Blood culture (BC) processes are critical to the utility of diagnostic testing, bloodstream infection (BSI) management, and antimicrobial resistance (AMR) surveillance. While Uganda has established BC guidelines, often laboratory practice does not meet the desired standards. This compromises pathogen recovery, reliability of antimicrobial susceptibility testing, and diagnostic test utility. This study assessed laboratory BC process outcomes among non-malarial febrile children below five years of age at five AMR surveillance sites in Uganda between 2017 and 2018. Secondary BC testing data was reviewed against established standards. Overall, 959 BC specimens were processed. Of these, 91% were from female patients, neonates, infants, and young children (1–48 months). A total of 37 AMR priority pathogens were identified; Staphylococcus aureus was predominant (54%), followed by Escherichia coli (19%). The diagnostic yield was low (4.9%). Only 6.3% of isolates were identified. AST was performed on 70% (18/26) of identified AMR priority isolates, and only 40% of these tests adhered to recommended standards. Interventions are needed to improve laboratory BC practices for effective patient management through targeted antimicrobial therapy and AMR surveillance in Uganda. Further research on process documentation, diagnostic yield, and a review of patient outcomes for all hospitalized febrile patients is needed.

Sepsis caused by drug-resistant pathogens remains a major contributor to under-five mortality in low- and middle-income countries, threatening progress toward Sustainable Development Goal (SDG) 3.2. Blood culture, the gold standard for sepsis diagnosis and antimicrobial stewardship, remains underutilised in routine pediatric care. This study assessed the extent and determinants of blood culture utilisation among hospitalised children under five years with suspected sepsis at four antimicrobial resistance (AMR) surveillance sites in Uganda. We conducted a cross-sectional mixed-methods study involving retrospective review of 384 pediatric patient records and in-depth interviews with 20 clinicians. Modified Poisson regression was used to identify factors associated with blood culture requests, while thematic analysis explored behavioral and contextual influences on diagnostic practices. Blood cultures were requested in 28.1% of suspected sepsis cases. Higher utilisation was independently associated with markers of clinical severity, including severe acute malnutrition (adjusted prevalence ratio [aPR] 1.3, 95% CI: 1.14–1.34), sickle cell disease (aPR 1.3, 95% CI: 1.19–1.40), and presence of WHO danger signs (aPR 1.1, 95% CI: 1.00–1.14). Senior clinician involvement (aPR 1.2, 95% CI: 1.08–1.32) and consultant review (aPR 1.4, 95% CI: 1.21–1.48) were also associated with higher use, while prior antibiotic exposure reduced the likelihood of blood culture request (aPR 0.9, 95% CI: 0.84–0.96). Qualitative findings identified four overarching themes influencing diagnostic behavior: motivation amid systemic constraints, institutional and environmental barriers, mentorship and teamwork, and emotional fatigue in the context of adaptive practices. Despite high clinician awareness, blood culture utilisation remains low, driven primarily by health system fragility, inefficient workflows, and emotional exhaustion rather than knowledge gaps. Improving utilisation will require integrated behavioral, workflow, and structural interventions, including clinical decision support and strengthened microbiology laboratory capacity, to enhance pediatric sepsis care, antimicrobial stewardship, and progress toward SDG 3.2.

While Uganda has achieved relatively high COVID-19 first dose vaccination rates, completion of the second dose remains low, particularly in Masindi district where only 44.0% of adults who were vaccinated with the first dose proceeded to receive the second dose. This shortfall threatens to undermine the achievement of herd immunity and the effectiveness of the nation’s COVID-19 vaccination campaign. This study aimed to determine the rate of second dose vaccine uptake and assess factors associated with second dose uptake among adults in Masindi district. We conducted a community-based cross-sectional study using multi-stage random sampling approach to select 637 study respondents. Data were collected using a pre-tested interviewer-administered structured questionnaire and analyzed using SPSS v26. Modified Poisson regression was used to identify independent predictors of second dose uptake. Results were reported using adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs), with statistical significance set at p<0.05. Among adults who had received at least one dose of a COVID-19 vaccine, 44.0% had completed the two-dose vaccination schedule. Independent factors significantly associated with higher second dose uptake included high economic status (APR = 2.2, 95% CI: 1.16-3.07), urban residence (APR = 1.3, 95% CI: 1.13-1.62), high perceived risk of COVID-19 (APR = 2.0, 95% CI: 1.59-2.55), chronic illness (APR 1.9; 95% CI: 1.60-2.33), living less than 1 km from a vaccination site (APR = 2.0, 95% CI: 1.49-3.01), Shorter waiting times; under 30 minutes (APR = 1.7, 95% CI: 1.41-2.08), community/religious leaders’ support (APR = 1.7, 95% CI: 1.41-2.16), Community outreach programs (APR = 2.5, 95% CI: 1.99-3.36), and Exposure to vaccination information through radio or TV (APR = 1.5, 95% CI: 1.25–1.88). Vaccine shortages (APR = 0.4, 95% CI: 0.31-0.55), and experiencing of adverse side effects after the first dose (APR = 0.8, 95% CI: 0.71-0.97) were associated with reduced prevalence of receiving a second dose. The findings suggest that COVID-19 vaccine second dose uptake in Masindi district remains low and is associated with interconnected socioeconomic, individual, health system, and community-level factors. Interventions should consider improving access, risk communication, and engagement of community structures are needed to boost vaccine completion rates.

