School of Health Sciences (SHS) Researches

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    Acceptability of pre-exposure prophylaxis and associated factors among HIV-negative young men in Kagwara fishing community-Serere district, Uganda: A cross-sectional study
    (PLOS ONE, 2025-06-04) Alex Omoding; Ronald Opito; Paul Oboth; Francis Okello; Joseph K. B. Matovu
    Background Despite the potential efficacy of Pre-Exposure Prophylaxis (PrEP) in reducing HIV risk, Oral PrEP acceptability remains strikingly varied by populations and locations. We assessed PrEP acceptability and associated factors among at-risk HIV-negative young men. Methods A cross-sectional analytical study design was used. Data were collected among 409 at-risk HIV-negative young men aged 15–24 years living in Kagwara fishing community- Serere district, Uganda between August and October 2023. Quantitative data were collected on socio-demographic characteristics, sexual risk behaviors and concerns about PrEP. Data was analyzed using Stata version 15.0 statistical software. Summary statistics were computed and presented as tables, frequencies and proportions. Bivariate analysis was conducted using binary logistic regression to identify independent factors associated with PrEP acceptability. All factors that had p < 0.10 at the bivariate analysis and confounders were entered into the final logistic regression model. All factors with p < 0.05 were considered significantly associated with the primary outcome Results The average age of 409 respondents was 21.8 (Standard Deviation [SD]=1.9) years. Majority, (97.8%, n = 393) had unprotected penetrative sex. PrEP acceptability was high as majority of the participants accepted to use PrEP based on the six constructs of acceptability (93.6%, n = 383). Participants with perceived risk of getting HIV infection had higher odds of PrEP acceptability, (adjusted odds ratio [aOR]=4.23, 95%CI = 1.05–17.04). Participants who knew their partner’s HIV status (aOR=0.25, 95%CI = 0.07–0.88), those who felt embarrassed to ask for PrEP from the facility (aOR=0.12, 95%CI = 0.04–0.39), and those who had stigma associated with use of PrEP (aOR=0.13, 95%CI = 0.04–0.41) had reduced odds of PrEP acceptability. Conclusion We found a high level of PrEP acceptability among young men at risk of HIV acqui sition in Kagwara fishing community. Improving access to PrEP services among high risk young men in the fishing communities may increase PrEP uptake in this population and across similar settings. The Ministry of health needs to use multiple approaches to provide PrEP such as peer-led models, drug distribution points, short message reminders for refills, pharmacies and retail drug shops.
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    Aneurysmal bone cyst of the mandible: a rare case report and literature review
    (Annals of Medicine & Surgery, 2023) Yahaya, J. J; Morgan, E. D; Abraham, Z. S; Othieno, E
    Introduction and importance: Aneurysmal bone cysts (ABCs) are benign, non-neoplastic cystic lesions composed of multiple blood-filled cavities, which are separated by connective tissue septa and they constitute ~6 and 1.5% of all cases of the skull and jaws lesions, respectively. Case presentation: Herein, the case of an 80-year-old male with a histologically confirmed diagnosis of ABC involving the body of the left mandible was presented. The patient underwent partial mandiblectomy after confirmation of the diagnosis using orthopantomography, a computed tomography scan, and a tissue biopsy. The patient was free from pain after 1-year of follow-up, and the control orthopantomography showed no evidence of recurrence. This was followed by reconstruction of the healed part of the bone with titanium plates and a piece of bone from the lateral two-thirds of the left femur and thereafter he was cosmetically well. Clinical discussion: Patients with ABCs present with expansile and radiolucent bone lesions, which may be associated with displacement and loss of teeth due to alveolar bone erosion. Complete excision of the lesions is mandatory for the prevention of recurrence and increased morbidity. Conclusion: ABCs that involve the jaws are extremely rare and are more likely to pose a diagnostic challenge as they are more likely to be confused clinically with other expansile radiolucent bone lesions such as ameloblastoma, osteoblastoma, and giant cell tumor among many others. Also, those with extensive bone matrix formation may sometimes be confused histologically with other bone forming tumors including osteosarcoma. Recurrence is common but it can be avoided or minimized by complete resection of the lesion.
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    Bottlenecks and opportunities towards achieving the targeted 95-95-95 HIV services in a rural district in Eastern Uganda
    (Health Services gateway, 2022-12-21) Monkya Samuel Namenkere; Ayaa Mary Stella; Sukuku Linda; Kharono Juliet; Mugabi Charles; Chelangat Benina; Mary Abwola Olwedo; Carol Nabasumba; Paul Oboth; Julius Osele; Rebecca Nekaka; Jacob Stanley Iramiot
    Background: Uganda has made progress in reducing its HIV prevalence from 7.3% in 2011 to 6% in 2017, however, more needs to be done to meet the World Health Organization (WHO) target of 95% of the population knowing their HIV status, 95% enrolled on treatment and 95% achieving viral suppression. This study aimed to assess the bottlenecks and opportunities towards achieving the 95 95 95 targeted HIV services in the Bukedea district. Methods: A mixed-methods cross-sectional study was conducted in the Bukedea district covering males and females aged 18-65 years who had consented to participate in the study. We used a purposive sampling procedure to select our study participants. Qualitative data was collected through focus group discussions, key informant interviews, and document reviews for quantitative data. Quantitative data were analyzed using STATA v 14 whereas qualitative data were analyzed using the thematic analysis approach. Results: The challenges were grouped as patient-related, medication-related, and facility-related. The patient-related challenges were stigma, fear of taking the medication, poor nutrition, long distances, alcoholism, busy working schedules, and domestic violence. The medication-related challenges were side effects and pill burden. The facility-related challenges were inadequate pretest counseling and stock-outs. The use of anti-retroviral drugs (ART) was common in piggery and poultry and the sources of these drugs were reported to be the people on ART and the health workers. The opportunities included home-based counseling, organizing more outreaches, counseling and health education, targeted testing, and strengthening the Village Health Teams (VHT) networks. Conclusions: The study revealed that the major challenges towards achieving the targeted 95-95-95 HIV services were stigma, inadequate pre-test counseling, fear of disclosure, and poor adherence due to alcoholism, sharing of drugs with animals and partners. The use of anti-retroviral drugs in animal husbandry was common in the Bukedea District. Keywords enrolment to care, HIV testing, Viral load suppression, HIV infection, HAART, expert clients, HIV care, Adherence to HIV treatment.
