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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Africa Portal is an online repository of open access library collection with over 3,000 books, journals, and digital documents on African policy issues. This is an initiative by the Centre for International Governance Innovation (CIGI), Makerere University (MAK), and the South African Institute of International Affairs (SAIIA). Please visit the Africa Portal at http://www.africaportal.org/library.

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    Changes in sexual behavior among women in studies evaluating the dapivirine vaginal ring for HIV prevention
    (Published by CSIRO Publishing., 2026-08-20)
    Hlahla, Kudzai;
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    Neradilek, Moni;
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    Garcia, Morgan ;
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    Mhlanga, Felix;
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    Palanee-Phillips, Thesla;
    Access to novel HIV prevention technologies often raise concerns of risk compensation. This analysis examined changes in the sexual behaviors of MTN 020/ASPIRE participants, a placebo controlled randomized control trial, who subsequently enrolled in MTN-025/HOPE, an open-label extension using the dapivirine vaginal ring. Both studies enrolled healthy, sexually active, HIV-negative women from Malawi, South Africa, Uganda and Zimbabwe. Longitudinal data on participants' sexual behaviors, specifically sex with a nonprimary partner (past 3 months), and use of male or female condoms at the last vaginal sex act were compared between ASPIRE and HOPE. Conditional and mixed ordinal logistic regression models evaluated associations between study and sexual behaviors at enrollment, and quarterly over the first 12 months. Of the 2629 individuals enrolled in ASPIRE, 1456 (55%) participated in HOPE. At enrollment, the proportion of participants who reported sex with a nonprimary partner and condom use at last vaginal sex act did not differ by study. Across all quarterly follow-up visits, sex with a nonprimary partner was more common in HOPE (13.9-18.7%) than ASPIRE (10.7-12.6%); adjusted OR 1.47, 95% CI 1.24-1.75, P < 0.001. There was no difference in condom use at the last vaginal act across all quarterly follow-up visits between ASPIRE (36.5-42.7%) and HOPE (43.6-46.7%); adjusted OR 1.05, 95% CI 0.94-1.18. More women reported sex with nonprimary partners in HOPE, with little change in condom use over time between the two studies. Understanding behavior changes during PrEP use allows for tailored, holistic reproductive health programming. MEDLINE
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    Predictors of prolonged decision-to-delivery interval in emergency caesarean section in Northern Uganda: a historical cohort study
    (Taylor & Francis Group, 2026-06-11)
    Ochola, Henry;
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    Omoro, Ronnie;
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    Buga, Paul ;
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    Ayella Odong, Emintone;
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    Ocaya, Oscar;
    Delays in decision-to-delivery interval (DDI) during emergency caesarean section (CS) may increase the risk of adverse maternal and neonatal outcomes. Evidence on health-system and provider-related factors influencing DDI in low-resource settings remains limited. We examined whether surgeon cadre, operating theatre location, and the presence of intern healthcare professionals were associated with prolonged DDI in a tertiary hospital in Northern Uganda.BACKGROUNDDelays in decision-to-delivery interval (DDI) during emergency caesarean section (CS) may increase the risk of adverse maternal and neonatal outcomes. Evidence on health-system and provider-related factors influencing DDI in low-resource settings remains limited. We examined whether surgeon cadre, operating theatre location, and the presence of intern healthcare professionals were associated with prolonged DDI in a tertiary hospital in Northern Uganda.We conducted a historical cohort study at St. Mary's Hospital Lacor, a tertiary hospital in Northern Uganda, involving women who underwent emergency CS (6 September 2022 to 1 June 2024). Logistic regression was used to examine the association between prolonged DDI (≥60 minutes) and surgeon cadre, operating theatre location, and intern presence, adjusting for confounders. Effect modification by emergency CS indication was assessed.METHODSWe conducted a historical cohort study at St. Mary's Hospital Lacor, a tertiary hospital in Northern Uganda, involving women who underwent emergency CS (6 September 2022 to 1 June 2024). Logistic regression was used to examine the association between prolonged DDI (≥60 minutes) and surgeon cadre, operating theatre location, and intern presence, adjusting for confounders. Effect modification by emergency CS indication was assessed.Of the 760 participants enrolled (median DDI was 51 minutes [IQR: 36-67]), 36.0% had prolonged DDI. Emergency CS performed by junior doctors had twice the odds of prolonged DDI compared to fully-licensed doctors (adjusted odds ratio [aOR]: 2.07; 95% CI: 1.38-3.10). Theatre location and presence of interns showed no association with prolonged DDI (aOR: 0.89; 95% CI: 0.61-1.28) and (aOR: 0.71; 95% CI: 0.50-1.02), respectively. There was no statistically significant evidence that these associations differed by the CS indication.RESULTSOf the 760 participants enrolled (median DDI was 51 minutes [IQR: 36-67]), 36.0% had prolonged DDI. Emergency CS performed by junior doctors had twice the odds of prolonged DDI compared to fully-licensed doctors (adjusted odds ratio [aOR]: 2.07; 95% CI: 1.38-3.10). Theatre location and presence of interns showed no association with prolonged DDI (aOR: 0.89; 95% CI: 0.61-1.28) and (aOR: 0.71; 95% CI: 0.50-1.02), respectively. There was no statistically significant evidence that these associations differed by the CS indication.Emergency CS performed by junior doctors was associated with increased odds of prolonged DDI compared with procedures performed by fully-licensed doctors. These findings highlight the importance of strengthening supervision, mentorship and emergency obstetric training for junior doctors in resource-limited settings. Operating theatre location and the presence of intern healthcare professionals were not significantly associated with prolonged DDI.CONCLUSIONSEmergency CS performed by junior doctors was associated with increased odds of prolonged DDI compared with procedures performed by fully-licensed doctors. These findings highlight the importance of strengthening supervision, mentorship and emergency obstetric training for junior doctors in resource-limited settings. Operating theatre location and the presence of intern healthcare professionals were not significantly associated with prolonged DDI. MEDLINE - Academic
