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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
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v e c o m m o n s . o r g / l i c e n s e s / b y - n c - n d / 4 . 0 /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 marriageThere was no funding for this stud
Factors associated with uptake and acceptability of cervical cancer screening among female sex workers in Northeastern Uganda: A cross-sectional study
No full textAcknowledgments
The authors acknowledge the contribution of Professor JR Odong Ikoja, the Soroti Univer
sity Vice Chancellor who acquired the funds for the research activities and Professor Francis
Ejobi, the Soroti University Director of Research and Innovation for his administrative sup
port and oversight on the management of this research projectBackground
Cervical cancer screening program in Uganda is opportunistic and focuses mainly on women
aged 25–49 years. Female sex workers (FSWs) are at increased risk of developing invasive
cervical cancer. There is limited data regarding the uptake and acceptability of cervical cancer
screening among FSWs in Uganda. This study aimed at identifying factors associated with
uptake and acceptability of cervical cancer screening among FSWs in Eastern Uganda.
Methods
This was a cross-sectional study conducted among 423 FSWs aged 18–49 years attending
care at six health facilities serving Key Populations (FSWs, Men who have sex with men,
transgender people, people who inject drugs and people in prisons) in the Teso sub-region.
Data was collected using structured investigator administered questionnaire and analyzed
using Stata statistical software version 15.0 (Stata Corp, Texas, USA). The primary outcome
was uptake of cervical cancer screening measured as the proportion of female sex workers
who have ever been screened for cervical cancer. Chi-square test was used to compare the
differences in uptake of cervical cancer screening by HIV status. Modified Poisson regres
sion model with a robust variance estimator was used to determine association between
the outcome variables and selected independent variables including demographic charac
teristics. Prevalence ratios (PR) with accompanying 95% confidence intervals have been
reported. Statistical significance was considered at two-sided p-values ≤ 0.05.
Results
The mean age of the participants was 28.1 (±SD = 6.6) years. The self-reported HIV
prevalence was 21.5% (n = 91). There were 138 (32.6%) participants who had ever been
screened for cervical cancer (uptake), while 397 (93.9%) were willing to be screened
(acceptability). There was a significant difference in cervical cancer screening uptake
between women living with HIV (WLHIV) and those who were HIV negative, 59.3% vs
26.9% respectively (P < 0.001). The significant factors associated with uptake of cervical
cancer screening included living with HIV, adjusted prevalence ratio (aPR) = 1.53 (95%CI:
1.15–2.07), increasing number of biological children, aPR = 1.14 (1.06–1.24) living near
a private not for profit (PNFP) facility, aPR = 2.84 (95% CI; 1.68–4.80) and availability of
screening services at the nearest health facility, aPR = 1.83 (95% CI, 1.30–2.57). Factors
significantly associated with acceptability of cervical cancer screening included being 40
years or older, aPR = 1.22 (95%CI: 1.01–1.47), having a family history of cervical cancer,
aPR = 1.05 (1.01–1.10), and living near a PNFP facility, aPR = 1.17 (95% CI, 1.09–1.27)
and having ever screened before, aPR = 0.92 (0.86–0.98).
Conclusion
Female sex workers living with HIV are more likely to screen for cervical cancer than the
HIV negative clients. Cervical cancer screening uptake is relatively low among the female
sex workers. However, majority of the FSWs are willing to be screened for cervical cancer
if the services are provided in the nearby healthcare facilities. There is need to make cer
vical cancer screening services available to all eligible women especially the female sex
workers and integrate the services with sexual reproductive health services in general and
not just HIV/ART clinics servicesGovernment of Uganda. Soroti University Research and Innovation Funds (SUNRIF
Factors associated with modern contraceptive use among sexually active youths attending secondary schools in Mbale City, Uganda
No full textData availability statement: All relevant
data are within the paper and its Supporting
information files.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.The authors received no specific funding for this work
Prostate Cancer Among Patients Presenting with Obstructive Lower Urinary Tract Symptoms at a Tertiary Hospital in South Western Uganda
No full textSpecial appreciation to Dr Kirya Musa and Dr Otim Paul of Soroti University Department of Surgery for their insightful
inputs during writing of this articleBackground: Prostate cancer is currently the second commonest male cancer both globally and in Uganda. Men are often tested after presenting with obstructive lower urinary tract symptoms (LUTS). We evaluated total prostate-specific antigen patterns (tPSA), digital rectal examination (DRE) findings, histological findings and prostate cancer rates among patients presenting to Mbarara regional referral hospital with obstructive LUTS.
