The National Research Repository of Uganda - NRU

Welcome to the National Research Repository of Uganda, abbreviated as "NRU". NRU was established in 2021. NRU is a collection of scholarly output by researchers from the UNCST Community, including scholarly articles and books, electronic theses and dissertations, conference proceedings, journals, technical reports and digitised library collections. It is the official Institutional Archive (IA) of UNCST.

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For information about the publishers' copyright policy on archiving your articles online or in an institutional archive, visit the Sherpa Site at http://www.sherpa.ac.uk/romeo.php The site gives a summary of the permissions normally given as part of each publisher's copyright transfer agreement. If you wish to publish your research findings in the NRU, please contact NRU administrator at admin@uncst.go.ug for details. NRU operates both open access and closed access models. Access to fulltext has been restricted in adherence to the UNCST Intellectual Property Rights (IPR) and Copyrights policies.

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    HIV service delivery after the PEPFAR and USAID HIV funding withdrawal in Uganda and Zimbabwe: an interrupted time-series study
    (Elsevier Ltd, 2026-10-04)
    Cust, Henry;
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    Chabata, Sungai T
    In January 2025, the US Government froze foreign aid and halted the President's Emergency Plan for AIDS Relief (PEPFAR), the largest external funder of HIV services globally. Early modelling studies and rapid assessments warned of major harm to millions, but robust quantitative evidence from those who relied most on the lost funding has been absent. We aimed to estimate the effect of the US funding withdrawal on HIV prevention, pre-exposure prophylaxis (PrEP), testing, and treatment services provided by non-governmental organisations (NGOs) serving primarily key populations in Uganda and Zimbabwe.BACKGROUNDIn January 2025, the US Government froze foreign aid and halted the President's Emergency Plan for AIDS Relief (PEPFAR), the largest external funder of HIV services globally. Early modelling studies and rapid assessments warned of major harm to millions, but robust quantitative evidence from those who relied most on the lost funding has been absent. We aimed to estimate the effect of the US funding withdrawal on HIV prevention, pre-exposure prophylaxis (PrEP), testing, and treatment services provided by non-governmental organisations (NGOs) serving primarily key populations in Uganda and Zimbabwe.In this interrupted time-series study, we used monthly and quarterly service-delivery data from NGOs in Uganda and Zimbabwe from January 2023 up to March 2026. All received stop-work orders and subsequent funding cuts. Core service indicators across prevention, PrEP, treatment, and testing were normalised into domain indices, in which 100 represents their mean 2024 amount. The main outcome was the change in these service indicators because of funding cuts. Specifying February 2025 as the interruption point, we estimated effects with an unweighted panel interrupted time-series (the organisation level) and a client-weighted interrupted time-series (the key-population level) on these indices.METHODSIn this interrupted time-series study, we used monthly and quarterly service-delivery data from NGOs in Uganda and Zimbabwe from January 2023 up to March 2026. All received stop-work orders and subsequent funding cuts. Core service indicators across prevention, PrEP, treatment, and testing were normalised into domain indices, in which 100 represents their mean 2024 amount. The main outcome was the change in these service indicators because of funding cuts. Specifying February 2025 as the interruption point, we estimated effects with an unweighted panel interrupted time-series (the organisation level) and a client-weighted interrupted time-series (the key-population level) on these indices.Eight organisations agreed to participate; four were subsequently excluded for reasons of data quality, lack of funding impact, and location, with four subsequently included in this study. All four service domains showed large, sustained declines. Across both the unweighted and weighted specifications, prevention fell by 36·8-62·7 index points, PrEP by 43·0-71·6, treatment by 22·0-31·5, and testing by 58·7-63·8 index points in February 2025 (index points are equivalent to percentage change from mean 2024 amounts). 95% CIs excluded zero for all estimates except PrEP in the unweighted panel. Services remained substantially below the 2024 amount up to March 2026. The antiretroviral therapy humanitarian waiver attenuated treatment effects but did not prevent substantial decline.FINDINGSEight organisations agreed to participate; four were subsequently excluded for reasons of data quality, lack of funding impact, and location, with four subsequently included in this study. All four service domains showed large, sustained declines. Across both the unweighted and weighted specifications, prevention fell by 36·8-62·7 index points, PrEP by 43·0-71·6, treatment by 22·0-31·5, and testing by 58·7-63·8 index points in February 2025 (index points are equivalent to percentage change from mean 2024 amounts). 