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Temporal variability and flooding influence the ecological niche of Biomphalaria intermediate hosts for Schistosoma mansoni in rural Uganda
(The royal society publishing, 2026-01-26) Iacovidou, Melissa A.;; Byaruhanga, Anatol M.;; Besigye, Fred ;; Nabatte, Betty;; Kabatereine, Narcis B.;; Chami, Goylette F.
Understanding the niches of intermediate hosts and vectors for environmentally transmitted pathogens is crucial for identifying endemic areas, assessing habitat suitability and targeting interventions. This study focuses on intermediate hosts of intestinal schistosomes, with over 700 million people at risk of lifelong infection. We compared habitat suitability and species interactions across 674 sites in 52 villages in rural Uganda between 2022 and 2024, capturing a severe flooding event. Spatiotemporal models incorporating a polygon-based method to account for space with time as a fixed effect were developed to analyse snail abundance for Biomphalaria sudanica and B. stanleyi. B. sudanica was associated with marshy sites near lake shorelines and presence of hyacinths, while B. stanleyi was more likely to be found in deeper waters with Vallisneria plants. However, cohabitation was common for both species. Habitat suitability for each species fluctuated temporally, and more starkly with extreme flooding, resulting in switching of species dominance. Our study suggests that events consistent with climate change may influence habitat suitability without necessitating an expansion of environmental areas. Our models enable tracking of dynamic ecological niches that, if replicated elsewhere and for other intermediate hosts or vectors, can be used to better target environmental and community interventions as environmental conditions change. MEDLINE
Co-designing family planning interventions: Insights from religious leaders in urban eastern Uganda
(Elsevier, 2026-01-20) Jacquellyn Nambi Ssanyu;; Catherine Birabwa;; Kharim Mwebaza Muluya ;; Felix Kizito;; Sarah Namutamba;; Moses Kyangwa;; Othman Kakaire;; Peter Waiswa;; Rornald Muhumuza Kananura
Background: In Uganda, religion strongly influences family planning (FP) practices, yet religious leaders are often excluded from FP program design and delivery. Engaging them meaningfully could help address misconceptions and improve voluntary FP uptake. Methods: We applied Community-Based Participatory Action Research and Human-Centered Design to engage 16 religious leaders from Muslim, Catholic, Anglican, and Pentecostal faiths in Jinja City and Iganga Municipality, eastern Uganda. Faith-specific discussions were conducted using a structured agenda and co-moderated by participants. Data from audio recordings and notes were transcribed, translated, and analyzed thematically. Results: All religious leaders expressed openness to FP but differed in their definitions and preferred methods. Christian leaders associated FP with responsible parenthood and manageable family sizes, while Muslim leaders emphasized parental responsibility without limiting fertility, stressing faith in divine provision. Natural methods were widely accepted, while hormonal methods were met with caution due to health concerns. There was unanimous opposition to providing FP to unmarried adolescents, with abstinence endorsed as the only acceptable option. Leaders welcomed the opportunity to share FP messages through their platforms, provided materials were accurate, respectful of religious values, and comprehensive in scope. Conclusions: Religious leaders can play a pivotal role in advancing FP awareness and acceptance when engaged as partners in design and messaging. Programs should prioritize culturally sensitive communication, clarify misconceptions, and co-create strategies that align with faith-based perspectives. These approaches can enhance trust, shift social norms, and improve access to FP services, especially in communities where religious influence is strong.
Delayed patient isolation and associated factors during the mpox outbreak in Uganda, July-December 2024
(Elsevier, 2025-12-21)
Objective: Rapid detection and isolation of mpox mpox patients reduces transmission. We assessed delays in patient isolation and associated factors during the mpox outbreak in Uganda from July to December 2024 to inform response efforts. Methods: We selected all laboratory-confirmed cases isolated at two mpox isolation centers in Uganda from July 24 to December 29, 2024. Time-to-Isolation (TTI) was number of days from symptom onset to isolation, categorized as ‘short’ (0-3 days) or ‘delayed’ (>3 days) based on operational benchmarks for rapid containment of a highly infectious disease and the biological urgency of early isolation of mpox cases. We summarized data from case narratives into descriptive statistics and used multivariable logistic regression to measure the level of association of individual factors with delayed TTI which was the outcome variable. Reasons for short or delayed TTI were obtained from qualitative interviews. Results: Among 832 mpox patients, 709 (91%) had delayed TTI, 473 (57%) were males, 713 (86%) were ≥18 years old, 698 (83%) had not visited a health facility before isolation, and 742 (89%) had self-medicated before isolation. Age ≥18 years (aOR = 2.6, 95% CI = 1.6-4.2) and self-medication (aOR = 5.4, 95% CI = 1.7-17.1) were associated with delayed TTI. Interviewed mpox patients with delayed TTI (n = 9) attributed this to lack of diagnostic skills among healthcare workers and attributed their delayed care-seeking to personal economic concerns. Mpox patients with short TTIs (n = 6) attributed this to prior knowledge about mpox from social media and response teams. Conclusion: Most mpox patients experienced delayed TTI, associated with being older than 18 years and self-medication, and driven by misdiagnosis and individual economic concerns. Targeting risk communication and strengthening frontline diagnostic capacity could improve early case detection and management.
