusion This study supports T. linearis as a safe herbal remedy for managing inflammation, suggesting further optimization through active ingredient isolation for enhanced therapeutic outcomes.Item Bacterial contamination and infection control practices in the mortuary at Mbarara Regional Referral Hospital, Uganda.(Shea, 2025) Wagido, Edwina Patience; Tom, Adima; Prosper, Niwamanya; Alfred, Tushabe; Genevieve, Tusiime Martha; Wagido, Okeny Christopher; Langoya, Akuu Susan; Ssenkumba, Brian; Kiconco, Ritah; Nalumaga, Pauline Petra; Yekosan, Mitala; Raymond, Atwine; Bagenda, Charles; Peter, Rugera Simon; Abraham, BirungiBackground: Increasing evidence demonstrates that medical personnel and the clinical environment such as surfaces and equipment are often sources of infections. However, limited data exists on the bacterial contamination of the hospital mortuary environment within a hospital setting. Objective: This study aimed to determine bacterial profiles, assess antimicrobial susceptibility patterns, and evaluate infection prevention and control (IPC) practices at the Mbarara Regional Referral Hospital (MRRH) mortuary in southwestern Uganda. Methods: This was a cross-sectional study involving qualitative and quantitative data collection methods. Ninety-three (93) surface swab samples from the inanimate surfaces were collected. Using standard operating protocols, the collected samples were processed at the microbiology laboratory. All isolates were cultured and identified by Gram staining and biochemical tests. Antimicrobial susceptibility testing was done on each isolate following the Kirby-Bauer disk diffusion method. Data was entered and analyzed using SPSS version 26 and results were explained by percentages and tables. Results: Klebsiella species were the most predominant isolated bacteria (44.7%) followed by Staphylococcus aureus (40.3%). Methicillinresistant Staphylococcus aureus (MRSA) was detected at a high frequency (98%). Resistance patterns showed that most isolates exhibited multidrug resistance, with high resistance to commonly used antibiotics. However, Azithromycin and Ciprofloxacin demonstrated the highest efficacy against both Gram-positive and Gram-negative isolates. Conclusion: Inanimate surfaces and equipment of the mortuary are heavily contaminated with multidrug-resistant bacteria such as Methicillin-resistant Staphylococcus aureus. Improper disinfection and waste segregation may contribute to bacterial contamination in the mortuary. Regular and enhanced cleaning with disinfectants, proper use of clean aprons, and displaying safety signage for workers and visitors can help improve infection prevention and control.Item Spectrum and trends of cancer among HIV patients in Southwestern Uganda.(PLOS One, 2025) Atwine, Raymond; Yekosani, Mitala; Birungi, Abraham; Ssenkumba, Brian; Tuhamize, Barbra; Ezinga, Richard; Male, Keneth; Kabanda, TaseeraBackground Antiretroviral therapy (ART) restores cellular immunity, significantly reducing AIDS-related mortality and morbidity thus improving the quality of life among People living with HIV (PLHIV). Studies done in several countries show a decline in AIDS defining cancers (ADCs) with the introduction of ART however the increased longevity has led to the increase of Non-AIDS defining cancers (NADCs). The study was aimed at studying the changing spectrum and trends of cancer among Human Immunodeficiency Virus (HIV) patients in southwestern Uganda. Methods The study was a retrospective chart review of records of HIV-positive patients attending/ receiving care from the Oncology clinic and ISS clinic of Mbarara Regional Referral Hospital (MRRH) who were, diagnosed with cancer for the past 10 years (January 2012–2021). Data were statistically analyzed using STATA version 17 (Stata Corp, Texas, US) at P <0.05. Results Males were more common at 64.5% while the median age was 37 years (IQR 29–47 years). ADCs were seen in 77.5% of the population while participants with NADCs were older (p<0.001). The majority 73.3% (283/386) were