http://ir.mu.ac.ke:8080/jspui/handle/123456789/68 2026-07-16T19:16:48Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10352 Editorial: Advancements in HPV research: integrating diagnostics, vaccination, and women’s health Nkwinika, Varsetile Varster; Ismail, Zeenat; Onywera, Harris; Adamu, Abdu Abdullahi; Malande, Oliver Ombeva Human papillomavirus (HPV) infection leading to cervical cancer remains one of the most urgent public health challenges worldwide. In 2022 alone, there were an estimated 662,301 new cervical cancer cases and 348,874 deaths globally, with the burden heavily affecting low- and middle-income countries (LMICs) where access to prevention, screening, and treatment remains limited (1, 2). Persistent infection with high-risk HPV genotypes, especially types 16 and 18, underpins nearly all cases of cervical cancer, causing over 300,000 deaths each year (3). Despite significant scientific advances in HPV diagnostics and vaccine development over the past two decades, translating these innovations into equitable healthcare practices remains a major global challenge (4). A clearer understanding of how best to deliver evidence-based interventions in real-world settings is crucial to bridging the gap between research and actual health outcomes, especially in low-resource settings where vaccination uptake, screening coverage, sociocultural barriers, and health system limitations continue to pose challenges. 2026-01-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10349 Clinical spectrum and management outcomes of acute febrile illness Among children attending health facilities in northwestern Tanzania, 2020–2021 Kayange, Neema M.; Malande, Oliver Ombeva; Gehring, Stephan; Scialabba, Silvia; Groendahl, Britta; Koliopoulos, Philip; Mshana, Stephen E. Background: The diagnostic challenges of febrile illness in children in low- resource settings and the risks of empirical overtreatment. We evaluated the range of clinical presentations and management outcomes in a cohort of children with acute febrile illness, building on our previous examination of the etiology of these illnesses. Methods: This prospective cohort study enrolled children aged 1 to ≤12 years who were cared for by attending clinicians across primary, secondary, and tertiary healthcare settings. Management decisions were based on clinical presentation and laboratory and radiographic findings available on the day of enrollment. Outcomes were measured on days 7, 14, and 28. The study also analyzed prescription patterns for antibiotics and antimalarials in relation to established guidelines. Results: In this cohort of 434 children with acute febrile illness, the most common initial diagnoses were acute respiratory infections (31.3%, 136/434), of which upper respiratory tract infection (URTI) was observed in 57.0% (77/ 136) and pneumonia in 43.0% (59/136), followed by malaria (23.7%, 103/434). Antibacterial agents were prescribed to 65.3% (284/434) of children. Antibiotic overprescription was observed in 29.6% (84/285) of study participants. Antimalarial drugs were prescribed to 38.9% (169/434) of patients, including 103 patients judged to have malaria by a positive MRDT or a positive blood smear. A total of 66 (39.0%) patients who received antimalarial drugs were negative for either MRDT or blood smear. Fever resolved in 398 children (96.0%, 386/402) by day 28 of follow-up. The most commonly documented complications among admitted children included anemia (36.0%), dehydration (9.1%), shock (8.5%), and acute kidney injury (8.5%). Overall mortality at day 28 was 1.0% (4/434). Conclusion: In environments with limited diagnostic resources, children with acute febrile illness are often treated empirically. This results in significant over prescription of antibiotics and antimalarials. While short-term results are usually positive, such practices raise concerns about antimicrobial resistance and adherence to guidelines. Better access to point-of-care diagnostics can help decrease inappropriate prescriptions and improve care quality. 2026-03-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10347 Exploring the drivers of low DPT3 vaccination coverage and the implications in rural, urban and peri-urban Uganda: a cross- sectional study of Hoima and Wakiso districts of Uganda Malande, Oliver Ombeva; Munube, Deogratias; Muhindo, Richard; Kigen, Barnabas; Songok, Julia Jerono; Kamulegeya, John; Meyer, Johanna Catharina; Adamu, Victor Eneojo; Godman, Brian Background In a recent observational study, we reported findings on barriers to effective immunization in rural Hoima District, western Uganda, where it emerged that rural contexts may not have same determinants as peri-urban or urban contexts driving underimmunization. In a continuation of that work to incorporate peri-urban and urban barriers to immunization, this study reports a follow up on the recommendations of our