Pilot mental health sensitisation programme for community leaders in Uganda: impact evaluation
(Cambridge University Press, 2025-07-30) Shuttleworth, Linda;; Pontin, Francesca
Despite worldwide uptake, there has been little published evaluation of actually delivering the World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) in typical low- and middle-income countries (LMICs). This paper aims to evaluate the impact of a pilot study in which mhGAP guidelines for mental health sensitisation of community leaders were implemented in 1-day training events across 25 urban and rural health facilities ( n = 1004 community leaders) in Uganda. A multiple choice mental health questionnaire was used to assess the community leaders’ mental health knowledge before and after completing the training. Training was evaluated across multiple sites and qualitative feedback comments were used to identify key themes on the impact of the training. The sensitisation training was found to be affordable, accessible and effective, and could be replicated in other LMICs and settings with local adaptations. CrossRef
Livelihoods as a key social determinant of malaria: Qualitative evidence from Uganda
(Taylor & Francis group, 2025-12-02) Deane, Kevin;; Atusingwize, Edwinah;; Musoke, David
Malaria continues to be one of the leading causes of morbidity and mortality in Africa. Recent progress towards eliminating malarias has stagnated and, in some cases began to reverse. One key dimension which remains poorly understood in malaria research is the social determinants of the disease, which direct attention to the conditions in which people live and work. We present findings from a qualitative study that explored perceptions and understanding of the social determinants of malaria in Uganda, one of the main endemic countries. We conducted 14 key informant interviews, 10 focus group discussions with community members, and 11 in-depth interviews with households recently impacted by malaria. Our participants identified livelihoods and related practices as important social determinants. These included engaging in crop production with a focus on maize cultivation, livestock husbandry, construction, a range of activities conducted at dusk/night, and the gendered nature of specific livelihoods. The precise mechanisms noted through which these livelihood activities were related to malaria include increasing exposure to mosquitoes at dusk/night, the creation of new mosquito breeding sites, attracting mosquitoes to housing, providing feeding sites for mosquitoes, working near mosquito breeding sites, and the role that gendered care responsibilities play in exposing children to mosquitoes. Our findings emphasize the importance of engaging in these livelihood activities, given that they are widespread in Uganda and other African countries. We recommend that malaria prevention be incorporated into socio-economic development strategies, and urge researchers, policy makers, practitioners and other stakeholders to engage with the social determinants of malaria. International Bibliography of the Social Sciences (IBSS)
Associations between the microbiome and immune responses to an adenovirus-based HIV-1 candidate vaccine are distinct between African and US cohorts
(American Society for Microbiology, 2026-01-15) Li, Yuhao;; Stieh, Daniel J;; Droit, Lindsay ;; Kim, Andrew HyoungJin;; Rodgers, Rachel;; Mihindukulasuriya, Kathie A;; Wang, Leran;; Pau, Maria G;; Yuan, Olive;; Virgin, Herbert W;; Barouch, Dan H;; Baldridge, Megan T;; Handley, Scott A
Optimization of prophylactic vaccine regimens to elicit strong, long-lasting immunity is an urgent need highlighted by the COVID-19 pandemic. Stronger vaccine immunogenicity is frequently reported in individuals living in high-income countries compared to individuals living in low- and middle-income countries. While numerous host genetic and immune factors may influence vaccine responses, geographic restrictions to vaccine effectiveness may also be influenced by the intestinal microbiota, which modulates host immune systems. However, the potential role of the gut microbiota on responses to HIV-1 vaccines has not yet been explored. We analyzed the bacteriome by targeted 16S sequencing and the virome by virus-like particle sequencing of 154 fecal samples collected from healthy individuals in Uganda, Rwanda, and the United States early (week 2) and late (week 26) after vaccination with multivalent adenovirus serotype 26 (Ad26)-vectored mosaic HIV-1 vaccines. Vaccination did not affect the enteric bacteriome or virome regardless of geographic location. However, geography was the major driver of microbiota differences within this cohort. Differences in overall bacterial and viral diversity and in specific microbial taxa, including and , between participants from the United States and East African countries correlated with differential immune responses, including specific antibody titers, antibody functionality, and cellular immune responses to vaccination regimens. These findings support the microbiota as a putative modifier of vaccine immunogenicity.IMPORTANCEOur research examined how gut bacteria might influence vaccine effectiveness in different parts of the world. We studied adults from the United States, Rwanda, and Uganda who received an experimental HIV vaccine. We found that participants from East Africa had more diverse gut bacteria than those from the United States, but their immune responses to the vaccine were weaker. This is the first study to directly show this relationship between higher gut bacterial diversity and reduced vaccine effectiveness in the same group of people. We also identified specific types of bacteria that were linked to either stronger or weaker immune responses. These findings are particularly relevant now as we use vaccines globally to fight diseases like COVID-19, as they suggest that regional differences in gut bacteria and might help explain why vaccines work better in some places than others. This could inform how we design and test future vaccines. PubMed