95% CIs excluded zero for all estimates except PrEP in the unweighted panel. Services remained substantially below the 2024 amount up to March 2026. The antiretroviral therapy humanitarian waiver attenuated treatment effects but did not prevent substantial decline.The sudden withdrawal of US funding was followed by severe, sustained disruptions to HIV service delivery in Uganda and Zimbabwe across all major domains, with the largest declines in prevention, PrEP, and testing services for key populations. These results are the first quantitative findings on service-volume changes in NGOs whose US funding was terminated or sharply cut and illustrate the effect on the NGO-led, key-population layer of HIV services in sub-Saharan Africa. These services are crucial to people living with HIV to remain healthy and have a good quality of life. Urgent investment in service-continuity protocols and domestic financing is needed to prevent a rebound in HIV incidence.INTERPRETATIONThe sudden withdrawal of US funding was followed by severe, sustained disruptions to HIV service delivery in Uganda and Zimbabwe across all major domains, with the largest declines in prevention, PrEP, and testing services for key populations. These results are the first quantitative findings on service-volume changes in NGOs whose US funding was terminated or sharply cut and illustrate the effect on the NGO-led, key-population layer of HIV services in sub-Saharan Africa. These services are crucial to people living with HIV to remain healthy and have a good quality of life. Urgent investment in service-continuity protocols and domestic financing is needed to prevent a rebound in HIV incidence.The Josiah Charles Trent Memorial Foundation Endowment Fund, the Sanford School of Public Policy, and Duke Global Publications Fund.FUNDINGThe Josiah Charles Trent Memorial Foundation Endowment Fund, the Sanford School of Public Policy, and Duke Global Publications Fund. MEDLINE - Academic
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    Children with cerebral malaria report lower long-term health-related quality of life four to twenty years after the illness, with decreased EQ-5D-3L and VAS scores versus children with severe malarial anemia and community peers.
    (Elsevier Inc, 2027-03)
    Ochanda, Perez N.;
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    Bangirana, Paul;
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    Kamya, Carol ;
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    Aakvik, Arild;
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    Datta, Dibyadyuti;
    Children with cerebral malaria report lower long-term health-related quality of life four to twenty years after the illness, with decreased EQ-5D-3L and VAS scores versus children with severe malarial anemia and community peers.
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    Hazardous child labour in smallholder coffee farming systems in Uganda: Prevalence, determinants, and implications for children's education
    (Elseveir, 2026-10)
    Isoto, Rosemary Emegu;
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    Schilling, Friederike;
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    Shortall, Patrick ;
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    Bashaasha, Bernhard;
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    von Braun, Joachim
    Hazardous child labour remains a concern in smallholder agricultural production, where household economic constraints and seasonal labour demands may expose children to activities that threaten their health, safety, and educational development. This study examines the prevalence, determinants, and educational implications of hazardous child labour in smallholder coffee farming systems in Uganda. It draws on primary data collected in October 2024 from 491 coffee-producing households across five major coffee-producing regions, covering 1,252 children aged 5–17 years. Using probit regression, multivariate probit models, and ordinary least squares regression, the study analyses children's exposure to physical and mechanical hazards, environmental and chemical hazards, and hazardous working conditions and time-related risks, alongside their educational attainment. The findings indicate that 42% of the children participated in coffee-related activities, while 23% of the children engaged in labour during the seven days preceding the survey had experienced hazardous activities in coffee production during the preceding 12 months. Common hazards included the use of sharp tools, land clearing, and excessive working hours on school days. Older children were more likely to engage in hazardous work, while higher household per capita expenditure was associated with a lower likelihood of hazardous child labour. Children who were biological children or grandchildren of household heads were less likely to participate in hazardous activities than other children residing in the household. Furthermore, hazardous child labour was significantly associated with wider educational gaps, particularly among children exposed to environmental and chemical hazards and hazardous working conditions. Given the cross-sectional design, these relationships should be interpreted as associations rather than causal effects. The study highlights the need for targeted interventions that address household economic vulnerability, strengthen child protection and awareness, and support continued school participation while reducing children's exposure to hazardous activities in coffee production.