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    (De)coding perinatal deaths: applying the International Classification of Diseases to perinatal mortality to a perinatal e-registry from 16 hospitals in Benin, Malawi, Tanzania, and Uganda
    (Taylor & Francis Group, 2026-08-04)
    María del Rosario Alsina;
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    Aliki Christou;
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    Phillip Wanduru ;
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    Bianca Kandeya;
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    Muzdalifat Abeid;
    Background To reduce perinatal deaths, identification of their causes is paramount. ‘The WHO application of ICD-10 to deaths during the perinatal period’ (ICD-PM) was developed to improve the quality of perinatal death data. Objectives To determine stillbirth and very early neonatal death rates across 16 hospitals in Benin, Malawi, Tanzania, and Uganda, examine causes of death and associated maternal conditions applying the ICD-PM, and assess how a clinical perinatal e-registry performed when applying the ICD-PM. Methods We used cross-sectional data collected between 1st July 2021 and 29th February 2024 of babies weighing ≥1000 g or ≥28 weeks of gestational age, born to women aged 13–50 years in the participating hospitals. Results After analyzing 143,105 births, the stillbirth rate was 36.9 per 1,000 births and very early neonatal death rate was 7.7 per 1,000 live births. Nine in ten antepartum stillbirths could not be assigned a cause of death. Among intrapartum stillbirths, the most common cause of death was ‘disorders of fetal growth’ and for very early neonatal death it was ‘complications of intrapartum events’. The e-registry provided information to report on 17 out of the 24 ICD-PM categories. Conclusions Collecting high-quality clinical data through an e-registry allowed the identification of a cause of death for most intrapartum stillbirths and very early neonatal deaths. A specifically designed clinical questionnaire and simple diagnostic procedures could enable the application of the ICD-PM in settings with limited diagnostic resources and high mortality rates.
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    The journey of strengthening mortality surveillance in Uganda through multisectoral guideline development
    (Springer International Publishing, 2026-05-29)
    Kyozira, Caroline;
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    Owori, Benard;
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    Bulamu, Martin ;
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    Muruta, Allan
    BackgroundUnderstanding who dies, where, and from what causes is essential for public health planning and outbreak preparedness. In Uganda, mortality surveillance has historically been constrained by fragmented systems, weak coordination, and underreporting, limiting the use of mortality data for decision-making. In response, the Ministry of Health developed national mortality surveillance (MS) guidelines to strengthen mortality data collection, integration, and use.MethodsA national situational analysis and desk review of existing mortality data systems and tools were conducted. The systems reviewed included the Health Management Information System (HMIS), electronic Integrated Disease Surveillance and Response (eIDSR), Mobile Vital Registration System (MVRS), electronic Community Health Information System (eCHIS) and the District Health Information System (DHIS2). The mortality data reported in DHIS2 between January and June 2025 were analysed via Excel and are reported in tables. A national technical writing team reviewed existing paper-based and digital tools, developed standardized tools, and aligned the guidelines with regional and global frameworks. The guidelines were validated and formally endorsed.ResultsKey gaps identified included weak governance, fragmented data flows, inadequate tools and indicators, and limited digital interoperability. The guidelines established multisectoral coordination committees, standardized all-cause death review tools, mortality registers, and gate passes, integrated non-health actors into national systems, and institutionalized quarterly mortality data reviews.ConclusionUganda’s national MS guidelines address critical coordination and data quality gaps and provide a replicable model for strengthening mortality surveillance and informing public health action in similar settings. Health & Medical Collection (Module)
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    Maize processors’ food handling competency and associated aflatoxin contamination of maize bran in northern Uganda
    (Springer International Publishing, 2026-04-11)
    Odongo, Kizito;
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    Okidi, Lawrence;
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    Kilama, Godfrey ;
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    Ongeng, Duncan
    Aflatoxins pose a serious threat to food and nutrition security. In Uganda, efforts have focused on reducing aflatoxin contamination in maize flour, yet maize bran, a key ingredient in poultry and livestock feed, has received limited attention. This study, conducted in Lira and Gulu districts, examined: (i) the knowledge, attitudes, and practices (KAP) of maize bran producers regarding aflatoxin contamination; (ii) levels of aflatoxin B1 in maize bran; and (iii) the status of regulatory monitoring. Using a closed-ended, interviewer-administered questionnaire and Enzyme Linked ImmunoAssay for aflatoxin B1 quantification, a cross-sectional survey was conducted among 55 maize bran producers. Data were analysed using descriptive statistics and binary logistic regression at a 5% significance level. Findings revealed poor knowledge, negative attitudes, and inadequate practices among producers. A significant positive correlation existed between knowledge and practices (p<0.05). The levels of aflatoxin B1 detected exceeded regulatory limits: 10ppb (Uganda/EAC), 4ppb (EU), and 20ppb (US FDA). Aflatoxin contamination was significantly associated with weekly bran sales volume (p=0.001), market size/stability (p=0.010), water sprinkling during processing (p=0.003), and drying of bran before storage (p=0.015). There was limited regulatory monitoring, with only prioritisation of safety, profit, or both (p=0.048) significantly associated with aflatoxin levels being below or above 20 µg/kg. The study has revealed that maize bran in northern Uganda is highly contaminated and unsuitable for animal feed. Enhancing producer KAP through food safety education and strengthening regulatory enforcement by responsible government agencies is urgently needed to address Aflatoxin contamination in maize bran.