Low-dose yellow fever vaccination in infants: a randomised, double-blind, non-inferiority trial
(Elsevier Ltd, 2026-01-13) Kimathi, Derick;; Juan-Giner, Aitana;; Bob, Ndeye S ;; Orindi, Benedict;; Namulwana, Maria L;; Diatta, Antoine;; Cheruiyot, Stanley;; Fall, Gamou;; Dia, Moussa;; Hamaluba, Mainga M;; Nyehangane, Dan;; Karanja, Henry K;; Gitonga, John N;; Mugo, Daisy;; Omuoyo, Donwilliams O;; Hussein, Mwatasa;; Oloo, Elizaphan;; Kamau, Naomi;; Wafula, Jackline;; Bendera, Josephine;; Silvester, Namanya;; Mwavita, James;; Joshua, Musiimenta;; Thuranira, Jane M;; Agababyona, Collins;; Ngetsa, Caroline;; Aisha, Nalusaji;; Moki, Felix;; Buluku, Titus;; Munene, Marianne;; Mwanga-Amumpaire, Juliet;; Lutwama, Julius;; Kayiwa, John;; Kamaara, Eunice;; Barrett, Alan D;; Kaleebu, Pontiano;; Bejon, Philip;; Sall, Amadou A;; Grais, Rebecca F;; Warimwe, George M
WHO recommends fractional dose vaccination to address yellow fever vaccine shortages during outbreaks. In adults, a 500 IU dose has recently been shown to be non-inferior to the full standard dose, but the minimum effective dose for children is unknown.BACKGROUNDWHO recommends fractional dose vaccination to address yellow fever vaccine shortages during outbreaks. In adults, a 500 IU dose has recently been shown to be non-inferior to the full standard dose, but the minimum effective dose for children is unknown.We conducted a randomised, double-blind, non-inferiority trial at two centres in Kenya and Uganda, including infants aged 9-12 months with no previous yellow fever vaccination or infection. Participants were randomly assigned 1:1 in blocks of variable sizes of four, six, or eight to receive either the standard dose (>13 000 IU) or 500 IU of the Institut Pasteur de Dakar (Dakar, Senegal) 17D-204 yellow fever vaccine, co-administered with the measles-rubella vaccine. The primary outcome was seroconversion 28 days post-vaccination, defined as a four-fold or greater increase in antibody titre at day 28 from baseline (day 0), as measured by the 50% plaque reduction neutralisation test. Non-inferiority was shown if the lower bound of the 95% CI for the difference in seroconversion rates between doses exceeded -10 percentage points. Safety was assessed in the safety population, which included all participants who received a study vaccine dose. This study is registered with ClinicalTrials.gov (NCT04059471) and is complete.METHODSWe conducted a randomised, double-blind, non-inferiority trial at two centres in Kenya and Uganda, including infants aged 9-12 months with no previous yellow fever vaccination or infection. Participants were randomly assigned 1:1 in blocks of variable sizes of four, six, or eight to receive either the standard dose (>13 000 IU) or 500 IU of the Institut Pasteur de Dakar (Dakar, Senegal) 17D-204 yellow fever vaccine, co-administered with the measles-rubella vaccine. The primary outcome was seroconversion 28 days post-vaccination, defined as a four-fold or greater increase in antibody titre at day 28 from baseline (day 0), as measured by the 50% plaque reduction neutralisation test. Non-inferiority was shown if the lower bound of the 95% CI for the difference in seroconversion rates between doses exceeded -10 percentage points. Safety was assessed in the safety population, which included all participants who received a study vaccine dose. This study is registered with ClinicalTrials.gov (NCT04059471) and is complete.Between Oct 7, 2021, and June 14, 2023, 420 infants were enrolled and randomly assigned (210 participants in each group). The seroconversion rate at day 28 was 99% (95% CI 96-100; 177 of 179 infants) for the standard dose and 93% (88-96; 166 of 179 infants) for the 500 IU dose in the per-protocol population. The difference in seroconversion rate was -6·15 percentage points (95% CI -10·27 to -2·02); therefore, non-inferiority was not met for the 500 IU dose. 12 serious adverse events were reported in the study (eight in the 500 IU dose group and four in the standard dose group), but all were considered unrelated to vaccination.FINDINGSBetween Oct 7, 2021, and June 14, 2023, 420 infants were enrolled and randomly assigned (210 participants in each group). The seroconversion rate at day 28 was 99% (95% CI 96-100; 177 of 179 infants) for the standard dose and 93% (88-96; 166 of 179 infants) for the 500 IU dose in the per-protocol population. The difference in seroconversion rate was -6·15 percentage points (95% CI -10·27 to -2·02); therefore, non-inferiority was not met for the 500 IU dose. 12 serious adverse events were reported in