in later stages (3 and 4). Having either ADCs or NADCs was different across HIV stages (p<0.001). The median baseline CD4 count was 205 cells/μl (IQR: 90–400 cells/μl). The median duration on ART was 15 months (IQR 3–65 months). Participants with ADCs had been on ART for a shorter duration of time (p<0.001). Only the outcome of patients with ADCs were available. The outcome varied with sex (p<0.036), baseline CD4 (p<0.048), and HIV stage (p<0.002). Males were more likely to die (30/38 or 78.95%) and lost to follow-up (26/41 or 60.98%). Participants with baseline CD4 cell count >200 cells/μl were more than twice likely to be active in care. The Commonest ADC was Kaposi Sarcoma (KS) while the commonest NADC was Squamous cell carcinoma, Not otherwise specified. Age above 50 years was associated with a significantly reduced risk of ADCs (OR: 0.11; 95% CI: 0.03–0.43; p value: 0.002). The risk of ADCs increased from stage 2 (OR: 0.46, p-value: 0.03; 95% CI: 0.23–0.91) to stage 3 (OR: 1.13; p-value: 0.66; 95% CI: 0.65–1.97) but this was not statistically significant. The risk of ADCs decreased with increasing ART duration (P value <0.05). Conclusion ADCs are still a major health challenge in Southwestern Uganda despite the increasing the coverage and uptake of ART in region. These have mostly affected the young people, people who have been on HAART for a shorter period and those with lower CD4 cell count at initiation of ART.Item Prevalence and factors associated with haematological side effects in MDR/RR-TB patients on linezolid-based regimens in Uganda : a multicentre retrospective study.(Research Square, 2025) Apio, Esther; Baluku, Joseph Baruch; Bwayo, Denis; Masaba, Peter J; Kirabo, Erias; Kebesu, Jasper; Nankunda, Oreb; Imalignat, Julius; Katuramu, RichardBackground: Linezolid holds a critical role in the management of multidrug-resistant and rifampicinresistant tuberculosis (MDR/RR-TB), a severe global health threat. The World Health Organisation strongly recommends its inclusion in treatment regimens for these challenging forms of tuberculosis. Despite its efficacy, linezolid is frequently associated with haematological toxicity, a complication insufficiently documented in resource-limited settings like Uganda. Objective: This study aimed to ascertain the prevalence and identify associated factors of haematological side effects in MDR/RR-TB patients receiving linezolid-based regimens in Uganda. Methods: A multicentre retrospective study was conducted, reviewing patient records from four Ugandan hospitals (2020 – 2024). Data were collected on the prevalence of anaemia: Haemoglobin (Hb) level below 12 g/dL for women or below 13 g/dL for men. Thrombocytopenia: Platelet count below 150,000/µL. Leukopenia: White blood cell (WBC) count below 3,700/mm³.Modified Poisson regression with robust error variance identified independent risk factors for these haematological side effects. Results: Out of 412 eligible patients, 62.9% developed at least one haematological side effect. Thrombocytopenia (56.6%) and leukopenia (56.3%) were the most common, followed by anaemia (43.7%). Most of these side effects occurred within the first month of linezolid initiation. Risk factors for developing at least one of the side effects included rural residence (adjusted Prevalence Ratio (aPR) 1.6; 95% CI: 1.11–2.33), divorced/widowed status (aPR 4.1; 95% CI: 1.58–10.77), and smoking (aPR 1.7; 95% CI: 1.28–2.80). Despite the high prevalence of side effects, 86% achieved treatment success (cure and completion); however, loss to follow-up was higher among those with toxicities, at 15.1% (39/259) and 5.9% (9/153) in those without hematologic side effects. Conclusion: Linezolid-related haematological toxicities are common and occur early in treatment. Targeted monitoring of high-risk patients may improve treatment adherence and outcomes. Keywords: MDR-TB, Linezolid, Haematological toxicity, Anaemia, Thrombocytopenia, Leukopenia, Treatment outcomesItem Green synthesized polyscias fulva silver nanoparticles ameliorate uterine fibroids in female wistar albino rats.