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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Parental death: a systematic review of support experiences and needs of children and parent survivors
(British Medical Journal Publishing Group, 2026-01) Wray, Alexandra;; Pickwell-Smith, Benjamin;; Greenley, Sarah ;; Pask, Sophie;; Bamidele, Olufikayo;; Wright, Barry;; Murtagh, Fliss;; Boland, Jason W
BackgroundBereaved people need a supportive response from those around them. Knowing children’s and surviving parents' needs following parental death is the first step to ensuring a supportive response. However, no systematic review has reported on this phenomenon.AimTo systematically identify and synthesise qualitative literature exploring support experiences of parentally bereaved children and surviving parents.MethodsSystematic review with thematic synthesis, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. MEDLINE, Embase, PsycINFO, CINAHL and the British Nursing Database were searched for relevant papers to September 2021. Included studies were appraised for quality and thematically synthesised using Thomas and Harden’s thematic synthesis framework.ResultsFifteen qualitative studies from nine countries were included. There were four analytical themes from the children’s perspectives (1) Openness of communication with children about death and dying, (2) Children’s challenges of managing change, (3) Navigating emotions, and (4) Children’s acceptability, access and engagement with support. There were three analytical themes from the parents' perspectives: (1) Adjusting as a parent, (2) Supporting their children, and (3) Parent’s acceptability, access and engagement with support.ConclusionsFollowing a parental death, open and honest communication and involvement in what is happening within the family will help children cope. Both children and parents suppress emotions and avoid conversations to protect each other and those around them. A taboo around death exists and constrains the support some families receive. Childhood bereavement is a public health issue, with a need for professionals and communities to better understand and respond to the needs of bereaved families.CRD42020166179
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Susceptibility Patterns and Factors Associated with Multidrug Antibiotic Resistance Among Patients with Productive Cough in Southwestern Uganda
(Dove Medical Press, 2026-01) Ezekiel W;; Kegoye ES;; Ssempijja F ;; Maniga JN;; Ampeire IP;; Abdi AA
Winnie Ezekiel,1 Eric Simidi Kegoye,2,3 Fred Ssempijja,4,5 Josephat Nyabayo Maniga,6 Isaac Petit Ampeire,1 Awil Abdulkadir Abdi1 1Department of Internal Medicine, Kampala International University Teaching Hospital, Bushenyi, Uganda; 2Department of Human Anatomy, Kenya Methodist University, Meru, Kenya; 3Department of Human Anatomy, Kampala International University, Bushenyi, Uganda; 4Infection Medicine, Edinburgh Medical School, Deanery of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK; 5School of Allied Health, St. Lawrence College, Kingston, Canada; 6Department of Microbiology and Immunology, Kampala International University, Bushenyi, UgandaCorrespondence: Awil Abdulkadir Abdi, Department of Internal Medicine, Kampala International University Teaching Hospital, Bushenyi, Uganda, Email awil6263@gmail.comBackground: Antibiotic resistance is a growing global public health concern, yet data on bacterial pathogens and susceptibility patterns among patients with productive cough in Uganda are scarce. This study aimed to determine the prevalence, bacterial isolates, susceptibility profiles, and factors associated with antibiotic resistance at Hoima Regional Referral Hospital, Uganda.Methods: A cross-sectional study was conducted among 216 adult outpatients presenting with productive cough. Sociodemographic, lifestyle, and medical data were obtained using structured questionnaires. Sputum samples were cultured, and antibiotic susceptibility testing was performed using Kirby-Bauer disk diffusion according to Clinical and Laboratory Standards Institute (CLSI) M100 (2022) guidelines. Logistic regression analyses were used to identify factors associated with antibiotic resistance. A p value of < 0.05 was considered statistically significant.Results: Bacterial pathogens were isolated in 139 (64.4%) patients. The most frequent were Streptococcus pneumoniae 57 (40.8%), Staphylococcus aureus 40 (28.6%), Klebsiella pneumoniae 17 (12.2%), and Streptococcus pyogenes 14 (10.2%). Most bacterial isolates were sensitive to imipenem 105 (75.5%), ceftazidime 92 (66.7%), and cefepime 81 (58.5%), while the lowest was to ampicillin 13 (9.5%) and amoxicillin 13 (9.5%). Antibiotic resistance