the study (eight in the 500 IU dose group and four in the standard dose group), but all were considered unrelated to vaccination.Compared with the standard yellow fever vaccine dose, a dose of 500 IU did not meet the non-inferiority criterion, suggesting that minimum dose requirements in adults are not generalisable to infants. Therefore, standard yellow fever doses should be used for infants in the routine WHO Expanded Programme on Immunization.INTERPRETATIONCompared with the standard yellow fever vaccine dose, a dose of 500 IU did not meet the non-inferiority criterion, suggesting that minimum dose requirements in adults are not generalisable to infants. Therefore, standard yellow fever doses should be used for infants in the routine WHO Expanded Programme on Immunization.European and Developing Countries Clinical Trials Partnership and the Wellcome Trust.FUNDINGEuropean and Developing Countries Clinical Trials Partnership and the Wellcome Trust. MEDLINE - Academic
Expulsion rates and risk factors for intrauterine device expulsion following medical management of first-trimester incomplete abortions: A prospective cohort study in central Uganda
(British Medical Journal Publishing Group, 2025-11-25) Kayiga, Herbert;; Looft-Trägårdh, Emelie;; Cleeve, Amanda ;; Kakaire, Othman;; Tumwesigye, Nazarius Mbona;; Byamugisha, Josaphat;; Gemzell-Danielsson, Kristina
ObjectiveIntrauterine device (IUD) user rates remain below 5% in low-income countries yet fertility after first-trimester abortions returns within 2 weeks. IUDs provide effective contraception. This study set out to explore the risk factors for IUD expulsion after medical management of first-trimester incomplete abortions.DesignProspective cohort studySettingMulticentre study at five public health facilities in central Uganda.Participants1050 women with first-trimester incomplete abortion managed with misoprostol, recruited on giving informed consent.InterventionAfter selecting either copper or levonorgestrel (LNG) IUDs, participants were randomised to early (within 1 week) or standard (at 2–4 weeks) insertion and assessed on IUD expulsion 6 months later.Main outcome measuresPrimary outcome was IUD expulsion rates at 6 months. Secondary outcomes were risk factors for IUD expulsions.ResultsBetween 8 July 2023 and 31 May 2024, 532 (50.7%) participants chose LNG IUDs, 488 (46.5%) chose copper IUDs, while 30 (2.9%) participants chose not to use IUDs. The IUD expulsion rate was 4.6% (95% CI 3.48 to 6.07). IUD expulsion was significantly associated with low overall satisfaction with IUD insertion procedure and use (adjusted odds ratio (aOR)=7.99, 95% CI 4.83 to 13.22, p<0.001), anxiety during the IUD insertion (aOR=4.28, 95% CI 1.09 to 16.85, p=0.038), use of ultrasound at follow-up (aOR=8.41, 95% CI 4.56 to 15.5, p<0.001) and breastfeeding at the time of IUD insertion (aOR=1.48, 95% CI 0.26 to 4.98, p=0.042).ConclusionOffering IUD insertion immediately after medical management of first-trimester incomplete abortion is associated with low expulsion rates and should be offered as a safe choice. ProQuest Health & Medical Complete (Alumni)
Phytochemical profile, antibacterial activity and acute toxicity of Rhoicissus tridentata used to manage dog bites
(Elsevier Ltd, 2025-11-25) Paul Mukasa;; Patrick Engeu Ogwang;; Christopher Adaku ;; Moses Andima;; Samuel Baker Obakiro;; Julius Bunny Lejju;; Ibrahim Ntulume;; Denis Byamugisha;; Emmanuel Ntambi;; Yuhao Ren;; Richard Oriko Owor
Dog bites often result into polymicrobial wound contamination, which pose several health risks including bacterial infections. In Uganda, Rhoicissus tridentata is traditionally used to manage dog bites, yet its secondary metabolite profile, antibacterial efficacy, and in-vivo toxicity had remained unexplored. Thus, the metabolites and the scientific evidence to validate the antibacterial activity and safety of the plant was limited. Identification of potent antibacterial agents could be crucial to manage dog-bite-related bacterial infections. The root extracts were analyzed using UHPLC–HRMS/MS—qTOF, followed by MZmine processing, and the metabolites characterized with GNPS Feature-Based Molecular Networking. For the first time, the high-resolution metabolomic approach resulted into annotation of 15 bioactive polyphenols like flavonoids, tannins. The antibacterial activity of the extracts was evaluated against standard strains of the zoonotic oral bacteria commonly associated with dog bites, namely: Enterococcus faecalis (ATCC 29,212), Streptococcus aureus (ATCC 25,932), Streptococcus mutans (ATCC 25,175), Proteus mirabilis (ATCC 25,933), Klebsiella pneumoniae (ATCC 700,603), and Escherichia coli (ATCC 25,922). The extracts exhibited moderate antibacterial activity against all the strains. The MIC and MBC ranged from (0.78 to 6.25) and (1.56 to 12.5) mg/mL respectively. The MBC/MIC ratios were between 1.9 and 2, signifying bactericidal extracts. In vivo acute toxicity testing, the extract showed no adverse signs of toxicity at doses up to 5000 mg/kg (LD50 > 5000 mg/kg), suggesting a favorable safety margin. These findings support the ethnopharmacological use of R. tridentata in managing dogbite-related bacterial infections and merit further investigations on its bioactive constituents identified for future antibacterial discovery.