(PLOS One, 2025) Kiyimba, Kenedy; Ahmed, Ayaz; Choudhary, Muhammad Iqbal; Rehman, Khadija; Hasan, Syed Mehmood; Jabbar, Abdul; Obakiro, Samuel Baker; Shah, Muhammad Raza; Munyendo, Were Lincoln; Guantai, Eric M.; Gavamukulya, YahayaUterine fibroids affect a substantial proportion of women in their reproductive age. Despite their effectiveness, surgical options such as hysterectomy are invasive, costly, and associated with recurrences. Pharmacological treatments are noncurative, only alleviate symptoms, and associated with adverse effects. Polyscias fulva (Araliaceae) is traditionally used to manage uterine fibroids in East Africa. In this study we synthesized Polyscias fulva silver nanoparticles (PFAgNPs), evaluated their toxicity and activity against monosodium glutamate (MSG)-induced uterine fibroids in Wistar albino rats. The UV-visible spectroscopy showed maximal absorbance at 425nm with adequate stability at varying temperatures, pH and storage conditions. Dynamic light scattering (DLS) analysis revealed an average hydrodynamic size of 107.4 d.nm, polydispersity index of 0.264, and zeta potential of -18.3 mV. X-ray diffraction (XRD) confirmed the crystalline nature of PFAgNPs with an average size of 25nm while scanning electron microscopy (SEM) showed a spherical shape with an average size of 35nm. The PFAgNPs caused lethargy, hyperventilation, and hyperactivity at a dose of 300mg/kg BW, whereas 2000mg/kg caused severe toxicity, resulting in death in acute toxicity testing. The no observed adverse effect level was 50mg/kgBW, the lowest observed adverse effect level was 100mg/kgBW, and median lethal dose (LD50) was 1000mg/kg. The PFAgNPs significantly decreased (P<0.05) serum proteins, cholesterol, estrogen and progesterone alongside preservation of the histoarchitecture of the uterus. Further research is needed to investigate the clinical safety of PFAgNPs in managing uterine fibroids.Item Deciphering the molecular mechanism of aloe-emodin in managing type II diabetes mellitus using network pharmacology, molecular docking, and molecular dynamics simulation approaches.(Springer Nature, 2025) Obakiro, Samuel Baker; Kiyimba, Kenedy; Gavamukulya, Yahaya; Maseruka, Richard; Nabitandikwa, Catherine; Kibuuka, Ronald; Lulenzi, Jalia; Lukwago, Tonny Wotoyitide; Chebijira, Mercy; Opio, Moses; Tracy, Edeya Sharon; Kibuule, Dan; Oriko, Richard Owor; Waako, Paul; Makaye, Angela; Shadrack, Daniel M.; Andima, MosesAloe-emodin (AE) has drawn interest due to its potential activity against type II diabetes mellitus (T2DM). However, the mechanisms underlying its antidiabetic activity are not well explored. Using network pharmacology, molecular docking and molecular dynamics simulation studies, we investigated its molecular mechanisms in the management of T2DM. Potential target genes of AE were predicted using the Swiss Target Prediction (http://www.swisstargetprediction.ch/) database. The GeneCards, OMIM and DisGeNET databases were used to compile a comprehensive list of genes associated with T2DM. A compound-disease-target network was constructed, and protein–protein interaction networks were analysed to identify hub genes. Finally, molecular docking and interaction analysis between AE and the identified proteins were performed using AutoDock tools. Investigation of AE targets and genes associated with T2DM identified 32 overlapping genes. Gene ontology studies revealed that AE may exert its anti-diabetic effects by modulating glucose metabolism and enhancing cellular response to glucose. Furthermore, KEGG pathway analysis suggested that AE influences these processes by targeting pathways related to apoptosis, insulin resistance, and T2DM signaling. The core target proteins identified were TNF, ALB, TP53, PPARG, BCL2, CASP3, and EGFR. AE interaction with each of these proteins exhibited a binding energy of>−5 kcal/mol, with TNF showing the lowest binding energy (−7.75 kcal/mol). Molecular dynamics simulation further