was associated with smoking (aOR = 2.89, 95% CI: 1.074– 7.784, p = 0.036) and prior use of antibiotic (aOR = 2.65, 95% CI: 1.103– 6.369, p = 0.029).Conclusion: Among outpatients with a productive cough at Hoima Regional Referral Hospital, Streptococcus pneumoniae, Staphylococcus aureus were the leading Gram-positive isolates, and Klebsiella pneumoniae was the most common Gram-negative. Gram-negative isolates showed more susceptibility to ceftazidime, and overall susceptibility was more for imipenem, whereas ampicillin and amoxicillin demonstrated very low activity. Antibiotic resistance was significantly associated with smoking and prior use of antibiotic. These findings underscore the need for routine sputum culture and sensitivity testing, and strengthened public health measures to reduce smoking and inappropriate use of antibiotic.Keywords: multidrug resistance, productive cough, Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae, use of antibiotic, smoking, Uganda
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The evolution of supportive supervision in low- and middle-income countries
(BMC, 2026-01-02) Khaled Shorbaji;; Gabriel L. Shedul;; Nanna Ripiye ;; Dike Ojji;; Lisa R. Hirschhorn;; Charles W. Goss;; Mark D. Huffman
Abstract Supportive supervision has shifted in low- and middle-income countries (LMICs) from hierarchical, inspection-based oversight toward collaborative, mentorship-driven approaches that emphasize two-way communication, joint problem-solving, and formative feedback. Evidence across diverse LMIC settings shows that supportive supervision can produce measurable improvements in healthcare worker performance, with particularly large gains when supervisors themselves receive coaching and when supervisory encounters prioritize collaborative problem-solving. Innovations such as peer and group supervision, facility-based internal supervision, and digital platforms have expanded the reach and adaptability of supervision systems, although digital tools alone consistently yield modest improvements in provider practices. Broader implementation packages that pair supervision with health-system enablers—such as strengthened infrastructure, supply chains, financing, and management—achieve substantially larger effects than supervision combined with training alone, highlighting the importance of addressing structural barriers to performance. Despite its demonstrated potential, supportive supervision is not a standalone solution; its effectiveness depends on alignment with local context, clear definitions and expectations, adequate resourcing, and integration within broader quality-improvement and systems-strengthening strategies. When selected through structured problem diagnosis and paired with appropriate complementary interventions, supportive supervision offers a pragmatic, scalable approach to improving frontline clinical performance and advancing high-quality, equitable care in LMIC health systems.
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Factors associated with all-cause mortality and morbidity of motorcycle crash-related neurological and musculoskeletal injuries in Uganda: the MOTOR cluster randomised trial ancillary study
(BMJ Publishing Group Ltd, 2025-11-30) Lule, Herman;; Mugerwa, Micheal;; Abio, Anne ;; Oguttu, Benson;; Kakeeto, Andrew;; Asiimwe, Daniel;; Lekuya, Hervé Monka Monka;; Ssebuufu, Robinson;; Kyamanywa, Patrick;; Bärnighausen, Till;; L Wilson, Michael;; Posti, Jussi P
This study examined the factors linked to all-cause mortality and morbidity from neurological and musculoskeletal injuries during motorcycle accidents in Uganda.INTRODUCTIONThis study examined the factors linked to all-cause mortality and morbidity from neurological and musculoskeletal injuries during motorcycle accidents in Uganda.The study was part of a two-armed, parallel, multi-period, cluster-randomised controlled trial of 1003 motorcycle crash victims. Morbidity was assessed using various scoring systems, and mixed effects regression models were employed for analysis.METHODSThe study was part of a two-armed, parallel, multi-period, cluster-randomised controlled trial of 1003 motorcycle crash victims. Morbidity was assessed using various scoring systems, and mixed effects regression models were employed for analysis.Ninety-day all-cause mortality was 9.2% (82/887). Factors associated with mortality included referral-to-dispatch >1 hour (OR 4.215 (1.802-9.858), p=0.001), Kampala Trauma Score (KTS) ≤6 (OR 7.696 (1.932-30.653), p=0.004), GCS 9-12 (OR 3.432 (1.194-9.870), p=0.022), GCS ≤8 (OR 6.919 (2.212-21.645), p=0.001), intra-axial lesions (OR 78.647 (9.871-626.587), p<0.001), extra-axial lesions (OR 11.933 (1.386-102.750), p=0.024), skull