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    Breakdown of simple female genital fi stula repair after 7 day versus 14 day postoperative bladder catheterisation: a randomised, controlled, open-label, non-inferiority trial
    (CrossMark, 2015) Mark A, Barone; Mariana, Widmer; Steven, Arrowsmith; Joseph, Ruminjo; Armando, Seuc; Evelyn, Landry; Thierno Hamidou, Barry; Dantani, Danladi; Lucien, Djangnikpo; Tagie, Gbawuru-Mansaray; Issoufa, Harou; Alyona, Lewis; Mulu, Muleta; Dolorès, Nembunzu; Robert, Olupot; Ileogben, Sunday-Adeoye; Weston Khisa, Wakasiaka; Sihem, Landoulsi; Alexandre, Delamou; Lilian, Were; Vera, Frajzyngier; Karen, Beattie; A Metin, Gülmezoglu
    Summary Background Duration of bladder catheterisation after female genital fi stula repair varies widely. We aimed to establish whether 7 day bladder catheterisation was non-inferior to 14 days in terms of incidence of fi stula repair breakdown in women with simple fi stula. Methods In this randomised, controlled, open-label, non-inferiority trial, we enrolled patients at eight hospitals in the Democratic Republic of the Congo, Ethiopia, Guinea, Kenya, Niger, Nigeria, Sierra Leone, and Uganda. Consenting patients were eligible if they had a simple fi stula that was closed after surgery and remained closed 7 days after surgery, understood study procedures and requirements, and agreed to return for follow-up 3 months after surgery. We excluded women if their fi stula was not simple or was radiation-induced, associated with cancer, or due to lymphogranuloma venereum; if they were pregnant; or if they had multiple fi stula. A research assistant at each site randomly allocated participants 1:1 (randomly varying block sizes of 4–6; stratifi ed by country) to 7 day or 14 day bladder catheterisation (via a random allocation sequence computer generated centrally by WHO). Outcome assessors were not masked to treatment assignment. The primary outcome was fi stula repair breakdown, on the basis of dye test results, any time between 8 days after catheter removal and 3 months after surgery. The non-inferiority margin was 10%, assessed in the per-protocol population. This trial is registered with ClinicalTrials.gov, number NCT01428830. Findings We randomly allocated 524 participants between March 7, 2012, and May 6, 2013; 261 in the 7 day group and 263 in the 14 day group. In the per-protocol analysis, ten (4%) of 250 patients had repair breakdown in the 7 day group (95% CI 2–8) compared with eight (3%) of 251 (2–6) in the 14 day group (risk diff erence 0·8% [95% CI –2·8 to 4·5]), meeting the criteria for non-inferiority. Interpretation 7 day bladder catheterisation after repair of simple fi stula is non-inferior to 14 day catheterisation and could be used for management of women after repair of simple fi stula with no evidence of a signifi cantly increased risk of repair breakdown, urinary retention, or residual incontinence up to 3 months after surgery.