validated the molecular docking results with TNF and EGFR exhibiting a strong affinity for AE and forming stable interactions. AE exerts its antidiabetic activity through multiple mechanisms, with the most significant being the amelioration of pancreatic β-cell apoptosis by binding to and inhibiting the actions of TNFα. Further cellular and molecular studies are needed to validate these findings. Keywords Aloe emodin · Type II diabetes mellitus · Network pharmacology · Molecular docking In Silico Pharmacology (2025) 13:45Item Watching over life : practices and meanings of postpartum vital signs monitoring in eastern Uganda.(medRxiv, 2025) Babuya, Jonathan; Kayemba, Frank; Waiswa, Sinani; Nsubuga, Allan G.; Ewing, Helen; Atuhairwe, Irene; Ijangolet, Esther; Otim, Eric; Ronald, Kibuuka; Jesca, Atugonza; Okello, Francis; Nakattudde, Prossy; Nyangoma, Faith; Nakawuka, Betty; Kabahinda, Nichola; Kamwesigye, Assen; Apoya, Jill; Waako, Paul; Wandabwa, Julius; Musaba, Milton; Bonaventure, Ahaisibwe; Aeby, Tod; Nandutu, Sarah; Mugabe, Kenneth; Pangholi, Kennedy; Nahurira, Doreck; Agaba, Brian; Mbwali, Immaculate; Bahati, Johnson; Kagoya, Enid KawalaIntroduction Postnatal deaths account for about one-third of maternal mortality in Low- and middle-income countries (LMICs). Nearly half occur within the first 24 hours and are preventable through continuous inpatient monitoring. This study assessed maternal mortality within the first 24 postnatal hours; and the current postpartum monitoring practices, including the availability of monitoring charts and the frequency of vital sign assessments in eastern Uganda. Methods This cross-sectional study reviewed the medical records of all postpartum women admitted at Mbale Regional Referral Hospital, Eastern Uganda, between August 2022 and February 2023. A semi-structured data extraction form was used. The outcome variable was postpartum monitoring; categorized as "No" for women with no vital signs monitored and "Yes" for those with at least one vital sign monitored. Descriptive analysis was performed using Stata Version 17.0, and Poisson regression was employed to explore the association between various factors and postpartum monitoring. Results Medical records of 2,717 postpartum mothers were reviewed. The median (interquartile range) age was 25(20-30) years. A minority (34%; 910/2717) of mothers had vital sign observation charts in their medical records and very few (4%; 110/2717) had a fluid balance chart. About 49 24% (651/2717) of mothers had at least one vital sign recorded. Blood pressure was the most (16.8%; 456/2717) recorded vital sign followed by pulse rate (13.6%; 369/2717). Respiratory rate and temperature were the least monitored vital signs with 1.2% and 1.1% records respectively. Mothers who delivered by C-section had a 151% higher prevalence of postpartum monitoring compared to those who had a vaginal delivery (aPR: 2.51; 95% CI: 2.19–2.89). Maternal mortality rate on the first postpartum day was 8.8 per 1000, with postpartum hemorrhage accounting for 61%. Conclusion Postpartum vital signs monitoring was low. LMICs need to devise means of automating the monitoring process.Item Perception of medical and nursing students plus clinical instructors towards objective structured clinical examination : a case study of five health training institutions in Sub-Saharan Africa.(Taylor & Francis, 2025) Kibuuka, Ronald; Mpasa, Ferestas; Kanyike, Andrew Marvin; Ndikom, Chizoma Millicent; Kaminga, Atipatsa Chiwanda; Owusu-Sekyere, Samuel; Ogah, Adenike; Amponsah, Abigail Kusi; Kiyimba, Kennedy; Obakiro, Samuel Baker; Munthali, Getrude; Msowoya, Wanangwa Kenneth; Kibuule, Dan; Phiri, Etta Chimbe; Baluwa, Masumbuko; Phiri, Tamara; Katuramu, RichardBackground: Objective Structured Clinical Examination (OSCE) is the gold standard for assessing clinical competencies. However, resource constraints and logistical challenges in Sub-Saharan Africa (SSA) hinder its effectiveness. This study investigated the perceptions and experiences of medical and nursing