Methods: This was a cross-sectional study of 140 patients aged ≥50 with obstructive LUTS. Data on demographics and severity of LUTS was collected, plus the results of tPSA testing and DRE. Later, digitally guided transrectal tru-cut prostate biopsy was performed, if necessary. Analysis was done using SPSS (Statistical Package for Social Scientists), version 14. Confidence interval (CI) was set at 95% and P at 0.005.
Results: The majority of patients had severe LUTS (n=103, 73.57%), with a median tPSA of 14.4 ng/mL. Ninety-nine patients experienced digitally guided transrectal tru-cut prostate biopsy (70.71%; Fisher’s exact test = 0.001). DRE abnormalities were found in 57.14% (n=80) of participants and these carried a higher risk for prostate cancer diagnosis (risk ratio = 5.895; Fisher’s exact test = 0.04; CI 95%: 1.59–21.822). The tru-cut biopsy positivity rate was high, at 46% (45/99; 95% CI: 30.1–46.3); all had prostate adenocarcinoma and the majority (77.78%, n=35) had a total Gleason score of 8 and above. Of those who had a malignancy, more than a quarter were between 60–80 years of age (37.8%, n = 17). There was no statistically significant relationship between LUTs and prostate cancer diagnosis (Fisher’s exact test 2-sided = 0.84).
Conclusion: Although severity of LUTS was not predictive of cancer, there was a high rate of advanced prostate cancer among study participants. DRE remains a valuable tool for identifying potential prostate cancer cases, especially in settings where PSA testing may be limited. Further research is needed to explore effective screening strategies and improve outcomes for men with prostate cancer in Uganda.The original place of publication is Research and Reports in Urology and Dovepress
Effect of corticosteroids on haemoglobinuria resolution among children with blackwater fever at Soroti regional referral hospital, Uganda: a retrospective cohort study
No full textThe authors would like to acknowledge the support rendered by Soroti
Regional Referral Hospital Senior Executive Consultant, Dr.Watmon Benedict
during the process of administrative clearance and data collection. In addition,
we would like to acknowledge Dr.Samuel Kabwigu, the Dean School of Health
Sciences- Soroti University for granting the funds for ethical clearance and
data collection for this research project.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.This study was funded by Soroti University, awarded to Dr.Opito Ronald
A Case Series
No full textAll the patients provided informed written consent for publication of this manuscript.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, acidosiThis study was supported by funding from Government of Uganda, through the Soroti University Research and
Innovation Fund (SUN-RIF/2022/21), which provided financial resources for data collection, analysis, and manuscript
preparation. The funding did not have any influence on the conduct of the study and the views and opinions reflected here
do not in any way reflect the opinion of the funder
Artificial intelligence in higher education institutions: review of innovations, opportunities and challenges
No full textNAArtificial intelligence is revolutionizing industries including institutions of higher
learning as it enhances teaching and learning processes, streamline administrative
tasks and drive innovations. Despite the unprecedented opportunities, AI tools if
not used correctly, can be challenging in education institutions. The purpose of
this study was to comprehensively review the AI innovations, opportunities and
challenges associated with the use of AI in higher Education of learning. A systematic
literature review methodology was adopted and used to locate and select existing
studies, analyze and synthesize the evidence to arrive at clear conclusion about
the current debate in the area of study. Following the PRISMA, the study analyzed
a total of 54 documents that met the inclusion and exclusion criteria set for
selection of the documents. The review unveiled many opportunities including
enhanced research capabilities, automation of administrative tasks among others.
Artificial Intelligence tools are found to refine and streamline the administrative
tasks in different units in higher institutions of learning. The challenges include
ethical concerns, integrity issues and data fabrication issues. With the challenges
notwithstanding, the benefits of Artificial Intelligence cannot be over emphasized.
Artificial intelligence remains a powerful tool for research, automation of administrative
tasked, personalized learning, inclusivity and accessibility of educational content
for all. Emphasis should be put in regulatory frameworks detailing how such tools
can be used while maintaining the level of ethical standards required.