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    Burden of gluteal fibrosis and postinjection paralysis in the children of Kumi District in Uganda
    (BMC Musculoskeletal Disorders, 2018) Kristin, Alves; Norgrove, Penny; John, Ekure; Robert, Olupot; Olive, Kobusingye; Jeffrey N., Katz; Coleen S., Sabatini
    Abstract Background: The purpose of this study was to estimate the prevalence of postinjection paralysis (PIP) and gluteal fibrosis (GF) among children treated in a rural Ugandan Hospital. Methods: We conducted a retrospective cohort study by reviewing the musculoskeletal clinic and community outreach logs for children (age < 18 yrs) diagnosed with either PIP or GF from Kumi Hospital in Kumi, Uganda between 2013 and 2015. We estimated the prevalence as a ratio of the number of children seen with each disorder over the total population of children seen for any musculoskeletal complaint in musculoskeletal clinic and total population of children seen for any medical complaint in the outreach clinic. Results: Of 1513 children seen in the musculoskeletal clinic, 331 (21.9% (95% CI 19.8–24.1%)) had PIP and another 258 (17.1% (95% CI 15.2–19.0%)) had GF as their diagnosis. Of 3339 children seen during outreach for any medical complaint, 283 (8.5% (95% CI 7.6–9.5%)) had PIP and another 1114 (33.4% (95% CI 31.8–35.0%)) had GF. Of patients with GF, 53.9% were male with a median age of 10 years (50% between 7 and 12 years old). Of patients with PIP, 56.7% were male with a median age of 5 years (50% between 2 and 8 years old). Conclusion: PIP and GF comprise over 30% of clinical visits for musculoskeletal conditions and 40% of outreach visits for any medical complaint in this area of Uganda. The high estimated prevalence in these populations suggest a critical need for research, treatment, and prevention. Keywords: Gluteal fibrosis, Post-injection paralysis
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    Clinical teaching models for the instruction of healthcare trainees in the 21st century: a scoping review
    (BMC Medical Education, 2026-06-22) Clement Munguiko; Enos Mirembe Masereka; Joseph Atukwatse; Joseph Smitha; James Kateregga; Clare Nankinga; Alice Alum Collete; Josephine Namujju; Safina Akello; Sylivia Nalubega
    Background: In the 21st century, health professions educators are required to adopt contemporary clinical teaching models that equip trainees with competencies that are responsive to the evolving healthcare needs of the population. Efforts to standardize clinical competencies across the globe further demand aligned pedagogical frameworks to guide clinical teaching across diverse contexts. However, evidence on such remains fragmented and inadequately synthesized. This study mapped existing evidence on models guiding clinical teaching of healthcare trainees in the 21st century. Methods: The review followed the Joanna Briggs Institute scoping review guideline. Electronic database searches were conducted between 1st and 4th January 2026 in CINAHL, PubMed, Scopus, Cochrane, and Informit to identify articles published from 1st January 2000 to 31st December 2025. Grey literature searches were conducted in google scholar and ProQuest. Studies were screened at title, abstract and full text levels, and data were extracted using a standardized Joanna Briggs Institute data extraction tool. Data was analyzed descriptively and summarized in a tabular form. ARTICLE IN PRESS Results: The search yielded 3,526 records, of which 70 went through full text screening and 26 met the inclusion criteria. Most studies were conducted in the United States, with none from Africa, and involved medical students. Eight clinical teaching models were mapped: i) One 1 ACCEPTED MANUSCRIPT ARTICLE IN PRESS Minute Preceptor Model (OMP); ii) Summarize, Narrow, Analyze, Probe, Plan, Select (SNAPPS); iii) Setting foundation, Tutor demonstrating without commentary, Explaining with repeated demonstration, Practicing under supervision, and Subsequent practice (STEPS); iv) Meeting, Introduction, In the moment, Inspection, Interruption, Independent thought, Patient care, Learner’s questions, Attending agenda, and Next steps (MiPLAN); v) Bridge-in, Objectives, Pre-assessment, Participatory learning, Post-assessment, and Summary (BOPPPS); vi) Emergency Department Strategies for Teaching Any Time (ED STAT); vii) Reporter Interpreter-Manager-Educator (RIME); and viii) Aunt Minnie. OMP and SNAPPS were the most commonly reported models. Conclusions and recommendations: Although eight clinical teaching models were identified, supporting evidence remains geographically and methodologically uneven, with no single model emerging as universally applicable. However, structured teaching, learner engagement, reflection, feedback, and role modelling consistently appeared across the identified models as core microteaching skills. Clinical educators and training institutions should strengthen these competencies through faculty development and context-sensitive application of clinical teaching models. Future research should prioritize methodologically rigorous and contextually grounded studies on clinical teaching models, particularly in underrepresented low-resource settings.
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    Clinical, Sonographic and Biochemical Profiles of Patients with a Mainz II Pouch Urine Diversion in Rural Uganda. A Case Series
    (2025-05-24) Ronald Opito; David Aderu; Joseph Epodoi; Denise Apolot; Ritah Kiconco; Richard Mpango; Jacob Eperu; Fred Kirya
    Background: Mainz II pouch urinary diversion is an alternative surgery for patients with an incurable vesicovaginal fistula (VVF). We report six (6) cases of patients who had incurable VVF and were offered Mainz II pouch surgery at Soroti Regional Referral Hospital, between 2009 and 2018 and followed up in 2023. Methods: A retrospective review of charts of 6 patients who were offered Mainz II pouch procedure and a cross-sectional assessment of their biochemical, sonographic and clinical profiles five (5) or more years after the procedure at Soroti Regional Referral Hospital were done. All case notes of patients who underwent the Mainz II procedure between 2009 and 2018 were retrieved from the registry and each patient profiled using a standard data abstraction tool. Results: The ages of the six participants ranged between 16 and 65 years at the time of the procedure. Four of the 6 participants had lived with the fistula for less than 10 years. Four participants had only one delivery and the other 2 had five and six deliveries. All the participants had lived with the Mainz II pouch urine diversion for at least five years (5–14 years). One participant (1/6) had hypertension (BP=161/101). Most participants reported nocturnal incontinence. Sonographic findings revealed one-sided mild vesi coureteral reflux with loss of corticomedullary differentiation in two participants (2/6). One of six (1/6) patients had severe vesicoureteral reflux grade 4. The commonest metabolic disorders were compensated metabolic acidosis (4/6). Conclusion: The Mainz II pouch procedure remains a viable option for managing incurable obstetric fistulas. However, the prevalence of metabolic complications, including acidosis and renal impairment, underscores the need for routine biochemical and sonographic monitoring to ensure optimal long-term patient outcomes. Keywords: Mainz II pouch, vesicovaginal fistula, urinary diversion, acidosi