fracture (OR 11.366, (1.197-107.977), p=0.034) and craniotomy (OR 0.260 (0.095-0.706), p=0.008).A percentage of 14.5% had unfavourable Glasgow Outcome Scale (1-3); associated factors included increasing age (OR 1.02 (1.013-1.045, p<.001), multiple injuries (OR 4.559 (1.185-17.531), p=0.027), KTS 7-8 (OR 2.755 (1.285-5.906), p=0.009), KTS ≤6 (OR 7.551 (2.815-20.255), p=0.001), GCS 9-12 (OR 4.07 (1.901-8.719), p=0.001), GCS ≤8 (OR 13.779 (5.643-33.645), p<0.001) and craniotomy (OR 0.149 (0.075-0.295), p<0.001).Factors associated with unfavourable patient-reported musculoskeletal outcomes included being married (OR 1.984 (1.322-2.976), p=0.001), multiple injuries (OR 1.762 (1.001-3.100), p=0.049) and enrolment after the onset of the COVID-19 pandemic (OR 2.095 (1.199-3.659), p=0.009].RESULTSNinety-day all-cause mortality was 9.2% (82/887). Factors associated with mortality included referral-to-dispatch >1 hour (OR 4.215 (1.802-9.858), p=0.001), Kampala Trauma Score (KTS) ≤6 (OR 7.696 (1.932-30.653), p=0.004), GCS 9-12 (OR 3.432 (1.194-9.870), p=0.022), GCS ≤8 (OR 6.919 (2.212-21.645), p=0.001), intra-axial lesions (OR 78.647 (9.871-626.587), p<0.001), extra-axial lesions (OR 11.933 (1.386-102.750), p=0.024), skull fracture (OR 11.366, (1.197-107.977), p=0.034) and craniotomy (OR 0.260 (0.095-0.706), p=0.008).A percentage of 14.5% had unfavourable Glasgow Outcome Scale (1-3); associated factors included increasing age (OR 1.02 (1.013-1.045, p<.001), multiple injuries (OR 4.559 (1.185-17.531), p=0.027), KTS 7-8 (OR 2.755 (1.285-5.906), p=0.009), KTS ≤6 (OR 7.551 (2.815-20.255), p=0.001), GCS 9-12 (OR 4.07 (1.901-8.719), p=0.001), GCS ≤8 (OR 13.779 (5.643-33.645), p<0.001) and craniotomy (OR 0.149 (0.075-0.295), p<0.001).Factors associated with unfavourable patient-reported musculoskeletal outcomes included being married (OR 1.984 (1.322-2.976), p=0.001), multiple injuries (OR 1.762 (1.001-3.100), p=0.049) and enrolment after the onset of the COVID-19 pandemic (OR 2.095 (1.199-3.659), p=0.009].The key determinants of mortality and adverse neurological and musculoskeletal injury outcomes observed in this study are essential for establishing core outcome sets in future research and predictive models.CONCLUSIONSThe key determinants of mortality and adverse neurological and musculoskeletal injury outcomes observed in this study are essential for establishing core outcome sets in future research and predictive models.Pan African Clinical Trial Registry (PACTR202308851460352).TRIAL REGISTRATION NUMBERPan African Clinical Trial Registry (PACTR202308851460352). MEDLINE - Academic
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Comparative Phytochemical Profiles of Medicinal Plants Used for Wound Treatment: Insights From Wild and Hydroponically Cultivated Species in Lugazi Diocese, Uganda
(Wiley Subscription Services, Inc, 2025-12-18) Kahwa, Ivan;; Seel, Christina;; Ikiriza, Hilda ;; Kulosa, Maria;; Billig, Susan;; Wiesner, Claudia;; Weisheit, Anke;; Makumbi, Olivia Harriet;; Gerth, André;; Kaysser, Leonard
Medicinal plants such as Centella asiatica, Conyza sumatrensis, and Justicia betonica are widely used in Uganda for traditional wound healing. However, the impact of cultivation conditions on their therapeutic potential remains poorly understood. This study compared the phytochemical profiles and bioactivities of hydroponically cultivated and wild-collected material of these species from Lugazi Diocese, Uganda. Extracts were prepared using ethanol, methanol, and water, and analyzed by thin-layer chromatography (TLC), high-performance liquid chromatography (HPLC-UV), headspace gas chromatography-mass spectrometry (HS-GC-MS), and liquid chromatography-tandem mass spectrometry (LC-MS/MS). TLC and HPLC-UV indicated terpenoids, flavonoids, and steroids, while HS-GC-MS revealed predominantly monoterpenes and sesquiterpenes. LC-MS/MS annotated flavonoids, including quercetin-3-O-glucuronoside, kaempferol-3-O-rutinoside, and kaempferol, as well as triterpenoids such as asiatic acid and katononic acid. Antibacterial activity was evaluated against Bacillus subtilis, Escherichia coli, Pseudomonas fluorescens, and Saccharomyces cerevisiae using the agar well diffusion method. Anti-inflammatory effects were assessed by IL-6 and IL-8 secretion, and cytotoxicity by MTT assay. Ethanol and methanol extracts exhibited moderate antibacterial activity, while aqueous extracts of wild C. asiatica and hydroponic C. sumatrensis significantly reduced IL-6 secretion. No cytotoxic effects were detected. These findings suggest hydroponic cultivation preserves essential phytochemicals and bioactivities, supporting sustainable production of medicinal plants for therapeutic applications.