earlier publication, through a case study of (peri) urban Wakiso district, and incorporates and compares the findings from both districts to propose unified recommendations to address low immunization coverage (under 90%) in Uganda. The aim was therefore to determine and describe the barriers to the uptake and utilization of immunization services in Hoima and Wakiso districts of Uganda and propose interventions, strategies and approaches that can help address the problem of vaccine hesitancy and underimmunization in Uganda. Methods This was a mixed methods study, that utilized interviews with child caregivers, for the quantitative design and focus group discussions (FGDs) with caregivers of children eligible for vaccination, and single in-person in-depth interviews with health workers, and immunization focal persons (KIs) for the qualitative part in both Wakiso (per- urban) and Hoima (rural) districts of Uganda. Results In this study, majority of the caregivers (369/643) were 21–25 years of age, female, married and protestants, with basic secondary education. The study found that 91% (588/643) of respondents consider vaccines safe, 85% (547/643) consider vaccines effective, 95% (611/643) have complete trust in vaccines and 13% have some misgivings regarding vaccines. Both Districts are under-immunized (Hoima 81% and Wakiso 75.3% DPT3 coverage). Factors independently associated with low DPT3 coverage include: low trust in vaccines, being a single parent caregiver, those who consider vaccines unsafe, relying on social media as source of vaccine information, those who did notreceive any education on vaccines during immunization visits, and those who have misgivings about vaccines. Additional drivers of underimmunization include access difficulties, geographical barriers, inadequate funding, cold chain inadequacies, inadequate social mobilization, vaccine stock outs, high training needs for health workers, and adverse events following immunization. Conclusions This study found that both Hoima and Wakiso districts are under-immunized given a DPT3 vaccine coverage less than 90%. The Ministry of Health needs to train Health Workers through improved mentorship, enhance outreach services, social mobilization, and build trust in communities. 2026-04-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10344 Surgical site infections after laparotomy in a tertiary Referral Hospital in Kenya: incidence and risk factors Agade, Ivy; Sherman, Suhail; Akute, Alma; Langat, Caleb; Njeri, Dennis; Chabari, Laban; Abdulhai, Sophia; Seno, Ivan Introduction: Globally, surgical site infection (SSI) remains a major nosocomial infection, contributing significantly tomorbidity and mortality. Laparotomies are known to have higher reported rates of SSI compared to other types of surgery. SSIrates are generally higher in Low‐ and Middle‐Income Countries (LMIC) than in High Income Countries (HIC) for similarsurgical procedures, though specific rates in LMICs are often unknown. Identifying population‐specific risk factors is critical forimplementing effective SSI surveillance programs aimed at reducing the infection burden.Methodology: Data was collected retrospectively from 393 general surgery patients who underwent surgery between January2022 and December 2023. The study included all patients aged 14 years and above who had an exploratory laparotomy per-formed by the general surgery team. Bivariate analysis was performed to establish associations between variables and SSIoccurrence, followed by a stepwise multivariable logistic regression. SSI was defined as per the World Health Organization(WHO) and Center for Disease Control (CDC) criteria.Findings: The overall complication rate among the 393 patients was 26.7%. The study identified 55 cases of SSI, yielding anoverall SSI rate of 14.1%. 40.4% of SSI cases were classified as superficial, 32.7% as organ space, and 25% as deep. Wound culturewas only performed in 24 patients, with Escherichia coli being the most common organism found. Multivariable logisticregression identified three independent predictors of increased SSI risk: Operative Time: Each additional hour of operative timewas associated with a 68% increase in the odds of SSI (aOR = 1.68, 95% CI 1.149–2.455, p = 0.007). Sex: Female patients had 2.6times higher odds of developing SSI compared to male patients (aOR = 2.599, 95% CI 1.251–5.399, p = 0.01). Wound Class: Dirtywounds were associated with 2.34 times higher odds of infection compared to clean wounds (aOR = 2.343, 95% CI 1.123–4.886,p = 0.023).Conclusion: The SSI rate of 14.1% at MTRH highlights the considerable burden of infection following laparotomies in thissetting. Operative duration, patient sex, and wound contamination level are critical, modifiable and unmodifiable, independentrisk factors that should be targeted for surveillance and preventative programs in western Kenya 2026-06-01T00:00:00Z