Effect of food insecurity on hazardous alcohol consumption and psychological well-being among people with tuberculosis in Kampala, Uganda
(Elsevier Ltd, 2025-11-27) Jonathan Izudi;; Saidi Appeli;; Francis Bajunirwe
Rationale: Food insecurity (FI), hazardous alcohol consumption (HAC), and poor mental health are common among people with tuberculosis (TB), yet empirical evidence on their interrelationships remains limited. Objective: We evaluated the effect of FI on HAC and psychological well-being among people with pulmonary TB in Kampala, Uganda. Methods: We collected data across five TB clinics and constructed a quasi-experimental design. FI was the exposure, measured using the FI Experience Scale (FIES). FIES scores range between 0 and 8, and individuals were classified as food insecure if they scored ≥ 4. The primary outcome was HAC, assessed using the Alcohol Use Disorders Identification Test (AUDIT) tool. Participants with AUDIT scores ≥ 16, indicating high-risk drinking or possible alcohol dependence, were categorized as having HAC. The secondary outcome was psychological well-being measured using the World Health Organization’s Five Well-Being Index, with a total score of <15 indicating poor psychological well-being. We used doubly robust estimation to report causal risk ratios (RR) and 95 % confidence intervals (CI). Results: Of 818 participants, 475 (58.1 %) were from food-insecure households, 153 (18.7 %) had HAC, and 316 (38.6 %) had poor psychological well-being. FI was independently associated with HAC (RR 1.43, 95 % CI: 1.21–1.69), but not poor psychological well-being (RR 1.06, 95 % CI: 0.81–1.37). Conclusion: FI is associated with a higher likelihood of HAC but not psychological well-being among people with TB in Kampala, Uganda. Given their high prevalence, there is a need to address food insecurity, HAC, and poor psychological well-being within TB control programs.
Nutritional knowledge and attitudes of adolescents in public secondary schools in Uganda: a case study of Nansana Municipality, Uganda
(Taylor & Francis group, 2025-12-26) Joshua Ssemakula;; Edward Kansiime;; Kenneth Ssekatawa
This study investigated sources of nutrition information, attitudes, and nutrition knowledge towards the consumption of healthy foods among adolescents. A mixed cross-sectional study involving 1174 adolescents randomly chosen from all five public schools in Nansana Municipality was carried out. Information was gathered using a questionnaire and focus group discussions. From the findings, ‘television’ and ‘lessons taught in class’ were the most preferred sources of nutrition information, with percentage scores of 27.6% and 23.2%, respectively. Statistical analysis showed that adolescents with greater nutrition knowledge in themes: ‘nutrition and health outcomes’ and ‘nutrition function and sources’ significantly outperformed their peers on several items, for example, understanding the function of proteins (t = 4.67, p < .001, d = 0.26, 95% CI [0.14, 0.38]) and recognizing the cause of scurvy (t = 15.50, p < .001, d = 0.86, [0.74, 0.98]). A larger portion of participants exhibited negative attitudes towards healthy eating. These findings underscore the need for targeted interventions.
Drivers of risky sexual behaviours among adolescents in Nebbi Municipality, Uganda: analytical cross-sectional study
(Taylor & Francis group, 2025-12-10) Kizito Omona;; George Wycliffe Bwire;; Godfrey Mugisa ;; Jane Tolit Akullu
Risky sexual behaviour among adolescents remains a major public health challenge in Uganda. In Nebbi Municipality, high rates of teenage pregnancy, early sexual debut, and HIV infections have compounded the problem. This study sought to determine individual, environmental, and family-level drivers associated with adolescents’ risky sexual behaviours. Analytical cross-sectional study was conducted from January 2022 to March 2022 using a mixed-methods approach. Multi-stage sampling was used to select 300 adolescents aged 10–19 years, who were interviewed using an interviewer-administered questionnaire. Quantitative data were analyzed using SPSS, while qualitative data were thematically coded and analyzed. We found that risky sexual behaviours were associated with multiple drivers, including school dropout (aPR = 2.27, 95% CI: 0.54–6.65), awareness of partner’s HIV status (aPR = 8.22, 95% CI: 3.11–33.19), and traditional beliefs (aPR = 5.48, 95% CI: 1.73–17.39). Qualitative findings revealed that many adolescents lacked the power to negotiate safe sex, were influenced by peers, social media, and financial hardship. Adolescents in Nebbi Municipality remain vulnerable to risky sexual behaviours due to a combination of factors. Our study highlighted the need for targeted preventive interventions that strengthen parental support, promote safe sexual negotiation skills, and engage schools and community structures.