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    Community perspectives and insights into cancer surveillance, prevention, and research: an engaged participatory approach to cancer epidemiology research in remote areas of Northeastern Uganda
    (Springer Nature, 2026-04-24) Ronald Opito; Alfred Jatho; Wilber Sabiiti; Hellen Akurut; Emmanuel Othieno; Lawrence Obado Osuwat; Anthony Mugeere; Patrick Igulot; Jackson Orem
    Background There is limited research on cancer screening, prevention and treatment in the remote areas of Northeastern Uganda. Specifically, there is limited research presenting cancer control stakeholder perspectives in remote settings, whereas stakeholders’ perspectives are critical for an engaged participatory approach to cancer control. This study therefore aimed to establish the community (patients, caretakers, opinion leaders, health managers and policy makers) perspectives on cancer surveillance, prevention, treatment and identify priorities for cancer research in Northeastern Uganda. Methods This qualitative research was part of a stakeholder’s consultation on cancer research priorities in Northeastern Uganda for Wellcome Trust research grant application, conducted by a consortium of research partners. Six semi structured Key Informant Interviews (KIIs), two focus group discussions (FGDs) and one community dialogue meeting were conducted between July and August 2025. Thematic data analysis was conducted to identify emergent themes from the interviews. Findings are presented using the key emergent themes, supporting quotes, and are presented in tables and text. This study is reported in accordance with Consolidated Criteria for Reporting Qualitative Research (COREQ). Key Findings There was delayed diagnosis in most cases for cancer patients. After the cancer diagnosis, patients were referred to Mulago Hospital, approximately 300Km away from their homes for further treatment, with many hesitations and incapacity to go to Mulago due to many social and economic challenges. There is no stand-alone cancer surveillance system in the country and currently it depends on health facility data which have lots of weaknesses including incompleteness and inaccuracy. Health facilities are ill-prepared to respond to the growing burden of cancers. Priorities for cancer research include epidemiology and etiology of cancer and a focus on population-based registry for unique populations in Uganda and strengthening cancer surveillance systems. Conclusion This study highlights the importance of an engaged approach based on Participatory Action Research theory to identify problems. Through this approach, the research team was able to accurately understand the research context, identify research issues, and priorities. Priorities for cancer research identified by this study include epidemiology and etiology of cancer, including the incidence studies and geographical mapping of these cancers, conducting cancer disease surveillance at the landing site and investigating the contribution of the locally available foods and environment to cancers. There is need for community sensitization and screening for cancers in the entire region. Involvement of community team leaders such as village health teams (VHTs), local council I (LCIs), traditional and church leaders in cancer surveillance should be encouraged and the community case definitions of common cancers should be refined and the capacity of the community workers (VHTs) built to detect cancers at community level. Through this preliminary research, the groundwork for science anchored on the realities of the affected people has been firmly laid upon which science can build on to solve the problem in a sustainable and equitable way.
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    Comparative Assessment of Red Blood Cell Morphology in Anaemic Children
    (International Journal of Sciences, 2020) Samuel, Mwesige; Clement, Munguiko; Didas, Mushabe
    Abstract Anaemia (haemoglobin level < 11 g/dl) is a health burden among preschool children and women of child bearing age and affects over 27% of the World population. Anaemia results from reduction in the functional haemoglobin or red blood cell numbers or mass leading to decreased oxygen carrying capacity characterized by clinical features such as; skin pallor, fatigue, shortness of breath, congestive heart failure, jaundice and tachycardia. Evaluating and interpreting red blood cell morphology provides key information in the differential diagnosis of Anaemia. However, the current standard Peripheral thin blood method of assessing red blood cell morphology is highly technical and time consuming. There was need to carry out assessment into the alternative Automated Complete Blood Count method to aid in the selection of the reliable assay. The objective of the study was to compare between Peripheral blood thin film and Automated Complete Blood Count morphologically classified Anaemia in children. The study was cross-sectional and employed simple random sampling technique. Blood samples were obtained from the participants, assessed for red blood cell morphology by Automated Complete Blood Count and Peripheral thin blood film. Data was analyzed using SPSS and a paired t-test used to test for the statistical significance. Results show no significant difference in the scores for Peripheral thin blood film (M=25.5, SD=11.82) and Automated Complete Blood Count (M=25.5, SD=12.66) t (3) =0.00, p =1.000. Automated Complete Blood Count is a method of choice in assessing red blood cell morphology and evaluating Anaemia. The study recommends assessment into various Automated Complete Blood Count models available in the market to aid in the selection of most reliable one.
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    The correctness and completeness of documentation of parameters on the partographs used by midwives in primary healthcare facilities in midwestern Uganda:
    (Nursing Open published by John Wiley & Sons Ltd, 2022) Archbald, Bahizi; Munguiko, Clement; Enos Mirembe, Masereka
    Abstract Aim: This study was conducted to determine the correctness and completeness of documentation of partographs. Design: This was a retrospective descriptive study. Methods: We included 365 partographs of deliveries conducted from January 1st to October 31st 2019. Data were collected using a checklist and analysed descriptively. The study based on 13 partograph parameters. Results: About 8–13 parameters were correctly documented in 71.5 % of the partographs. About 38.9%, 24.7%, 99.7%, 22.5% and 16 % of the partographs had no documentation of obstetric risk factors, foetal heart rate, colour of liquor, uterine contractions and cervical dilatation respectively. About 12.1% of the cervicographs crossed the action line and 61.4% of partographs where cervicographs crossed the action line had no documentation of action(s) taken.
