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.
Other Useful Resources:
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.
Communities in NRU
Select a community to browse its collections.
- This community contains Books and Book Abstracts
- This community contains Ugandan Conference proceedings
- This community contains consolidated Ugandan Institutional Annual Research Reports on a broad range of subjects
- This community contains approved and running institutional repository policies from different research institutions
- This community contains peer reviewed publications about Uganda and from Ugandan Researchers. The community has been classified to thematic research sub communities of Agricultural Sciences, Engineering and Technology, Humanities, Medical and Health Sciences, Natural Sciences and Social Sciences.
Recent Submissions
Viral load suppression and retention in care among children and adolescents receiving multi-month anti-retroviral therapy refills: a program data review in Uganda
(BioMed Central Ltd, 2024-12) Ainembabazi, Bridget; Ssebunya, Rogers N; Akobye, Winnie; Mugume, Alexander; Nahirya-Ntege, Patricia; Birungi, Denise J; Maganda, Albert K; Elyanu, Peter J; Kiragga, Dithan
Abstract Background In July 2022, Uganda’s Ministry of Health extended the 2021 WHO guidelines that recommended 3–6 monthly dispensing of antiretroviral therapy (ART) to include all children and adolescents living with HIV (CALHIV). Treatment outcomes following this recommendation have not yet been documented. We compared viral load (VL) suppression and retention in HIV care rates among CALHIV receiving 1, 2–5, and > = 6 monthly ART dispensation in Uganda. Methods A cross-sectional study of electronic medical records in 118 health facilities was conducted. Data for CALHIV 10–19 years captured at their most recent five clinic visits as of 15th May 2023 were analysed. Most recent two VL < 1000 copies/ml were used as measures for VL suppression and sustained VL suppression. A client was considered retained in care if they visited the clinic within 28 days from their expected return visit date. We used margins plots and a modified poisson model adjusting for facility level clustering to assess VL suppression and retention across multi-month ART categories. Results A total of 2864 CALHIV, 1609 (56.2%) being females and with a median age of 12 years (inter quartile range, iqr = 7) were included. Overall suppression and retention rates were 80.4% (2133/2654) and 87.8% (2514/2864) respectively. A significant number had been dispensed ART for ≥ 2 months (50%, 2–5 months and 43.5%, ≥ 6 months). Probability of having a suppressed VL was higher among CALHIV that had received ≥ 6 months and 2–5 months of ART compared to those of 1 month i.e., 83% vs 79% vs 41% respectively. Probability of being retained in care didn’t differ across multi-month ART categories. CALHIV who received ART for 2–5 months and ≥ 6 months compared to 1 month were more likely to have a suppressed VL; (adj.PR = 1.98; 95%CI:1.41, 2.80) and (adj.PR = 2.21; 95% CI:1.59, 3.05) respectively. CALHIV with a Tuberculosis diagnosis history were less likely to have a suppressed VL (adj.PR = 0.73; 95%CI:0.65,0.81), however this was not statistically significantly different between multi-month categories. Conclusion CALHIV receiving multi-month ART including 6 months dispensation had better VL suppression rates. Retention rates however didn’t differ by multi-month dispensing categories as observed among adults in the interval trial. We recommend multi-month ART dispensation including more than 6 months among CALHIV irrespective of their age, clinical stage, and history of prior co-morbidities.
HIV Knowledge and Sexual Behaviors in Perinatally Infected Ugandan Youth: A Cross-Sectional Survey
(SAGE Publications, 2024-12) Becker, Greta; Namanya, Paul; Kiganda, Charles; Nabukenya, Josephine; Wendt, Linder; Rukundo, Gordon; Yoyeta, Irene; Motevalli, Mahnaz; Mooberry, Megan; Voss, Natalie; Jackson, J Brooks; Etima, Juliane
Our objective was to assess human immunodeficiency virus (HIV) knowledge and sexual behaviors in 294 perinatally HIV-infected
youth aged 18 to 25 years from a psychosocial support group in Kampala using a self-administered survey. Seventy-nine percent
reported an undetectable viral load, 9.5% detectable, and 12% did not know. Of those with sexual partners, 19% did not know
the HIV status of their partner, 64% knew negative, and 22% knew positive. Sixty-two percent disclosed their HIV status to their
partner. Seventy-two percent of participants previously had sex, and of those, 57% were sexually active in the last three months.
Sixty-eight percent of participants used methods to prevent pregnancy. Seventy percent of participants denied physical, sexual, or
emotional intimate partner violence. There was good adherence to antiretroviral therapy and a high proportion of contraceptive
use, highlighting the importance of integrating these topics into psychosocial support programs for youth living with HIV.