Quantifying mpox transmission and control: A regional analysis of vaccination strategies in East Africa
(Elsevier B.V, 2025-09-05) Rabiu, Musa;; Fagbemigun, Bosede;; Fadugba, Sunday ;; Shatalov, Michael;; Malesela, Kekana;; Adeniji, Adejimi
Africa is home to the endemic mpox disease, especially in the tropical rain-forest regions of Central and West Africa. Although it is mostly found in the Democratic Republic of the Congo, reports of it have also come from other neighboring African nations. To understand the dynamics of mpox, we studied its spread in Burundi, Uganda, Rwanda, Congo, and Kenya before and after the implementation of interventions. Using a Bayesian framework, a simple mathematical model of Susceptible-Infected-Recovered type was calibrated and fitted to the 2022 mpox data covering the period before the introduction of intervention strategies. The model was then re-stratified to incorporate key epidemiological features, including vaccination with imperfect efficacy, partial immunity, exposure, and demographics. The transmission of mpox varied throughout East Africa, with Uganda exhibiting the highest basic reproduction number R0 = 2.51, suggesting the possibility of a rapid spread. Despite having the highest initial infection count and the lowest R0 (1.23), Congo may have had delayed detection. The moderate R0 values (1.35 and 1.88) in Rwanda and Burundi have implications for prompt intervention to control epidemics. Transmission and vaccination rates have a non-linear relationship with the thresholds required to contain mpox outbreaks. Our model shows that in high-transmission settings, substantially higher vaccination coverage (exceeding 80 % at an effectiveness of 70 %) is required to reduce the control reproduction number below unity, whereas in moderate-transmission contexts, coverage above 40 % may suffice. These quantitative thresholds provide actionable guidance for tailoring vaccination strategies to different epidemiological conditions. In particular, sustained vaccination strategies that achieve coverage above the threshold predicted by our model (approximately 80 %) can guarantee mpox eradication, even in situations with strong transmission rates. While real-world complexities such as heterogeneous risk groups and behavioral factors may affect outcomes, these findings shed light on potential quantitative thresholds and provide a foundation for more detailed, population-specific modeling of mpox interventions.
Prevalence of sleep disturbances and factors associated among school going children in Uganda, a cross-sectional study
(Elsevier B.V, 2024-12-09) Innocent, Baluku Reagan;; Lorraine, Oriokot;; Katabira, Elly ;; Sajatovic, Martha;; Catherine, Abbo;; Mark, Kaddumukasa
AbstractBackgroundSleep disturbances greatly impact children's academic performance and social well-being. This study set out to determine the prevalence of sleep disturbances and factors associated among school going children in Kawempe division, Kampala, Uganda. MethodsIn a community cross-sectional study, 548 study participants using random cluster sampling were enrolled. The children start lessons at 8am and end the days classes at 5pm. Random cluster sampling method was used to select participants from the 19 parishes in Kawempe district. Data was collected using a semi-structured questionnaire and Sleep Disturbance Scale for Children (SDSC). Descriptive statistics and multivariate binary logistic regression were performed with a p < 0.05 level of significance, and a 95 % confidence interval as a measure of association between the sleep disturbance. ResultsAbnormal total sleep score (T- score >70) was at 3.5 %, and overall, 21.7 % of the children had an abnormal score on at least one SDSC factor. Among the children with sleep disturbances, we noted the following factors; use of an electronic device before bed, sleeping <7 h at night, having unemployed parents and lack of regular parental interaction. ConclusionBetter understanding of sleep disturbances in needed to address challenges associated with sleep among children in Uganda.
