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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Long-term risk of tuberculosis among individuals with Xpert Ultra trace screening results in Uganda: a longitudinal follow-up study
(Elsevier Ltd, 2025-10-07) Sung, Joowhan;; Nantale, Mariam;; Nalutaaya, Annet ;; Biché, Patrick;; Mukiibi, James;; Akampurira, Joab;; Kiyonga, Rogers;; Kayondo, Francis;; Mukiibi, Michael;; Visek, Caitlin;; Kamoga, Caleb E;; Dowdy, David W;; Katamba, Achilles;; Kendall, Emily A
Systematic screening for tuberculosis using Xpert Ultra can generate trace results of uncertain significance. Additional microbiological testing in this context is often negative, but untreated individuals might still progress to culture-positive disease. We aimed to estimate the 2-year risk of tuberculosis among screened participants with trace-positive sputum (PWTS). In this longitudinal follow-up study, we conducted Ultra-based systematic screening for tuberculosis in Kampala, Uganda, from Feb 2, 2021, to April 27, 2024, enrolling PWTS as well as participants who were Ultra-positive or Ultra-negative controls. Recruitment occurred primarily through community-based screening events and door-to-door screening. Ultra sputum testing was offered to individuals aged 15 years or older who were not on active tuberculosis treatment, regardless of their symptoms. All PWTS, as well as age-matched and sex-matched participants with negative screening results and consecutive participants with positive screening results, were recruited. Participants underwent extensive initial evaluation, and untreated PWTS and negative-control participants were followed up with re-testing for up to 24 months. Our primary outcome was the cumulative hazard of tuberculosis among PWTS, using two definitions of tuberculosis: one incorporating clinician judgement and one strictly microbiological. We then compared hazards between PWTS and negative-control participants. We also assessed whether the presence of symptoms or chest x-ray abnormalities at baseline were associated with tuberculosis diagnosis during follow-up in PWTS. We screened 31 505 people for tuberculosis in Uganda using sputum Xpert Ultra as an initial test through event-based and door-to-door screening. We enrolled 128 PWTS and 139 age-matched and sex-matched control participants who were Ultra-negative (negative-control participants) into prospective cohorts and 110 control participants who were Ultra-positive (more than trace) for cross-sectional comparison. Of 128 PWTS, 79 (62%) were male, 49 (38%) were female, and 19 (15%) were HIV positive; 45 (35%) were recommended for treatment upon enrolment, eight (6%) were lost to follow-up within 3 months, and 75 (56%) were followed up for a median of 706 days (IQR 344–714), of whom 19 (25%) were recommended for treatment during follow-up. The cumulative hazard of tuberculosis among PWTS not treated at baseline was 0·24 (95% CI 0·15–0·40) at 1 year and 0·33 (0·21–0·54) at 2 years, versus 0·03 (0·01–0·10) at 2 years for negative-control participants. Hazards were similar for microbiologically defined tuberculosis (0·36 [95% CI 0·22–0·58] for PWTS vs 0·02 [0·01–0·10] for negative-control participants at 2 years). Tuberculosis diagnosis during follow-up was strongly associated with atypical baseline chest x-ray (ie, interpreted by radiologists as having any abnormality; hazard ratio 14·6 [95% CI 3·3–63·8]) but not with baseline symptoms (cough, fever, night sweats, or weight loss). Individuals with trace-positive sputum during screening have a substantial 2-year risk of tuberculosis, even when extensive initial evaluations do not confirm disease. Treatment should be considered for most screening participants with trace-positive sputum and atypical chest imaging. National Institutes of Health and the Gates Foundation.
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A scoping review of community-based stroke rehabilitation in low-resource settings
(SAGE Publications, 2025-08-08) Hardianto, Yudi;; Lynch, Elizabeth;; Irwan, Andi Masyitha ;; Kandasamy, Thoshenthri;; Purvis, Tara;; Callisaya, Michele L;; Lindley, Richard I;; Gandhi, Dorcas;; Liu, Ning;; Abd Aziz, Noor Azah;; Pandian, Jeyaraj;; Cadilhac, Dominique A
Background: There is a need for accessible and affordable rehabilitation services in low-resource settings (low- and middle-income countries) to support the increasing number of survivors of stroke. Aims: To synthesize existing literature on the delivery of community-based stroke rehabilitation programs in low-resource settings. Summary of review: We followed the PRISMA Scoping Review guidelines. Seven databases (including MEDLINE, PsycINFO, and CINAHL) were searched to identify relevant articles published between January 2012 and December 2024. Studies were considered if they included physical rehabilitation strategies as part of a community-based rehabilitation program for individuals with stroke aged ⩾18 years in low-resource settings. Titles, abstracts, and full texts were screened by multiple authors for inclusion. A predefined template that covered physical rehabilitation strategies, setting, providers, frequency, session duration, and program duration was used for data extraction. Results were synthesized narratively. After screening 2892 abstracts, 25 studies were included from 11 countries throughout Asia, Africa, and South America. Most studies were carried out in middle-income countries, with only one study taking place in a low-income country (Uganda). Over half of the studies (n = 16) were randomized controlled trials (RCTs). The physical rehabilitation programs were primarily delivered at home, in person, by a single healthcare professional, typically a physiotherapist or nurse. Session duration was not specified for more than half of the studies. Where reported, sessions were 1 h or less, usually occurring at least once weekly over a 2-to-3-month period. Over 36 different outcome measures were identified, with the Barthel Index being the most common (48%). Overall, 10 RCTs showed a statistically significant difference between intervention and control groups, while five RCTs had no significant difference at the post-intervention outcome evaluation. None of the included publications reported costs or cost-effectiveness data. Conclusion: Community-based rehabilitation programs in low-resource settings differ in their physical rehabilitation strategies and characteristics. While the evidence base in this field is growing, the lack of cost-effectiveness evaluations means there is limited guidance to inform investment in, or optimization of, these multi-component, community-based programs. Graphical abstract