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    Diabetic Foot Ulcers: Surgical Characteristics, Treatment Modalities and Short-Term Treatment Outcomes at a Tertiary Hospital in South-Western Uganda
    (Open Access Surgery, 2022) Mvuyo Maqhawe, Sikhondze; Deus, Twesigye; Charles Newton, Odongo; David, Mutiibwa; Edson, Tayebwa; Leevan, Tibaijuka; Samuel D, Ayana; Carlos Cabrera, Dreque
    Abstract Background: Diabetic foot ulcers (DFUs) are a prevalent and serious consequence of poorly controlled diabetes. Hospitalizations are frequent among DFU patients, and these patients are at risk of lower extremity amputations (LEA). Uganda has few studies detailing DFUs and their management. We described the surgical characteristics, treatment modalities and short-term treatment outcomes of DFUs at Mbarara Regional Referral Hospital, in southwestern Uganda. Methods: A prospective cohort study involving 62 patients with DFUs was conducted from February 2021 to September 2021. We captured socio-demographic data, surgical characteristics, treatment and treatment outcomes of DFUs over a 5-week follow-up period, through an interviewer-administered structured questionnaire. Descriptive statistics were used at analysis. Results: The mean age of participants was 57.0 ± 12.27 years, comprising 35 (56.5%) females. Majority had diabetes mellitus (DM) for more than 10 years, predominantly type 2 (93.5%), and 33.9% with very poor glycaemic control (HBA1c>9.5%). Most ulcers involved the toes (27.4%), with 80.7% being large (>3 cm2 ). Severe DFUs (Wagner grade 3–5) were seen in 66.2% of patients. Clinically infected ulcers mainly had Pseudomonas spp cultured. Arterial occlusion was detected in 35.5% through lower extremity Doppler ultrasonography. Initial surgical interventions were surgical debridement and LEA performed in 50.0% and 46.8%, respec tively. Eight (42.1%) patients suffered surgical site infection, while 26.3% had persistent gangrene after initial surgery. Revision surgery was performed in 25.8% of the participants. Mortality rate was 1.6%, and mean length of hospital stay was 17.0 ± 11.1 days. Conclusion: More than half of the patients had advanced DFUs (Wagner grades 3–5). Poor glycemic control and late presentation were common. Lower extremity amputation was a common initial treatment modality for DFUs. Routine lower extremity Doppler ultrasonography is recommended to assess peripheral arterial disease for DFU patients. Wound swabbing for culture and sensitivity testing is encouraged for appropriate antibiotic coverage
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    Diagnostic and pre-treatment intervals among patients with cervical cancer attending care at the Uganda Cancer Institute: a cross-sectional study
    (BMC Women's Health, 2023-11-03) Jackie Lalam Lacika; Henry Wabinga; Joseph Kagaayi; Ronald Opito; Christopher Garimoi Orach; Amos Deogratius Mwaka
    Background Majority of patients with cervical cancer in the low- and middle-income countries experience long diagnostic and pre-treatment intervals. This study sought to determine the factors associated with the diagnostic and pre-treatment intervals among patients with cervical cancer. Methods This was a cross-sectional study conducted at the Uganda Cancer Institute (UCI) during October 2019 to January 2020. Patients aged ≥ 18 years with histological diagnosis of cervical cancer were consecutively sampled. Data were collected using a pre-tested semi-structured questionnaire and a data abstraction form. Diagnostic intervals, defined as the time between first visit of a patient to a primary healthcare provider to time of getting confirmed diagnosis, of ≤ 3 months was defined as early & >3 months as late. Pre-treatment intervals, which is the time from histological diagnosis to starting cancer chemo-radiotherapy of ≤ 1 month was defined as early and > 1 month as late. Data were analysed using STATA version 14.0. We used modified Poisson regression models with robust variance to determine socio-demographic and clinical factors associated with the intervals. Results The mean age of the participants was 50.0 ± 11.7 years. The median diagnostic and pre-treatment intervals were 3.1 (IQR: 1.4–8.2) months and 2.4 (IQR: 1.2–4.1) months respectively. Half of the participants, 49.6% (200/403) were diagnosed early; one in 5 patients, 20.1% (81/403) promptly (within one month) initiated cancer chemo radiotherapy. Participants more likely to be diagnosed early included those referred from district hospitals (level 5) (aPR = 2.29; 95%CI: 1.60–3.26) and with squamous cell carcinomas (aPR = 1.55; 95%CI: 1.07–2.23). Participants more likely to be diagnosed late included those who first discussed their symptoms with relatives, (aPR = 0.77; 95%CI: (0.60–0.98), had > 2 pre-referral visits (aPR = 0.75; 95%CI (0.61–0.92), and had advanced stage (stages 3 or 4) (aPR = 0.68; 95%CI: 0.55–0.85). Participants more likely to initiate cancer chemo-radiotherapy early included older patients (≥ 60 years) (aPR = 2.44; 95%CI: 1.18–5.03). Patients likely to start treatment late were those who had ≥2 pre-referral visits (aPR = 0.63; 95%CI: 0.41–0.98) and those that took 3 - 6 months with symptoms before seeking healthcare (aPR = 0.52;95%CI: 0.29 - 0.95). Conclusion Interventions to promote prompt health-seeking and early diagnosis of cervical cancer need to target primary healthcare facilities and aim to enhance capacity of primary healthcare professionals to promptly initiate diagnostic investigations. Patients aged < 60 years require targeted interventions to promote prompt initiation of chemo-radiation therapy. Keywords Cervical cancer, Diagnostic intervals, Pre-treatment intervals, Advanced stage
