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Associated factors with nutrient intake and nutritional status of HIV positive breastfeeding mothers in apac district: a cross-sectional study
(Nature, 2026) Atim, Sharon Victoria; Opio, Bosco; Omoko, Jasper; Aloka, Bonny
Undernutrition among HIV/AIDS patients impedes the achievement of sustainable development goals by placing additional strain on healthcare systems. HIV causes nutrient loss and malabsorption, increasing nutritional requirements, particularly in lactating women. HIV-infected breastfeeding mothers are at greater nutritional risk than their non-HIV counterparts. Although global studies have addressed maternal undernutrition, few in Uganda have focused on factors affecting nutrient intake and nutritional status among HIV-positive breastfeeding women. This study aimed to explore these factors in Apac District. A cross-sectional study involving 220 HIV-positive breastfeeding mothers was conducted. A pre-tested 24-hour recall questionnaire, using the dietary diversity score for women (DDS-W), was used to collect data. Nutritional status was assessed using body mass index (BMI), while nutrient intake was determined by entering actual intakes into an Excel sheet to calculate total nutrient intake per individual, from which mean nutrient intake and mean adequacy ratio (MAR) were calculated. Data were analysed using Stata version 15 at univariate, bivariate, and multivariate levels. The level of significance was set at 5%, with a 95% confidence interval; the null hypothesis was rejected when p-values were less than 0.05. A total of 10.6% of participants were undernourished, with a dietary diversity score of 4.3 food groups, while 21% had a poor dietary diversity score. Participants met 61% of their recommended micronutrient intake, with energy, lipid, zinc, calcium, and vitamins A, C, B6, and B12 intakes below recommendations. Factors associated with nutritional status included maternal age [AOR = 1.94, 95% CI (1.05–3.59)], presence of a market [AOR = 0.42, 95% CI (0.223–0.784)], means of obtaining food [AOR = 0.55, 95% CI (0.234–0.94)], and presence of cultural food taboos [AOR = 0.44, 95% CI (0.136–0.998)]. Factors associated with nutrient intake were presence of a market [p = 0.018, 95% CI (0.010–0.104)], income [p = 0.010, 95% CI (0.007–0.048)], DDS [p < 0.001, 95% CI (0.022–0.058)], and household head [p = 0.049, 95% CI (–0.095–0.001)]. There is a prevalence of undernutrition among HIV-positive breastfeeding mothers in Apac District, accompanied by poor dietary diversity scores and low micronutrient intake. Interventions to increase dietary diversity scores, provide nutrition education, and improve income should be promoted.
Organoleptic drivers of caregiver-reported acceptability of locally formulated nutrientdense products formulated from local ingredients for nutritional intervention in nodding syndrome in northern Uganda
(BMC, 2026) Aloka, Bonny; Ongeng, Duncan; Amito, Freda Oceng; Omech, Bernard; Olum, Solomon
Background Nutritional approaches based on local food resources offer a potential intervention to address nodding syndrome (NS), a chronic neurological condition associated with undernutrition and micronutrient deficiency, with a 4.5% prevalence among children and adolescents in northern Uganda. Most interventions have been medical in nature, but diet influences the onset of such neurological diseases and their associated consequences. This study evaluated the organoleptic drivers of caregiver-reported acceptability of locally formulated nutrient-dense products formulated from local ingredients for nutritional intervention in nodding syndrome in northern Uganda as a potential nutritional intervention. Methods The products were developed from two main energy sources: maize and sorghum, and included orange-fleshed sweet potato (OFSP), silver fish, soybean, iron-rich beans, and chia seeds. A total of 47 untrained panelists, who were caregivers of NS cases, evaluated different organoleptic properties of porridges from the two energy sources using a 5-point Hedonic scale to determine the level of preference for different formulations. Results Overall acceptability increased with an increase in the proportion of cereals in the composite formulae. The formulation with 70% cereal scored highest, with products from the sorghum-based formula being preferred to those from the maize-based formula. Several food attributes and socio-demographic characteristics significantly influenced the acceptability of the products (p < 0.05). For the maize-based formula, taste, thickness, and education level had a positive influence, whereas texture, age, and the number of children under two years had a negative influence on overall acceptability. For the sorghum-based formula, taste, texture, and age all had a positive influence on overall acceptability. Conclusions The results demonstrate that composite formulae with 70% cereals are highly acceptable and can be scaled up for consumption by NS having used the caregivers’ acceptability as a proxy for NS patients. The study provides recommendations for the effective delivery of selected formulae in the study context.
