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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.
Factors associated with modern contraceptive use among sexually active youths attending secondary schools in Mbale City, Uganda
(PLOS Global Public Health, 2025-10-03) Mary Abwola Olwedo; Nelson Bunani
Sexual and reproductive health of youths constitutes a significant public health
challenge because of the high risk for morbidity and mortality. There is low uptake
of modern contraceptives among the sexually active youths despite availability. We
investigated the factors associated with the uptake of modern contraceptives among
youths attending secondary schools in Mbale City. This was a cross-sectional study
that enrolled 2,690 students from six purposively selected high-volume secondary
schools in Mbale City. Data were collected using a validated semi-structured
questionnaire and analyzed using descriptive statistics and multivariable logistic
regression to identify factors associated with modern contraceptive use. The factors
associated with modern contraceptive were stratified by sex. Statistical significance
was set at 5% confidence level. Out of 2690 participants, 38.0% were sexually active.
The proportion of sexually active participants who had ever used modern contraceptives
was 60.9%. Factors associated with modern contraceptive use among
male participants were not knowing the fertility days of the female (AOR = 0.49; 95%
CI: 0.32-0.77; p = 0.002) and not receiving health education from a health worker
(AOR = 0.44; 95% CI: 0.30-0.64; p < 0.001). Among females, factors associated with
modern contraceptive use were knowledge of fertility days (AOR = 0.39; 95% CI:
0.18-0.85; p = 0.018), history of abortion (AOR = 0.10; 95% CI: 0.02-0.62; p = 0.014),
and receiving health education from a health worker (AOR = 0.36; 95% CI: 0.22-0.59;
p < 0.001). Modern contraceptive use was low compared to the national average,
with knowledge of fertility days and health education significantly influencing uptake.
Among males, lack of fertility knowledge and absence of health education were
associated with low use of modern contraceptives. Among females, knowledge of
fertility, history of abortion, and health education were key factors. Strengthening
school-based sexuality education and increasing health worker-led reproductive
health counselling can improve modern contraceptive knowledge and uptake, with
gender-specific interventions needed to address barriers to access and use.
Prevalence, factors associated, and negative outcomes of "probable PTSD" among HIV infected children and adolescents: CHAKA study 2014-2017
(Advances in Global Health, 2025-09-29) Richard Stephen Mpango; Wilber Ssembajjwe; Godfrey Zari Rukundo; Philip Amanyire; Tatiana Taylor Salisbury; Jonathan Levin; Kenneth D. Gadow; Vikram Patel; Eugene Kinyanda
The aim of this study was to determine the prevalence of “probable post-traumatic stress disorder (PTSD),” factors associated with probable P-T-S-DPTSD, and its relationship with clinical and behavioral problems among children and adolescents with H-I-V/A-I-D-S (CA-HIV). A random sample of 1,339 C-A-H-I-V (aged 5–18 years, living with H-I-VHIV) whose caregivers completed an extensive battery of measures. The caregivers evaluated psychiatric symptom severity using a standardized D-S-MDSM-5-referenced psychiatric rating scale, the Child and Adolescent Symptom Inventory-5. The prevalence of “probable P-T-S-DPTSD” was estimated with 95% confidence intervals (95% C-ICI). Logistic and ordinal regression models were fitted to determine factors associated with probable P-T-S-D P-T-S-D , including study site, sex of the child, age of the child, caregiver religion, caregiver psychological distress, any anxiety and any attention-deficit/hyperactivity disorder (ADHD). Logistic and ordinal regression models were fitted to determine factors associated with probable P-T-S-D
and to evaluate the relationship between probable P-T-S-D and clinical and behavioral outcomes. The overall prevalence of “probable P-T-S-DPTSD” was 19.6%. C-A-H-I-V with “probable P-T-S-DPTSD” were more likely to have had their sexual debut (a-o-r = 2.78; 95% C-I 1.12–6.55; P = 0.02). “Probable P-T-S-DPTSD” was marginally associated with poor adherence to H-I-V medication (a-o-r = 0.13, 95% C-I 0.02–0.97; P = 0.05).The study identified a high prevalence of “probable P-T-S-DPTSD” among C-A-H-I-V HIV, with significant associations with caregiver psychological distress, anxiety, and A-D-H-D . These findings underscore the need for targeted mental health interventions tailored to the unique needs of C-A-H-I-V in Uganda. Furthermore, integrating mental health services into routine H-I-V care could address the significant burden of P-T-S-D and its comorbidities in this vulnerable population in Uganda.
Prevalence and factors associated with teenage pregnancy among girls aged 13 to 19 years in Atutur sub-county, Kumi district, Eastern Uganda: a community-based cross sectional study
(Reproductive Health, 2025-06-25) Michael Akol; Ronald Opito; Bonniface Oryokot; Hellen Akurut; James Kalema; Maxwell Chekwoti; John Paul Matovu; Nasta Mayamba Chelimo; Hannah Muwanguzi; Moses Eremu; Samuel Kabwigu
Abstract
Background Teenage pregnancy remains a pressing public health issue with profound effects on health, education,
and socio-economic outcomes. Rural areas, such as parts of Teso, often face higher prevalence of teenage pregnancy
due to socioeconomic challenges. This study aimed at determining the prevalence of teenage pregnancy and
associated factors in Atutur sub-county, Kumi district.