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    Diagnostic and pre-treatment intervals among patients with cervical cancer attending care at the Uganda Cancer Institute: a cross-sectional study
    (BMC Women's Health, 2023-11-27) Jackie, Lalam Lacika; Henry, Wabinga; Joseph, Kagaayi; Ronald, Opito; Christopher, Garimoi Orach; Amos Deogratius, Mwaka
    Abstract Background Majority of patients with cervical cancer in the low- and middle-income countries experience long diagnostic and pre-treatment intervals. This study sought to determine the factors associated with the diagnostic and pre-treatment intervals among patients with cervical cancer. Methods This was a cross-sectional study conducted at the Uganda Cancer Institute (UCI) during October 2019 to January 2020. Patients aged ≥ 18 years with histological diagnosis of cervical cancer were consecutively sampled. Data were collected using a pre-tested semi-structured questionnaire and a data abstraction form. Diagnostic intervals, defined as the time between first visit of a patient to a primary healthcare provider to time of getting confirmed diagnosis, of ≤ 3 months was defined as early & >3 months as late. Pre-treatment intervals, which is the time from histological diagnosis to starting cancer chemo-radiotherapy of ≤ 1 month was defined as early and > 1 month as late. Data were analysed using STATA version 14.0. We used modified Poisson regression models with robust variance to determine socio-demographic and clinical factors associated with the intervals. Results The mean age of the participants was 50.0 ± 11.7 years. The median diagnostic and pre-treatment intervals were 3.1 (IQR: 1.4–8.2) months and 2.4 (IQR: 1.2–4.1) months respectively. Half of the participants, 49.6% (200/403) were diagnosed early; one in 5 patients, 20.1% (81/403) promptly (within one month) initiated cancer chemoradiotherapy. Participants more likely to be diagnosed early included those referred from district hospitals (level 5) (aPR = 2.29; 95%CI: 1.60–3.26) and with squamous cell carcinomas (aPR = 1.55; 95%CI: 1.07–2.23). Participants more likely to be diagnosed late included those who first discussed their symptoms with relatives, (aPR = 0.77; 95%CI: (0.60–0.98), had > 2 pre-referral visits (aPR = 0.75; 95%CI (0.61–0.92), and had advanced stage (stages 3 or 4) (aPR = 0.68; 95%CI: 0.55–0.85). Participants more likely to initiate cancer chemo-radiotherapy early included older patients (≥ 60 years) (aPR = 2.44; 95%CI: 1.18–5.03). Patients likely to start treatment late were those who had ≥2 pre-referral visits (aPR = 0.63; 95%CI: 0.41–0.98) and those that took 3 - 6 months with symptoms before seeking healthcare (aPR = 0.52;95%CI: 0.29 - 0.95). Conclusion Interventions to promote prompt health-seeking and early diagnosis of cervical cancer need to target primary healthcare facilities and aim to enhance capacity of primary healthcare professionals to promptly initiate diagnostic investigations. Patients aged < 60 years require targeted interventions to promote prompt initiation of chemo-radiation therapy.
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    Disseminated peritoneal leiomyomatosis as an incidental finding: A case report
    (John Wiley & Sons Ltd., 2023-02-16) Morgan, E. D; Kahiye, M; Kule, I; Yahaya, J. J; Othieno, E
    We present the case of a 23-year-old female with multiple diffuse and nodular masses of different sizes involving predominantly the posterior wall of the uterus, omentum, and peritoneum which were histopathologically confirmed to be dis seminated peritoneal leiomyomatosis. Meticulous investigation and accurate di agnosis are of utmost importance for the establishment of the correct diagnosis. Additionally, proper management of the patient while considering choice of the patients including close follow-up of the patients is mandatory for the reason of ensuring early detection of recurrence.
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    Duodenal Strongyloides stercoralis infection in a 56-year old male: A case report
    (International Journal of Surgery Open, 2023) Yahaya, J. J; Morgan, E. D; Othieno, E
    Introduction and importance: The infection caused by Strongyloides stercoralis (S stercoralis) is usually an asymptomatic condition particularly in immunocompetent individuals and the condition may remain unnoticed even for decades, however, strongyloidiasis is more severe in patients who are immunocompromised. Case presentation: The patient is a 56-year old male who presented with nine months history of episodes of abdominal pain, nausea loss of appetite, and chronic diarrhea. His diarrhea had mucus and trace blood. His oesophagogastroduodenoscopy (OGD) revealed erythematous, hypertrophied, and ulcerating lining mucosa of the duodenum. The specimen sampled showed sections of the duodenum with numerous Strongyloides stercoralis larvae, some inside the crypts with associated active duodenitis. Clinical discussion: Despite the asymptomatic nature of Strongyloides stercoralis infectious condition especially for immunocompetent patients, the infection may sometimes result into serious complications including exudative enteropathy and paralytic ileus. The clinical outcome of patients with strongyloidiasis is usually better despite severe infection may develop and it is associated with slightly increased morbidity and even mortality. Conclusion: Diagnosis of Strongyloides stercoralis infection in individuals residing in tropical or subtropical countries who present with chronic diarrhea, abdominal pain should always be considered so as to avoid delay of diagnosis. This may help in preventing unnecessary complication such as severe anaemia, intestinal perforation or even death.