students and clinical instructors toward OSCE in Sub-Saharan Africa (SSA). Methods: A mixed-methods sequential explanatory design was utilized involving 686 undergraduate health care students and 46 clinical instructors from Busitema University (Uganda), Mzuzu University (Malawi), University of Ibadan (Nigeria), Kwame Nkrumah University of Science and Technology (Ghana), and University of Zambia (Zambia). Quantitative responses were analyzed using IBM SPSS Statistics version 25, with comparisons between medical and nursing student responses made using chi-square test. Qualitative data were thematically analyzed. Results: A total of 686 students and 42 clinical instructors participated in the study. Majority of students 57.6% (n = 395, P-value <0.001) and 71.8% (n = 33) instructors recognized OSCE as a comprehensive tool for assessing clinical skills and knowledge, respectively. Among students, 80.8% (n = 554, P-value = 0.031), 66.6% (n = 457, P-value = 0.001), 66.6% (n = 456, P-value = 0.020) and 61.4% (n = 421, P-value = 0.001) cited anxiety, station timing, examiners’ behavior and content load as factors influencing performance. Of the clinical instructors 58.7% (n = 27) noted that it takes longer time to prepare scenarios, however 71.8% (n = 33) highlighted its objectivity. Students praised OSCE’s objectivity but criticized insufficient time on some stations and organizational issues. Facilitators cited objectivity and competence assessment but noted resource insufficiencies and student stress. Suggestions for improvement included mock OSCEs, training of clinical instructors, mixed method assessment and feedback to improve performance. Conclusion: In conclusion, while OSCE demonstrates significant strengths in promoting fairness in assessing clinical competencies, addressing logistical challenges, examiner variability, student anxiety, and timely feedback is crucial. Plain Language Summary: This study explored the perception of medical and nursing students and clinical instructors Objective Structured Clinical Examination (OSCE) in five sub-Saharan African health training institutions (Uganda, Malawi, Nigeria, Ghana, Zambia). We used questionnaires among 686 students and 46 clinical instructors, focused group discussions, and key informant interviews to find out their perception. Both students and clinical instructors mostly preferred OSCE because it is fair, organized, and tests real healthcare skills more than the conventional methods like long case. But students said the time on some stations was too short, stressful, and noted challenges during OSCE such as lack of some materials on some stations. Teachers agreed that OSCE is helpful but hard to do due to insufficient staffing and space. Both suggested more practice sessions through Pre OSCE, better training for teachers, and feedback to help students improve. The study confirms that OSCE is the most efficient way to evaluate nursing and medical students, however the study also highlights that a mixed method evaluation would be the best option for evaluation of clinical competence. Keywords: OSCE, health care professions education, Sub-Saharan Africa, medical assessmentItem In vitro antiplasmodial activity, acute toxicity and phytochemical quantification of selected medicinal plants used for the management of uncomplicated malaria in eastern Uganda.(Elsevier Ltd., 2025) Obakiro, Samuel Baker; Nabitandikwa, Catherine; Kiyimba, Kenedy; Ocan, Moses; Gavamukulya, Yahaya; Andima, Moses; Lukwago, Tonny Wotoyitide; Maseruka, Richard; Chebijira, Mercy; Opio, Moses; Hokello, Joseph Francis; Kibuule, Dan; Nabatanzi, Alice; Orena, Stephen; Waako, Paul; Owor, Richard OrikoEthnopharmacological relevance The emergence of artemisinin resistance and limited antimalarial drug access in Uganda has increased reliance on herbal medicines as complementary and alternative therapies. Indigenous use of Albizia coriaria, Zanthoxylum chalybeum, Entada abyssinica, Maytenus senegalensis, and Kigelia Africana for malaria treatment is widespread