Methodology The authors employed a cross-sectional study design and sampled 444 teenage girls aged 13–19
years from 12 randomly selected villages in Atutur sub-county, Kumi district in April 2024. They were interviewed
using structured researcher administered questionnaire. Data was collected using kobo collect tool, downloaded,
cleaned and exported to SPPS version 27.0 for further management and analysis. Descriptive statistics was conducted
to determine the prevalence of teenage pregnancy. After adjusting for covariates, multivariate analysis was conducted
using modified Poisson regression to determine predictors of teenage pregnancy. Results were reported with a 95%
confidence interval (CI) and factors whose CI did not contain a null (1.0), with p-value (P < 0.05) for adjusted PR, were
considered statistically significant.
Results Of the 444 teenage girls, the mean age was 17 (standard deviation = 1.9) years. About one third of the
participants, 132(29.7%) had ever conceived. Teenage girls in cohabitation were 3.0 times more likely to have
conceived (aPR = 3.0, 95% CI: 2.23–4.10, P < 0.001) compared to those staying with their parents. Teenagers with both
parents deceased were 1.9 times more likely to conceive (aPR = 1.9, 95% CI: 1.15–3.31, P = 0.032) compared to those
whose parents were both alive. Teenage girls who were not satisfied with basic needs provided by parents were 3.3
times more likely to conceive (aPR = 3.3, 95% CI: 2.26–4.85, P < 0.001) compared to those satisfied with the basic needs
provided by their parents.
Conclusion Teenage pregnancy rates in Atutur sub-county Kumi district was higher than the national average, due
to adverse socio-economic situation. Strengthening parental support of the girl child, with legal and community
measures to reduce early marriages in rural settings may reduce teenage pregnancy. There is need to make deliberate
efforts to provide socio-economic strengthening for the teenage girls to reduce their vulnerability.
Keywords Teenage pregnancy, Prevalence, Cross-sectional, Early marriage
Severe malaria burden, clinical spectrum and outcomes at Apac district hospital, Uganda: a retrospective study of routine health facility based data
(Malaria Journal, 2023-10-25) Emmanuel Ocen; Ronald Opito; Crispus Tegu; Alex Oula; Peter Olupot‑Olupot
Background Most data describing severe malaria (SM) in sub‑Saharan Africa (SSA) are from research settings out
side disease endemic areas. Using routinely collected data from Apac District Hospital, this study aimed at determin
ing the burden and clinical spectrum of severe malaria.
Methods This was a retrospective study that reviewed all paediatric admission records for malaria in the 24 months
period from Jan 2019 to Dec 2020 at Apac District Hospital. Data on children aged 60 days to 12 years who at admis
sion tested positive for malaria and fulfilled the World Health Organization clinical criteria for surveillance of severe
malaria were abstracted using a customized proforma designed to capture variables on social demographic, clinical
presentation, treatment, and outcomes. In addition, the tool included laboratory variables for complete blood counts,
haemoglobin, and glucose levels. Data were analysed using STATA V15.0. The study had ethical approval from Mbale
Regional Referral Hospital REC, Approval No. MRRH‑REC 053/2019.
Results A total of 5631 admission records were retrieved for this study period. Of these, 3649 (64.8%) were malaria
admissions and 3422/3649 were children below 12years, with only 1864 (54.5%) of children having complete data.
Of the 1864 children, 745 (40.0%) fulfilled the severe malaria inclusion criteria. Of the 745 children, 51.4% (n = 381)
were males. The median age at admission was 31 months (IQR = 17–60). The most common clinical presentations
among children with severe malaria were fever 722 (97.3%), cough 478 (64.2%), and difficulty in breathing 122 (17.9%).
The median length of hospital stay was 2 (IQR; 2–4) days and 133 (17.9%) had prolonged hospital stay (> 4 days).
Factors independently associated with prolonged hospital stay were, presenting with difficulty in breathing, aOR 1.83
(95% CI 1.02–3.27, P = 0.042) and prostration aOR 8.47 (95% CI 1.94–36.99, P = 0.004). A majority of admitted children,
735 (98.7%) survived, while 10 (1.3%) died of SM.
Conclusion A high proportion (40.0%) of malaria admissions were due to SM. Prolonged Hospital stay was associ
ated with prostration and difficulty in breathing. Overall mortality was low, 1.3% compared to mortality in the previ
ously reported series. This study was able to use routinely collected data to describe the burden and clinical spectrum
of SM. Improvement in the quality of data from such settings would improve disease descriptions for policy, monitor
ing of epidemics, response to interventions and to inform research.