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    Gene editing applications, opportunities and challenges for crop improvement in Africa a review
    (Springer International Publishing, 2026-09-22)
    Mequanint, Gebremeskel;
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    Kuru, Birkneh;
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    Wondmaneh, Adane
    Gene editing, particularly CRISPR/Cas-based new genomic techniques (NGTs), offers significant opportunities for accelerated crop improvement in developing African countries, ensuring food security, livelihoods, climate resilience, and economic growth. This review critically evaluates the scientific basis, applications, breeding value, technical capacity, and regulatory developments of gene editing in major African crops. Recent evidence shows that it has shown significant progress in improving disease resistance, nutrient use efficiency, climate resilience, grain quality, and yield traits in teff, maize, wheat, banana, cassava, and sorghum and other important crops with active research in Kenya, Nigeria, Ghana, Uganda, South Africa, and Ethiopia. Key findings highlights CRISPR/Cas9 remains the dominant editing platform, while base editing, prime editing, and multiplex genome engineering are expanding opportunities for precise trait modification in major and orphan crops. Evidence to date shows measurable gains include improved resistance to banana Xanthomonas wilt through MusaDMR6 editing, enhanced cassava disease resistance, and drought-tolerant ARGOS8-edited maize. However, most African gene-editing pipelines remain at pre-release or at reserach stage because of limited transformation and phenotyping capacity, fragmented regulatory implementation, inadequate funding, and social and institutional constraints and weak seed-delivery systems. Compared with product-based regulatory approaches in Argentina, Brazil, Japan, and the United Kingdom, African framework remains less harmonized and enabling. Future priorities focus on harmonizing SDN-1/SDN-2 regulatory pathways, participatory public engagement mechanisms, strengthening biosafety and research infrastructure, applying AI-assisted guide RNA design, pangenomics, machine learning, epigenome editing, and de novo domestication, and expanding research on orphan crops such as finger millet, cowpea, and enset that underpin food security but remain under-researched. By focusing on crop-specific examples and well-documented breeding targets, this review aims to provide a scientifically grounded perspective on how gene editing can complement conventional and emerging precision breeding approaches to support sustainable and climate-resilient agriculture in Africa. Agricultural Science Database
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    Spectrum and immunovirological determinants of tumours among people living with HIV in Uganda: A retrospective cross sectional study from a specialised HIV centre, 2017–2026
    (Public Library of Science, 2026-09-22)
    Mwaka, Joseph;
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    Sserunjogi, Conrad;
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    Natalayi, Jesca
    Sub-Saharan Africa carries a disproportionate burden of HIV-associated malignancies. The contemporary tumour spectrum in the dolutegravir (DTG) era remains incompletely characterised in East African routine HIV-care settings. The immunovirological context at the time of cancer or benign tumor diagnosis is similarly under-described. We sought to describe the spectrum, malignant fraction, and immunovirological correlates of neoplasms diagnosed at a specialised HIV centre in Kampala, Uganda. We conducted a retrospective, cross-sectional analysis of 219 tumour records identified within the longitudinal clinical cohort of people living with HIV (PLHIV) in continuous care at Mildmay Hospital, contributed by 216 individual patients (three of whom each had two separate tumour diagnoses on different dates) between November 2017 and January 2026. Tumours were classified by ICD-10 disease group and malignancy status (benign/malignant). Bivariate associations with malignancy status were tested using χ² or Fisher exact tests for categorical variables and Mann-Whitney U tests for continuous variables (two-sided α = 0.05), with Benjamini-Hochberg false discovery rate (FDR) correction applied across each panel of comparisons given the number of variables tested. Crude odds ratios (OR) with 95% confidence intervals (CI) were computed for dichotomous comparisons. A sensitivity analysis restricted to one tumour record per patient (n = 216) was performed to assess the influence of the three patients with two records each. The cohort had a median age of 47 years (IQR 39-54) and was 127/219 (58.0%) female. Overall, 138/219 tumours (63.0%) were malignant. Kaposi sarcoma (KS) was the most frequently registered malignancy (n = 65; 47.1% of all malignant tumours; 29.7% of the full cohort). Among 155 records with viral load data, 133 (85.8%) were virally suppressed at tumour diagnosis, yet 70/133 (52.6%) of those suppressed records were malignant. Advanced WHO clinical stage (III/IV) at ART initiation was associated with malignant diagnosis (OR 3.51, 95% CI 1.54-8.81; FDR-adjusted p = 0.003). Median CD4 at ART initiation was lower among malignant compared with benign tumour records (147 vs 476 cells/µL; FDR-adjusted p = 0.001), and median ART duration before diagnosis was shorter (37 vs 101 months; FDR-adjusted p < 0.001). Restricting the analysis to KS versus other malignancies only (n = 138), KS patients had lower CD4 at ART initiation (136 vs 171 cells/µL, p = 0.079) and markedly shorter ART duration before diagnosis (4 vs 63 months, p < 0.001) than patients with other malignancies. All associations were materially unchanged in the patient-level sensitivity analysis. HIV-associated tumours in this Ugandan cohort remain predominantly malignant and are dominated by KS despite high viral suppression rates. Malignancy clusters among patients with low pre-ART CD4 counts, advanced WHO stage, and short ART duration, though these are unadjusted, hypothesis-generating comparisons rather than evidence of causal or temporal gradients. These data establish the analytic platform for a prospective HIV-oncology cohort at Mildmay Hospital and Mildmay Research Centre and inform context-appropriate cancer screening priorities. MEDLINE