High recent PrEP adherence with point-of-care urine tenofovirtesting and adherence counselling among young African women:results from the INSIGHT cohort
(John Wiley and Sons Inc, 2024-12) Gati Mirembe, Brenda; Donnell, Deborah; Krows, Meighan; Zwane, Zinhle; Bukusi, Elizabeth; Panchia, Ravindre; Louw, Cheryl; Mwelase, Noluthando; Selepe, Pearl; Senne, Melissa; Naidoo, Logashvari; Chihana, Rachel; Kasaro, Margaret; Nuwagaba-Biribonwoha, Harriet; Kotze, Philip; Gill, Katherine; MacDonald, Pippa; vanHeerden, Alastair; Bosman, Shannon; Jaggernath, Manjeetha; du Preez, Phillip; Ward, Amy; Peters, Remco P H; Delany-Moretlwe, Sinead; Et.al
Adolescent girls and young women (AGYW) account for two-thirds of new HIV infections in Africa. African AGYW have had high uptake of oral HIV pre-exposure prophylaxis (PrEP) but low adherence, which might be improved by point-of-care adherence monitoring with tailored counselling. From August 2022 to July 2023, we conducted a PrEP demonstration project with sexually active AGYW ages 16-30 years from 20 sites in South Africa, Eswatini, Kenya, Malawi, Uganda and Zambia. Participants were offered oral tenofovir-based PrEP at enrolment and followed up at 1, 3 and 6 months. PrEP adherence was assessed by a point-of-care qualitative lateral flow urine tenofovir (TFV) assay indicating PrEP use in the prior 4 days, which accompanied real-time adherence counselling that incorporated urine TFV results when testing was available (70.8% of month 1, 35.3% of month 3 and 83.9% of month 6 visits). We estimated overall adherence, correcting for missing test results, and analysed the association of having received urine TFV results at month 1 or 3 with subsequent urine TFV test positivity, using modified Poisson regression. Of the 3087 AGYW enrolled, the median age was 24 years (interquartile range 21-27), 75.7% were from South Africa, 2878 (93.2%) initiated PrEP at enrolment and 107 (3.5%) after enrolment. Visit retention was 92.0-96.2% for months 1, 3 and 6, and 2518 (90.1%) exited the study with a PrEP refill. Adherence, based on the point-of-care urine tenofovir test positivity rate, was estimated as 72%, 71% and 65% at months 1, 3 and 6, respectively. Women who received one prior urine TFV test had a 42% higher likelihood of a subsequent positive urine TFV test (adjusted odds ratio, OR = 1.42, 95% confidence interval, CI 1.27-1.60), and those having received two prior tests had a 67% higher likelihood (adjusted OR = 1.67; 95% CI 1.41-1.98). Observed HIV incidence was 1.38/100 person-years (95% CI 0.97-2.08). Oral PrEP uptake, recent adherence and persistence were high in a multisite cohort of young African women over 6 months of follow-up. The use of a novel point-of-care tenofovir assay with tailored real-time adherence counselling was associated with increased adherence to PrEP at subsequent visits, warranting further study. clinicaltrials.gov NCT05746065.
Causal Inference for Continuous Multiple TimePoint Interventions
(Wiley Subscription Services, Inc, 2024-12) Schomaker, Michael; McIlleron, Helen; Denti, Paolo; Díaz, Iván
There are limited options to estimate the treatment effects of variables which are continuous and measured at multiple time points, particularly if the true dose-response curve should be estimated as closely as possible. However, these situations may be of relevance: in pharmacology, one may be interested in how outcomes of people living with-and treated for-HIV, such as viral failure, would vary for time-varying interventions such as different drug concentration trajectories. A challenge for doing causal inference with continuous interventions is that the positivity assumption is typically violated. To address positivity violations, we develop projection functions, which reweigh and redefine the estimand of interest based on functions of the conditional support for the respective interventions. With these functions, we obtain the desired dose-response curve in areas of enough support, and otherwise a meaningful estimand that does not require the positivity assumption. We develop -computation type plug-in estimators for this case. Those are contrasted with g-computation estimators which are applied to continuous interventions without specifically addressing positivity violations, which we propose to be presented with diagnostics. The ideas are illustrated with longitudinal data from HIV positive children treated with an efavirenz-based regimen as part of the CHAPAS-3 trial, which enrolled children years in Zambia/Uganda. Simulations show in which situations a standard g-computation approach is appropriate, and in which it leads to bias and how the proposed weighted estimation approach then recovers the alternative estimand of interest.
Association of COVID-19-related perceptions and experiences with depression and anxiety in Ugandan caregivers of young children with malaria and iron deficiency: A cross-sectional study
(Public Library of Science, 2024-12-10) Park, Saeun; Bangirana, Paul; Mupere, Ezekiel; Baluku, Reagan I; Helgeson, Erika S; Cusick, Sarah E
Caregivers of young children may have been particularly vulnerable to mental health challenges during the COVID-19 pandemic due to its negative impacts on their housing, finances, and childcare demands. This study explored the associations between COVID-19-related experiences and symptoms of depression and anxiety among Ugandan caregivers. This cross-sectional study included 100 Ugandan caregivers of young children aged 6-59 months with uncomplicated malaria and iron deficiency (N = 85) and without malaria or anemia (N = 15) who were enrolled in the Optimizing Iron Status in Malaria-Endemic Areas (OptiM) study. Sociodemographic data and COVID-19 experiences were collected using an internally developed survey and symptoms of depression and anxiety were measured using the Hopkins Symptom Checklist (HSCL-25) and the Center for Epidemiologic Studies Depression (CESD-20) scale. Multiple linear regression models were used to assess the associations between COVID-19 survey scores with HSCL-25 or CESD-20 scores. Nearly half of caregivers reported clinically meaningful symptoms of depression (46%) and/or anxiety (49%). Caregivers had more severe symptoms of depression and/or anxiety if they experienced greater changes in living situations or decreases in physical activity (CESD-20: [beta] = 3.35, 95% CI [1.00, 5.70], p = .01), food insecurity (HSCL-25: [beta] = 3.25, 95% CI [0.41, 6.10], p = .03, CESD-25: [beta] = 3.09, 95% CI [0.79, 5.39], p = .01), and domestic violence (HSCL-25: [beta] = 3.82, 95% CI [0.94, 6.70], p = .01) during COVID-19. These associations did not vary depending on whether the caregivers had children with malaria. Negative COVID-19 experiences were significantly associated with more severe depression and anxiety in Ugandan caregivers, regardless of their children's malaria status. Urgent attention and action are needed to support the mental well-being of this vulnerable population. Further prospective studies should investigate the long-term impact of COVID-19 on caregivers and their children.