KEYWORDS
artificial, intelligence, innovations, opportunities, challenges, literatureN
Applying Learning Theories to Clinical Teaching in Contemporary Settings: A Conceptual Analysis
No full textCopyright © 2025 The Author(s): This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International
License (CC BY-NC 4.0) which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original
author and source are credited.Abstract: Background: Learning theories play a crucial role in shaping clinical instructional strategies, materials, and
activities. By applying these theories, clinical teachers can create engaging, interactive, and student-centred learning
experiences. However, some theories are complex and require time and adequate training to fully understand and
implement. This study presents a theoretical concept analysis aimed at identifying clear and readily applicable concepts
from well-known learning theories to enhance clinical teaching and learning in contemporary settings. Methods: A search
for published articles on well-known learning theories was conducted. Articles were retrieved from Google Scholar and
PubMed using search terms such as 'learning theories,' 'learning theories and clinical teaching,' 'applying learning theories
to clinical teaching,' and 'learning theories in clinical instruction.' The principal investigator screened articles at the title,
abstract, and full-text levels. Selected articles were thoroughly reviewed to identify relevant learning theories, from which
key concepts underpinning clinical teaching and learning in contemporary settings were extracted and described. Results:
We retrieved 625 articles, removed 38 duplicates, and screened the remaining articles at the title, abstract, and full-text
levels. Ultimately, 23 articles were included in the study. The documented learning theories included behaviorism, social
learning, constructivism, social constructivism, discovery learning, meaningful learning, experiential learning, humanistic
theory, self-determination theory, and expectancy-value theory. Conclusion: Guiding clinical teaching sessions with well
established learning theories can significantly enhance learning outcomes in contemporary settings. Therefore, we
recommend the intentional application of learning theories in clinical education to improve student engagement, knowledge
retention, and skill acquisition. Additionally, policymakers should integrate evidence-based learning theories into clinical
teaching guidelines and training programs to standardize and enhance the quality of education in healthcare settings.
Keywords: Learning, Theories, Clinical, Teaching, Contemporary, Concepts.N/
Educational factors influencing academic achievement in biomedical sciences among undergraduate nursing students in Uganda: analytical cross‑sectional study
No full textSupplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1007/ s44217- 025-
00601-8.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 · NursingThis study did not have external funding. The funds that were involved were internally generated by the corresponding author
Factors Associated with Cervical Cancer Screening Uptake Among Women Attending Outpatient Department in a Rural District Hospital in Uganda. A Cross-Sectional Study
No full textAll authors made a significant contribution to the work reported, whether that is in the conception, study design,
execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically
reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article
has been submitted; and agree to be accountable for all aspects of the work.Background: Sub-Saharan Africa (SSA) faces persistently low cervical cancer screening uptake, averaging only 13% over the past
f
ive years, with Uganda reporting less than 5%. This study aimed to assess the factors influencing cervical cancer screening uptake in
a rural district hospital to inform targeted interventions that enhance screening coverage for the rural community.
Methods: This was a cross-sectional study conducted at Kaberamaido General Hospital (KGH) outpatient department. A total of 422
participants aged between 25 and 49 years were interviewed and data analyzed using STATA version 16.0. Bivariate and multivariate
analyses were performed using modified Poisson regression with robust error estimates to identify key factors associated with cervical
cancer screening uptake. Variables with P-value <0.05 were considered statistically significant.
Results: The average age of participants was 32 (SD ±7) years. 77.5% (n=327) of participants were married, had primary level of
education, 69.2% (n=292), and were unemployed, 89.3% (n=377). Awareness about screening was high as 85.5% (n=360) of
respondents had heard about cervical cancer screening. Cervical cancer screening uptake was low, as only 20.4% (n=86) had been
screened in the past five years. Factors significantly associated with increased screening uptake, including age older than 35 years,
adjusted Prevalence Ratio [aPR]= 1.7 (95% CI: 1.08–2.69), availability of free government screening services, aPR = 1.6 (95% CI:
1.09–2.38), provision of screening service at the nearest health facility, aPR = 2.1 (95% CI: 1.09–3.97), and a positive family history of
cervical cancer, aPR = 1.7 (95% CI: 1.14–2.65).
Conclusion: Our study confirms that cervical cancer screening uptake in Kaberamaido District remains low, highlighting the need for
enhanced awareness campaigns and improved access to screening services. Our findings emphasize the need for policies that
strengthen community outreach programs and expand cervical cancer screening services at primary healthcare facilities.
Keywords: uterine cervical neoplasms, cervical cancer screening, women, cervical cancer awarenessThere was no funding received for this stud