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    Educational factors influencing academic achievement in biomedical sciences among undergraduate nursing students in Uganda: analytical cross‑sectional study
    (2025-06-25) Clement Munguiko; Anne Ngeno; Safinah Museene
    Introduction Biomedical science courses, including anatomy, physiology, and biochemistry, are challenging for many undergraduate nursing students. This study explored academic achievement in these subjects and the impact of student educational factors on performance among nursing students in Uganda. Methods Analytical cross-sectional study of 208 nursing students from four Ugandan public universities examined aca demic achievement in biomedical sciences. Using Grade Point Average (GPA) and letter grades as measures, the study analysed the influence of student educational factors like prior academic performance, career choice, and learning methods through Welch’s Analysis of Variance, Pearsons’s correlation and Linear Mixed-Effects model. Results Academic achievement varied slightly across universities, with physiology having the highest mean GPA of 2.89 (1.83–3.70) and anatomy the lowest at 2.63 (2.04–3.30), resulting in an overall GPA of 2.80 ± 0.747. Most students received C (37%) and D (33.7%) grades. Choosing nursing as a lower-priority career (β = 0.42, 95% CI 0.08–0.76, p = 0.02) and infrequent participation in group discussions (β = −0.61, CI −1.21 to −0.12, p < 0.001) influenced academic achieve ment in biomedical sciences. Secondary school performance showed negligible correlation with biomedical science GPA (r = 0.1163). Conclusion Academic achievement in biomedical sciences among Ugandan nursing students is marginal to moderate, with most earning C and D grades. Universities should provide extra support to students who select nursing as their f irst choice while continuing to admit those who choose nursing as a later option. Encouraging small group discussions among students could also be beneficial. Keywords Academic · Performance · Biomedical · Sciences · Nursing
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    Effect of corticosteroids on haemoglobinuria resolution among children with blackwater fever at Soroti regional referral hospital, Uganda: a retrospective cohort study
    (Springer Nature, 2025-11-03) Amos Odiit; Patrick Lubogo; Moses Ochora; Isaac Ebiju; Ronald Opito
    Background Corticosteroids are sometimes used in clinical practice in the treatment of blackwater fever (BWF), a complication of severe malaria, despite limited evidence of benefit. This study aimed to compare the time to haemoglobinuria resolution between children with BWF who received corticosteroids and those who did not, and determine if corticosteroid use significantly influences this outcome. Methods This was a retrospective cohort study carried out at Soroti Regional Referral Hospital in Soroti, Uganda, among children diagnosed with blackwater fever (BWF), between 1st January 2023 to 31st December 2024. Participants included in the study were 889. Time to haemoglobinuria resolution was determined using the Kaplan–Meier survival function and compared using log rank test. Predictors of time to haemoglobinuria resolution were determined using an extended cox proportional hazard model, with results expressed as adjusted hazard ratios (aHR) and 95% confidence intervals (CI). Results The median time to haemoglobinuria resolution was 3 days in both the corticosteroid and non-corticosteroid groups. Corticosteroid use was not significantly associated with time to haemoglobinuria resolution (aHR: 0.90; 95% CI 0.75–1.07, p = 0.239). The predictors of time to haemoglobinuria resolution were: antibiotic use (aHR: 0.68; 95% CI 0.58–0.81, p < 0.001), blood transfusion (specifically for those who received transfusions twice [aHR: 0.78; 95% CI 0.62–0.97, p = 0.024], three times [aHR: 0.59; 95% CI 0.40–0.88, p = 0.010], and four times [aHR: 0.36; 95% CI 0.24–0.53, p < 0.001]), presence of jaundice (aHR: 1.49; 95% CI 1.14–1.94, p = 0.003), and administration of normal saline (aHR: 0.57, 95% CI 0.45–0.74, p < 0.001). Conclusion Corticosteroid use did not accelerate haemoglobinuria resolution in children with blackwater fever, supporting current WHO guidance against their use. These findings suggest limited benefit of corticosteroids in BWF management.