Nutritional knowledge, attitude, and practices among caregivers and nutritional status of children 6–24 months: evidence from Amuria and Soroti districts of Uganda
(Springer International Publishing, 2025-04-07) Anyati, Christine;; Okello, Daniel Micheal;; Mainimo, Edmond Nyuyki ;; Okello-Uma, Ipolto
This study assessed the factors associated with caregiver’s nutritional knowledge, attitude, and practices (KAP) as well as their implication on the nutritional status of children aged 6–24 months old in Soroti and Amuria districts, eastern Uganda. A cross-sectional research design was applied to collect primary data from 408 caregivers of children between 6 and 24 months. Data was collected using questionnaires and analyzed using descriptive and inferential statistics including regression analysis. Anthropometric approaches were used to assess the nutritional status of the reference child. Results showed that there was a generally low level of knowledge on complementary feeding (CF) among caregivers in this study. There was, however generally good attitude of caregivers towards CF. The findings on practices were mixed with both good practices such as feeding the child with colostrum and bad practices such earlier than recommended introduction of complementary foods. From this study, the average time for introduction of complementary foods was 4.4 months. This was less than the recommended 6 months with only 36% of the children being introduced to complementary feeding at the recommended 6 months. Caregiver’s nutritional knowledge was predicted by child’s sex, mother as caregiver and occupation of household head, while, caregiver’s attitude was predicted by household occupation and farming as source of foods in the case caregiver’s attitude. Results on influence knowledge and attitude on child nutritional status shows that attitude is a significant predictor of stunting and wasting, but not underweight, on the other hand, knowledge was not a significant predictor of child nutritional status. The study recommends the need to improve the level of knowledge of caregivers. This could be by introducing child nutrition education through available sources of information.
Survival of children with endemic Burkitt lymphoma in a prospective clinical care project in Uganda
(Pediatric blood & cancer, 2019-06-03) McGoldrick, Suzanne M.; Mutyaba, Innocent; Namirembe, Constance; Nabakooza, Susan; Ndagire, Mariam
“Endemic” Burkitt lymphoma (BL) is a common childhood cancer in Africa. Social and treatment factors may contribute to poor survival. With the aim of improving BL outcomes in Uganda, we undertook a comprehensive project (BL Project) that provided diagnostic support, access to standard chemotherapy, nutritional evaluations, and case management. We evaluated survival of children with BL in the context of the project. Patients followed by the BL Project who consented to research were enrolled in this study. Children with a pathology diagnosis consistent with BL were eligible. Data were collected prospectively. First-line chemotherapy generally consisted of six cycles of cyclophosphamide, vincristine, low-dose methotrexate (COM). We used Kaplan–Meier and Cox regression analyses to evaluate factors associated with overall survival (OS). Between July 2012 and June 2017, 341 patients with suspected BL presented to the BL Project. One hundred eighty patients with a pathology-based diagnosis were included in this study. The median age was seven years (interquartile range, 5–9), 74% lived ≥100 km from the Uganda Cancer Institute, 61% had late-stage disease, 84% had ECOG performance status < 3, 63% reported B-symptoms, and 22% showed neurologic symptoms. Fewer than 10% abandoned therapy. The four-year OS rate was 44% (95% CI, 36%–53%). In a multivariate model, ECOG status was significantly associated with mortality. The BL Project reduced effects of lacking supportive care and oncology resources, and allowed patients from Uganda to receive curative intent therapy with minimal loss to follow-up. Nonetheless, OS remains unacceptably low. Improved therapeutic approaches to endemic BL are urgently needed in Africa.
Ebola haemorrhagic fever outbreak in Masindi District, Uganda: outbreak description and lessons learned
(BMC infectious diseases, 2011-12-28) Borchert,Matthias; Mutyaba,Imaam; Lutwama, Julius; Bisoborwa, Geoffrey
Ebola haemorrhagic fever (EHF) is infamous for its high case-fatality proportion (CFP) and the ease with which it spreads among contacts of the diseased. We describe the course of the EHF outbreak in Masindi, Uganda, in the year 2000, and report on response activities. We analysed surveillance records, hospital statistics, and our own observations during response activities. We used Fisher's exact tests for differences in proportions, t-tests for differences in means, and logistic regression for multivariable analysis. The response to the outbreak consisted of surveillance, case management, logistics and public mobilisation. Twenty-six EHF cases (24 laboratory confirmed, two probable) occurred between October 21st and December 22nd, 2000. CFP was 69% (18/26). Nosocomial transmission to the index case occurred in Lacor hospital in Gulu, outside the Ebola ward. After returning home to Masindi district the index case became the origin of a transmission chain within her own extended family (18 further cases), from index family members to health care workers (HCWs, 6 cases), and from HCWs to their household contacts (1 case). Five out of six occupational cases of EHF in HCWs occurred after the introduction of barrier nursing, probably due to breaches of barrier nursing principles. CFP was initially very high (76%) but decreased (20%) due to better case management after reinforcing the response team. The mobilisation of the community for the response efforts was challenging at the beginning, when fear, panic and mistrust had to be countered by the response team. Large scale transmission in the community beyond the index family was prevented by early case identification and isolation as well as quarantine imposed by the community. The high number of occupational EHF after implementing barrier nursing points at the need to strengthen training and supervision of local HCWs. The difference in CFP before and after reinforcing the response team together with observations on the ward suggest a critical role for intensive supportive treatment. Collecting high quality clinical data is a priority for future outbreaks in order to identify the best possible FHF treatment regime under field conditions.