Evaluation of the nutritional quality of food composites developed from local ingredients to target the needs of persons experiencing nodding syndrome in Northern Uganda
(Scientific reports, 2025) Aloka, Bonny; Olum, Solomon; Ongeng, Duncan
Undernutrition is widespread in developing countries and exacerbated by conditions such as nodding syndrome, with a prevalence of 4.5% in northern Uganda. To combat this problem, nutrient-rich formulae were developed using locally sourced ingredients. Preferred formulae were analysed for nutritional, physico-chemical, antinutritional, and functional properties using standard methods. The composites were developed from two main energy lines (maize and sorghum), with ingredients at ratios of 70:2:15:5:3:5 for maize/sorghum: silver fish: soybean: orange-fleshed sweet potato (OFSP): beans: chia seeds, respectively. Compared with the sorghum-based formula, maize-based formula had significantly higher amounts of selenium, potassium, and vitamins A and D; the bioavailability of iron and zinc; and in vitro protein digestibility. Unlike the sorghum-based formula, the maize-based formula also had lower levels of antinutritional factors and a better fatty acid profile (p < 0.05). The sorghum-based formula had significantly higher levels of ash, crude protein, magnesium, calcium, and vitamin B6 and a higher oil absorption capacity and bulk density. Whereas maize-based formula is good in levels of selenium, vitamins A and D, bioavailability of zinc and iron, protein digestibility and antinutritional factors, the sorghum-based formula is better in terms of crude protein, ash, oil absorption capacity and bulk density. Therefore, the choice of each formula should depend on the benefits targeted.
Multilevel factors associated with virological suppression among adolescents and young people with prior non-suppression receiving intensive adherence counselling in East-Central Uganda
(AIDS Research and Therapy, 2026) Ejalu, David Livingstone; Namutundu, Juliana; Puleh, Sean Steven; Acen, Joy; Nankinga, Ziadah; Akech, Stella Immaculate; Nangendo, Joanita; Bakeera-Kitaka, Sabrina; Katamba, Achilles; Katahoire, Anne R.; Kalyango, Joan; Cattamanchi, Adithya.; Semitala, Fred C.; Kamya, Moses R.
Background: Adolescents and young people living with HIV continue to experience disproportionately high rates of virological non-suppression despite scale-up of enhanced adherence interventions such as Intensive Adherence Counselling (IAC). While prior research has quantified post-IAC suppression outcomes, there remains limited empirical evidence regarding the multilevel factors that shape virological response in this population. This study investigated multilevel factors associated with viral load suppression among adolescents and young people (AYP) with prior non-suppression who were enrolled in IAC in East-Central Uganda. Methods: A facility-based analytical cross-sectional study was conducted using routinely collected programmatic data from 580 AYP aged 10-24 years with documented unsuppressed viral load who were enrolled in IAC across 32 health facilities. Eligible participants had a repeat viral load measurement following completion of the adherence intervention. Multivariable analysis was performed using modified Poisson regression with robust variance estimation to determine factors independently associated with virological suppression, accounting for clustering at the facility level. Adjusted prevalence ratios (aPRs) with corresponding 95% confidence intervals were reported. Results: The study population had a median age of 16.4 years (interquartile range [IQR]: 12.9-21.2), with females comprising 62.8% of participants. Overall, over half of the cohort achieved virological suppression following the intervention. Engagement in peer-led support was associated with a higher likelihood of suppression (aPR=1.71, 95% CI: 1.36-2.15), as was prior disclosure of HIV status (aPR=1.43, 95% CI: 1.02-2.11). Conversely, participants enrolled in differentiated antiretroviral therapy (ART) delivery models based on community drug distribution prior to IAC had lower suppression compared to those managed through facility-based individualized care (aPR=0.51, 95% CI: 0.35-0.74). Conclusion: Virological outcomes among AYP receiving enhanced adherence support are shaped by a combination of individual and service delivery factors. Interventions that strengthen peer engagement and facilitate safe disclosure, alongside careful alignment of differentiated service delivery models with adherence needs, may improve treatment outcomes in this high-risk population.
Degrees Are Not Enough: An Analysis of Why Today’s Graduates Must Compete Beyond the Classroom in Uganda
(East African Journal of Education Studies, 2026) Angela Geoffrey; Muwees Charles; Ibore Christine Margaret Okurut
This article analyses why university degrees in Uganda no longer ensure employment and examines how skills, work-based learning and the labourmarket context influence graduate outcomes. The manuscript synthesises empirical and conceptual studies on Ugandan education, employability and school-to-work transitions. Methods include analysing evidence from tracer studies, cross-sectional surveys, case studies and qualitative inquiries involving students, graduates, employers and educators. The analysis highlights skills mismatches, the quality of internships and industrial training, readiness for the Fourth Industrial Revolution (FIR), and structural constraints in the labour market. Findings reveal ongoing gaps between academic knowledge and the skills employers require, especially in practical, digital and soft skills. Workbased learning opportunities tend to be brief, poorly aligned with programmes, and lack adequate mentorship, which limits their effectiveness in enhancing employability. Meanwhile, university curricula only partially address emerging technological demands, leaving many graduates underprepared for technologydriven workplaces. These individual and institutional issues are worsened by high youth unemployment and underemployment and reliance on informal hiring networks, which weaken the signalling value of degrees and increase dependence on social capital and entrepreneurial skills. In conclusion, the synthesis demonstrates that degrees alone are insufficient to secure good jobs in Uganda, as employability now relies on a broader range of skills, experiences, and networks. Recommendations include improving curriculum– industry alignment, adopting structured and mentored work-based learning, embedding digital and Fourth Industrial Revolution competencies across programmes, and expanding career guidance and entrepreneurship support. Universities and policymakers should also work with employers to establish shared standards for graduate attributes and create more transparent recruitment pathways. Future research should explore longitudinal studies of graduate career paths, assess specific employability interventions such as revamped internship models or skills boot camps, and investigate how gender, socioeconomic background, and regional factors influence access to opportunities beyond formal education.