Diabetes mellitus is an increasing public health challenge in Uganda and other low- and middle-income countries, where health systems face growing demands for chronic disease care. Although quantitative studies have documented poor glycemic control and health system constraints, less is known about how patients and healthcare providers experience diabetes management in peri-urban public health settings. This study explored barriers and facilitators to diabetes management among adults with diabetes mellitus and healthcare providers at a peri-urban health facility in Uganda. We conducted a qualitative descriptive study at Kasangati Health Centre IV, Wakiso District, Uganda, between February and March 2025. Data were collected through 15 in-depth interviews with adults living with diabetes mellitus and 8 key informant interviews with healthcare providers involved in diabetes care. Participants were purposively selected based on their experience with diabetes management and service delivery. Interviews were audio-recorded, transcribed verbatim, translated where necessary, and analyzed using a hybrid inductive–deductive thematic approach informed by the Theoretical Domains Framework. Five interrelated themes were identified: (1) institutional and environmental factors influencing access to diabetes care; (2) cognitive and informational factors influencing medication adherence; (3) social influences on diabetes management; (4) emotional experiences of patients and healthcare providers; and (5) self-management strategies and continuity of care. Across these themes, participants identified barriers including resource limitations, communication challenges, medication management difficulties, stigma, emotional distress, and weak follow-up systems. Facilitators included peer support, religious and community networks, health education, provider flexibility, and patient-developed adherence strategies. Diabetes management was influenced by interacting health-system, social, informational, and behavioural factors. Resource constraints, limited health literacy, stigma, and weak follow-up systems hindered effective management, while social support, health education, and patient self-management strategies facilitated continued engagement in care. Interventions that strengthen chronic care services, patient education, and community support may improve diabetes outcomes in similar resource-constrained settings.

Adolescent pregnancy is a global public health problem with serious social and medical implications relating to maternal and child health. In Uganda, particularly Hoima district, limited information about the factors influencing adolescent pregnancy is available. The study estimated the prevalence of adolescent pregnancy and identified factors independently associated with adolescent pregnancy among girls aged 13-19 years in Hoima district. We conducted a community-based cross-sectional study among 543 adolescent girls randomly selected using multistage sampling. Data were collected using a structured, interviewer-administered questionnaire. Bivariate logistic regression was used to assess associations between independent variables and adolescent pregnancy. Variables with p < 0.20 at bivariate analysis were included in a multivariable logistic regression model to identify factors independently associated with adolescent pregnancy. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, and statistical significance was set at p < 0.05. Findings revealed 29.1% prevalence of adolescent pregnancy. Age (18-19 years) AOR 4.4 (95%CI 1.5-12.8), low parents' economic status AOR 5.4 (95%CI 2.5-11.8), multiple sexual partners AOR 8.0 (95%CI 4.5-14.2), being out of school AOR 12.0 (95%CI 5.0-29.1), early marriage AOR 37.0 (95%CI 13.4-107.5), having no control over sex AOR 7.4 (95%CI 3.7-16.4), not discussing SRH with parents AOR 8.4 (95%CI 3.3-21.5), witnessed domestic violence AOR 30.0 (95%CI 12.0-77.5), never received counselling AOR 5.7 (95%CI 3.6-9.0), and, rural residence AOR 1.8 (95%CI 1.2-2.9) were significant predictors of adolescent pregnancy. These findings suggest that adolescent pregnancy in Hoima district remains high and is associated with interconnected individual, family, health system, and community-level factors. Interventions should prioritize keeping girls in school, strengthening adolescent-friendly and non-judgmental health services, addressing household poverty, preventing early marriage, and promoting supportive family and community environments to reduce adolescent pregnancy in rural Ugandan settings.

Background: Teenage pregnancy is a global public health problem with serious social and medical implications relating to maternal and child health. In Uganda, particularly Hoima district, limited information about the factors influencing teenage pregnancy is available. This study estimated the prevalence of teenage pregnancy and associated factors among teenage girls aged 13-19 years to guide design the interventions to mitigate this problem. Methods: This was a community-based cross-sectional study that utilized multi-stage random sampling approach to select 543 study respondents. Data were collected using a pre-tested interviewer-administered structured questionnaire and analyzed using SPSS V26. Multivariable logistic regression analysis was conducted to determine independent predictors of teenage pregnancy among girls 13-19 years. Results: The prevalence of teenage pregnancy was 29%. Age (18-19 years) (AOR 4.4, 95%CI 1.52–12.78), low parents’ economic status (AOR 5.4, 95%CI 2.47–11.78), multiple sexual partners (AOR 8.0, 95%CI 4.51–14.18), being out of school (AOR 12, 95%CI 5.02–29.06), early marriage (AOR 37, 95%CI 13.35–107.54), having no control over sex (AOR 47, 95%CI 13.7-163.8), not discussing SRH with parents (AOR 8.4, 95%CI 3.31–21.51), witnessed domestic violence (AOR 30, 95%CI 11.97–77.53), never received counselling (AOR 5.7, 95%CI 3.56–9.01), and, rural residence (AOR 1.8, 95%CI 1.15–2.94) were significant predictors of teenage pregnancy. Conclusion: Teenage pregnancy is highly prevalent suggesting that teenage pregnancy is still a public health and social problem in Hoima district, Uganda. It is imperative for the Ministry of Health (MOH) and implementing partners to scale up and expand teenage friendly health services, consolidate efforts towards keeping girls in school, strengthen the policy of delaying early/child marriage, improve on the economic welfare of households through job creation and skill the youth for self-employment.