but scientific evidence of their efficacy and safety was limited. Aim of the study This study aimed to validate the traditional antimalarial use of the five medicinal plants by evaluating their phytochemical composition, acute toxicity, and in vitro antiplasmodial activity against chloroquine-sensitive (3D7), chloroquine-resistant (Dd2) and clinical P. falciparum isolates. Materials and methods Phytochemical screening and quantification was conducted on 70 % hydroethanolic extracts from dried plant samples using UV–Vis spectrophotometry. The acute oral toxicity testing was conducted in Wistar albino rats using OECD 423 limit dose test. The antiplasmodial efficacy was evaluated using a 72-h SYBR Green assay on Plasmodium falciparum laboratory strains (3D7, Dd2) and clinical isolates. Results Alkaloids, flavonoids, tannins, and terpenoids were present in all the plant samples in varying quantities. Z. chalybeum was the most potent extract (IC50 0.81–1.28 μg/ml), followed by A. coriaria and E. abyssinica (IC50 10–50 μg/ml). M. senegalensis showed weak activity while K. africana was largely inactive (IC50 > 100 μg/ml). A. coriaria and M. senegalensis showed moderate acute toxicity (LD50 < 2000 mg/kg), while the other extracts showed no severe signs of acute toxicity in Wistar albino rats (LD50 > 2000 mg/kg). Conclusion Zanthoxylum chalybeum, Albizia coriaria and Entada abyssinica demonstrated promising antiplasmodial activity that supports their traditional use in management of malaria. However, more efficacy studies using in vivo models, sub-chronic and chronic toxicity studies particularly on A. coriaria and advanced phytochemical profiling are needed to delineate their therapeutic potential before being prioritized for development of standardized herbal remedies and novel antimalarial drugs.Item Coping mechanisms for students with mental disorders : an exploratory qualitative study at Busitema University’s Mbale and Busia campuses.(PLOS One, 2025) Kagoya, Enid Kawala; Mpagi, Joseph; Waako, Paul; Muhwezi, Martha R. L.; Namaganda, Agnes; Nsubuga, Allan G.; Atala, Christine Etoko; Okello, Francis; Okibure, Ambrose; Kibuuka, Ronald; Wandera, Ernest; Ndamanywa, Kalisiti; Kirabira, JosephIn recent years, Ugandan universities have faced a rising incidence of mental health issues among students, with prevalence rates of mental disorders reaching up to 60% among undergraduates. These challenges significantly impact both academic performance and social interactions. This study aimed to investigate the coping mechanisms among students with mental disorders at Busitema University. We conducted 42 key informant interviews with students diagnosed with mental disorders, as determined by the Mini International Neuropsychiatric Interview. Interviews were guided by a structured protocol developed by the research team, and all participants provided informed consent. The interviews were audiotaped, transcribed verbatim, and analyzed using thematic analysis. This approach was chosen for its efficiency and directness. Nvivo software facilitated the coding and organization of themes. The study identified several coping strategies used by students at the two Busitema University campuses. Five main themes emerged: Alcohol and Substance Use, Use of Sedatives, Social and Personal Initiatives, Seeking Counseling Services, Withdrawal and Confrontation, and Faith Healing. Various subthemes were also noted, including substance use, withdrawal, confrontations, witchcraft, participation in co-curricular activities, abortions, and seeking psychosocial support. These findings are detailed in Table 2. Addressing the mental health challenges faced by university students requires a thorough understanding of their coping strategies. While some strategies are self-developed, others involve university-led interventions. It is crucial to reinforce effective coping mechanisms and address detrimental ones to improve students’ mental health outcomes. Mental disorders, coping strategies, university students, Uganda