Knowledge, attitudes and practices on cervical cancer screening among the medical workers of Mulago Hospital, Uganda
(BMC medical education, 2006-03-01) Mutyaba,Twaha; Mmiro,Francis A.; Elisabete, Weiderpass
Cervical cancer is the commonest cancer of women in Uganda. Over 80% of women diagnosed in Mulago national referral and teaching hospital, the biggest hospital in Uganda, have advanced disease. Pap smear screening, on opportunistic rather than systematic basis, is offered free in the gynaecological outpatients clinic and the postnatal/family planning clinics. Medical students in the third and final clerkships are expected to learn the techniques of screening. Objectives of this study were to describe knowledge on cervical cancer, attitudes and practices towards cervical cancer screening among the medical workers of Mulago hospital.
Spectrophotometric analysis of artesunate injections availablein community pharmacies in Northern and Western Uganda
(Taylor & Francis group, 2025-06-12) Ayogu, Ebere Emilia;; Ngolryeko, Emmanuel Aryon;; Ezeonwumelu, Joseph Obiezu Chukwujekwu ;; Wawata, Ibrahim Garba;; Sadiq, Bashir Olaniyi
The surge in different brands of artesunate injection in Uganda, has raised the need for this study, which aimed at quantifying the actual amount of artesunate in different brands of artesunate injections available in Northern and Western Uganda.AIMThe surge in different brands of artesunate injection in Uganda, has raised the need for this study, which aimed at quantifying the actual amount of artesunate in different brands of artesunate injections available in Northern and Western Uganda.The wavelength at maximum absorbance of pure artesunate powder was determined using Ultraviolet-visible spectrophotometer and Beer Lambert's plot was generated. This was validated and used to assay 27 brands of artesunate.MATERIALS AND METHODSThe wavelength at maximum absorbance of pure artesunate powder was determined using Ultraviolet-visible spectrophotometer and Beer Lambert's plot was generated. This was validated and used to assay 27 brands of artesunate.In the spectrophotometric assay method used, Beer Lambert's law was obeyed within the range of 20 µg/ml-140 µg/ml with linear regression equation of y = 0.012 + 0.030 and correlation coefficient of (R2) 0.999 (n = 9). The limits of detection (sensitivity) and quantification were found to be 0.83 mg/ml and 2.09 mg/ml respectively. About 66.6% (18) and 33.3% (9) had actual artesunate content higher and lower than labeled claim respectively, while 40.7% (11) had deviations from labeled claim that were within acceptable limits.RESULTSIn the spectrophotometric assay method used, Beer Lambert's law was obeyed within the range of 20 µg/ml-140 µg/ml with linear regression equation of y = 0.012 + 0.030 and correlation coefficient of (R2) 0.999 (n = 9). The limits of detection (sensitivity) and quantification were found to be 0.83 mg/ml and 2.09 mg/ml respectively. About 66.6% (18) and 33.3% (9) had actual artesunate content higher and lower than labeled claim respectively, while 40.7% (11) had deviations from labeled claim that were within acceptable limits.Most brands of artesunate injection assayed deviated from labeled claim, regional/environmental factor impacted much on the stability of artesunate thus there is need for further screening of the quality of artesunate injection in circulation in view of the therapeutic consequences of substandard artesunate injection.CONCLUSIONMost brands of artesunate injection assayed deviated from labeled claim, regional/environmental factor impacted much on the stability of artesunate thus there is need for further screening of the quality of artesunate injection in circulation in view of the therapeutic consequences of substandard artesunate injection. MEDLINE - Academic
Prevention messages and AIDS risk behavior in Kampala, Uganda
(Informa UK Limited, 2011-06-16) Hearst, Norman; Kajubi, Phoebe; Hudes, Esther Sid; Maganda, Albert K.; Green, Edward C.
Uganda was one of the first countries to substantially reduce HIV rates through behavior change, but these gains have not continued in recent years. Little is known about what messages Ugandans are currently hearing about AIDS prevention, what they themselves believe to be important prevention strategies, and how these beliefs are associated with behavior. We interviewed men and women aged between 20 and 39 in two poor peri-urban areas of Kampala, using a random sample, cross-sectional household survey design. Respondents provided detailed reports of sexual behavior over the past six months, the main prevention message they are currently hearing about AIDS, and their own ranking of the importance of prevention strategies. Condom use was the main AIDS prevention message that respondents reported hearing, followed by getting tested. These were also what respondents themselves considered most important, followed closely by faithfulness. Abstinence was the lowest ranked strategy, but a higher ranking for this prevention strategy was the only one consistently associated with less risky behavior. A higher ranking for condoms was associated with higher levels of risk behavior, while the ranking of testing made no difference in any behavior. These results present challenges for AIDS prevention strategies that rely primarily on promoting condoms and testing. HIV prevention programs need to assess their impact on behavior.

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