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Emergence of measles virus genotype D8 amidst endemic B3 circulation in Uganda, 2023-2025
(Elsevier, 2024-11-24) Prossy Namuwulya;; Irene Turyahabwe;; Rena Nakyeyune ;; Molly Birungi;; Phionah Tushabe;; James Peter Eliku;; Francis Aine;; Jonathan Comfort Haumba;; Mathias Ssenono;; Lucy Nakabazzi;; Maria Nabbuto;; Jacob Mpiima;; Micheal Baganizi;; Immaculate Ampeire;; Annet Kisakye;; Qouilazoni Aquino Ukuli;; Henry Bukenya;; Josephine Bwogi;; Barnabas Bakamutumaho
Objectives: Measles remains a significant global health threat, with recurrent outbreaks, even in regions such as America, where the disease had been eliminated. Despite the availability of an effective and freely accessible vaccine, measles remains a global burden especially in children. The World Health Organization (WHO) estimated 107,500 measles-related deaths in 2023, with over 95% occurring in low- and middle-income countries reflecting fragile health systems. Uganda has similarly experienced persistent outbreaks since 2023. This study aimed at investigating the emergence of measles genotype D8 in Uganda for the first time, alongside the endemic measles genotype B3. Methods: To track measles circulating strains, molecular genotyping targeting the measles virus N450 region was performed on 137 specimens. Phylogenetic analysis of the sequences was carried out along with WHO reference sequences and GenBank selected sequences. Results: Alongside the endemic B3 genotype, genotype D8 was detected for the first time in Uganda, revealing co-circulation of both lineages. Conclusions: The detection of measles D8 alongside the endemic B3 indicated possible gaps in the existing surveillance system and vaccination coverage. These findings highlight the critical importance of molecular surveillance and the urgent need to enhance measles vaccination coverage.
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Perception as a mediator between service quality, customer satisfaction, and customer loyalty: evidence from savings and credit cooperatives (SACCOs) in Uganda
(Taylor & Francis group, 2026-01-14) Sandra Esagala;; Peter Dithan Ntale
savings and credit cooperatives (saccOs) in Uganda continue to face challenges infostering and sustaining member loyalty despite ongoing improvements in servicequality. Persistent member turnover, limited trust and weak relational bonds raisequestions about how service quality and satisfaction translate into enduring loyalty.this study examined the mediating role of customer perception in the relationshipsamong service quality, customer satisfaction and customer loyalty in Ugandan saccOs.guided by expectation confirmation theory (ect), a cross-sectional quantitative designwas employed using 384 distributed questionnaires, of which 196 were valid. Data wereanalyzed using correlation, hierarchical regression and mediation techniques. resultsrevealed significant positive associations among all key variables and confirmed thatcustomer perception partially mediates the effects of both service quality andsatisfaction on loyalty, accounting for 27.9% of the variance in the outcome variable.these findings highlight that while service quality directly influences loyalty, much ofits impact operates through members’ cognitive evaluations of fairness, value and trust.the study contributes to the service quality–loyalty literature by positioning perceptionas a critical cognitive mechanism in cooperative finance. in practice, it proposes aperception-centered framework for strengthening trust and loyalty through transparentcommunication, responsive service delivery and technology-driven solutions, includingmobile banking and digital service platforms, to enhance the member experience andinstitutional resilience.
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Compressive strength and cost-effectiveness of confined waste plastic bottle brick masonry walls
(Taylor & Francis group, 2026-01-14) Masaba, Emmison Eric;; Kyakula, Micheal;; Ssenyondo, Vicent
Uganda faces a substantial housing deficit, and escalating construction costs resulting from unsustainable extraction of construction materials and inadequate management of plastic and sawdust waste. This study evaluates the compressive strength and cost effectiveness of Plastic Bottle Brick (PBB) masonry walls as a potential substitute for conventional concrete block walls in Mbale City, Uganda. The work specifically addresses the limited empirical evidence concerning the behaviour of vertically oriented confined PBB units incorporating uncompressed air (EB), sawdust (SD) and pit sand (PS). Compressive strength testing showed that PS walls achieved a strength of 0.6 ± 0.02 MPa, comparable to hollow concrete block (HCB) walls (0.6 ± 0.06 MPa). SD and EB walls exhibited lower strengths of 0.3 ± 0.05 MPa and 0.3 ± 0.03 MPa, respectively, below the strength of solid concrete block (SCB) walls (0.8 ± 0.03 MPa). All PBB walls demonstrated higher failure strains (1.8–2.0%) than concrete block walls (1.0–1.2%). The cost-benefit analysis considering materials, labour, time utilisation and carbon emissions costs found that EB blocks were the most economical (USD 3.22/UGX 11,694), while SCB were the least economical (USD 7.97). PBB production was commercially feasible, with casting time only 17% slower than conventional block production.