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    Endometriosis of the umbilicus in a 36-year-old woman: a case report and literature review
    (Annals of Medicine and Surgery, 2023) Yahaya, J. J; Morgan, E. D; Abraham, Z. S
    Introduction and importance: Extrapelvic endometriosis is quite rare, with a reported prevalence ranging between 0.5 and 1%, and the condition is more likely to pose diagnostic challenges. This condition is more likely to pose clinical diagnostic challenges as it may mimic metastasis such as Sister Mary Joseph’s nodule. Case presentation: Herein is reported the case of a 36-year-old woman who presented with a hard nodular dark-bluish umbilicus mass that had a tendency to increase in size and was accompanied by severe pain during menstruation for ∼2 years is reported. Laparotomy revealed a normal uterus without involvement of any other pelvic organ by the endometrial tissue except the umbilicus part. Histological evaluation revealed endometriosis of the umbilicus. Clinical discussion: By far, primary endometriosis of the umbilicus is extremely rare, and most of the time, extrapelvic endometriosis involving the umbilicus would be secondary to surgical procedures involving the abdominal cavity as it was for the presented patient. Although endometriosis is rare, it should always be considered among women of reproductive age presenting with cyclic pains. Conclusions: Meticulous investigation of patients suspected to have umbilical endometriosis helps to confirm the diagnosis and hence expedites proper management of the patients; this also prevents chances of malignant transformation of the condition despite such possibilities being extremely rare.
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    Etiology, Clinical Presentations, and Short-Term Treatment Outcomes of Extrahepatic Obstructive Jaundice in South-Western Uganda
    (Clinical and Experimental Gastroenterology journal, 2022-11-13) Charles Newton, Odongo; Carlos Cabrera, Dreque; David, Mutiibwa; Felix, Bongomin; Felix, Oyania; Mvuyo Maqhawe, Sikhondze; Moses, Acan; Raymond, Atwine; Fred, Kirya; Martin, Situma
    Background: The diagnosis of extrahepatic obstructive jaundice (EHOJ) remains a challenge and is often made late in low-resource settings. Systematic data are limited on the etiology and prognosis of patients with obstructive jaundice in Uganda. The objective of this study was to determine the etiology, clinical presentations, and short-term treatment outcomes of patients managed for EHOJ at Mbarara Regional Referral Hospital (MRRH) in south-western Uganda. Methods: Between September 2019 and May 2020, we prospectively enrolled a cohort of patients who presented with EHOJ at MRRH. A pretested, semi-structured data collection tool was used to abstract data from both the study participants and their files. Results: A total of 72 patients, 42 (58.3%) of whom were male with a median age of 56 (range of 2 months to 95 years) were studied. Forty-two (58.3%) participants had malignancies: Pancreatic head tumors 20 (27.8%), cholangiocarcinoma 13 (18.1%), duodenal cancers 5 (6.94%), and gall bladder cancer 4 (5.6%). The remaining 30 (41.7%) participants had benign etiologies: choledocholithiasis 10 (13.9%), biliary atresia 7 (9.7%), pancreatic pseudo cyst 6 (8.3%), Mirizzi syndrome 5 (6.9%) and 1 (1.4%) each of chronic pancreatitis and choledochal cyst. Sixty-seven (93.1%) patients presented with right upper quadrant tenderness, 65 (90.3%) abdominal pain and 55 (76.3%) clay-colored stool. Cholecystectomy 11 (25.6%) and cholecystojejunostomy + jejunojejunostomy 8 (18.6%) were the commonest procedures performed. Twelve (17.0%) of cases received chemotherapy (epirubicin/cisplatin/capecitabine) for pan creatic head tumors and (gemcitabine/oxaliplatine) for cholangiocarcinoma. Mortality rate was 29.2% in the study, of which malignancy carried the highest mortality 20 (95.24%). Conclusion: Malignancy was the main cause of EHOJ observed in more than half of the patients. Interventions aimed at early recognition and appropriate referral are key in this population to improve outcomes.
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    Facilitators and Barriers to Cervical Cancer Screening Among Women in a Rural District of Northeastern Uganda, a Qualitative Study
    (Dove Medical Press Limited, 2026-04-23) Ibra Mutyaba; Hellen Akurut; Racheal Nabaasa; Jonathan Limo; Emmanuel Okupa; Christine Acari Omuke; Ronald Opito
    Introduction: Cervical cancer screening in Uganda has remained relatively low, with fewer than one in 10 of eligible women screened, despite the availability of cervical cancer screening services in most health facilities. The barriers and facilitators of cervical cancer screening in remote rural settings of Northeastern Uganda like Ngora are not yet well understood. This study therefore aimed to assess the barriers and facilitators to cervical cancer screening among women of reproductive age in a remote rural district Ngora, Northeastern Uganda. Methods: This study employed a qualitative approach to gather in-depth insight into the barriers and facilitators of cervical cancer screening. We conducted six focused group discussions (FGDs) (4 females and 2 males) with the community members and nine key informant interviews (KIIs) with the health workers in Ngora district. The participants for FGDs were chosen through convenient sampling while those for KIIs were chosen through purposive sampling methods. The interviews were audio-recorded and subse quently transcribed for analysis. Data was analyzed using thematic analysis techniques to identify significant patterns and themes related to cervical cancer screening behaviors, while inductive coding was conducted to identify codes and create meaning around the texts. Results: The facilitators of cervical cancer screening were active community sensitization, availability of screening services at designated facilities, supportive national policies, and integration with other health services, while the barriers included myths and misconceptions about cervical cancer screening, stock-outs of essential commodities for screening, long distances to the health facilities, limited human resources, and informal costs charged by the health facilities. Conclusion: Improving cervical cancer screening uptake requires a multi-pronged approach that strengthens health systems, addresses myths and misinformation, reduces financial and logistical burdens, and mobilizes community support. Keywords: cervical cancer, facilitators, barriers, community sensitization