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A New Study Reveals that Children with Cerebral Palsy have 25 Times Higher Risk Of Premature Death

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The largest study on Cerebral palsy in Africa to date reveals that interventions to prevent malaria infections such as the use of insecticide-treated mosquito nets, coupled with caregiver training and support, including best feeding practices and simple measures to prevent other infections, could potentially reduce mortality in children with Cerebral palsy in this region. The study found out that the main causes of death were malaria and aneamia. The children with severe malnutrition and severe motor impairments were the most likely to die.

Cerebral palsy (CP) is a developmental disorder and the most common cause of childhood physical disability globally. CP is significantly more prevalent in low-income and middle-income countries like Uganda where the researchers noted a lower prevalence in the older (8-17 years) than younger (2-7 years) age groups as demonstrated in the findings of an earlier study conducted in 2015. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30374-1/fulltext

The decline in prevalence of children with CP with increasing age in the 2015 study, led the researchers to hypothesize about the risk of premature death in these children.

In order to get a better understanding of the situation, a follow-up study was carried out at the Iganga-Mayuge Health and Demographic Surveillance Site (IM-HDSS) in eastern Uganda. Earlier in 2015, the researchers had screened 31,756 children and identified 97 (aged 2–17 years) who were diagnosed as having CP. The children with CP were followed up to 2019 and compared with an age-matched sample of the IM-HDSS general non-CP population (n=41, 319). The rates and causes of deaths in these groups were determined.

The research team found that the rate of death was 25 times higher in the CP group than the general non-CP population sample. The mean age at death among the CP group was 10•2±5•9 years and 7•2±4•8 years among the general non-CP population sample. In the CP group, females and older children (10-18 years) had higher relative risks of death in relation to the non-CP general population. Significantly, in children with CP, there was an almost 7 times risk of death in those with severe motor impairments compared to those with milder ones. In addition, those with severe malnutrition had a more than 3 times higher risk of death than children without severe malnutrition. The causes of death were from common conditions like anemia, malaria and common infections.

The results of this study, are the first of its kind to reveal the true extent of the hidden humanitarian crisis of excessive mortality in the CP child population. Severe malnutrition as one of the risk factors of excessive mortality plays a dynamic multifaceted role, partly aggravated by severe oral motor impairments which lead to chewing and swallowing problems, and the need for special foods and prolonged feeding times. Furthermore, the age pattern for mortality in children with CP confirms this study’s hypothesis with many dying when approaching school age, compared to the non-CP general population. The probable reasons for this may be attributed to caregivers eventually losing hope as these children grow older when they realize that their child will not be cured, or alternatively as a result of the minimal time provided to the child with increasing age (including during supervised feedings), which increases their vulnerability.

The higher mortality among the females may suggest a preferential treatment of boys with CP in Uganda which needs further study. Finally, regarding the causes of death, the frequent occurrence of anemia as a cause of death may signify the interplay of the conditions of underlying malaria infections and severe malnutrition in severely impaired children with feeding problems.

A multipronged approach including raising awareness about this challenge should be emphasized locally and internationally to promote the development of appropriate health and advocacy policies. Although efforts to reduce child mortality are quite evident in the recent decades, targeted interventions to reduce mortality in the CP child population, such as the use of insecticide-treated mosquito nets to prevent malaria infections, provision of easy to use, locally available nutritious foods coupled with caregiver information and support should be encouraged. Reinforcement and regular review of the existing laws and policies related to their specific requirements should be enacted. In general, further research to identify long-term risk factors and immediate causes of death in children with developmental disabilities in the region is also urgently required

These findings are to be formally published in the journal ‘PLOS ONE’ and entitled: “Excessive premature mortality among children with cerebral palsy in rural Uganda: a longitudinal, population-based study”.

Publication

Excessive premature mortality among children with cerebral palsy in rural Uganda: A longitudinal, population-based study.

Namaganda LH, Almeida R, Kajungu D, Wabwire-Mangen F, Peterson S, Andrews C, et al
PLoS One 2020 ;15(12):e0243948

Related story by collaborators at Karolinska institute here:

https://news.ki.se/children-with-cerebral-palsy-in-rural-uganda-have-25-times-higher-risk-of-premature-death

This study was funded by the Swedish Research Council, and Promobilia.

Dr. Angelina Kakooza – Mwesige
Makerere University, College of Health Sciences
Kampala, UGANDA.
On behalf of the Researchers

Elias Tuhereze

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75th Graduation Ceremony of Makerere University:  MakCHS presents Graduands

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Graduands jubilate during the Mak75thGrad Ceremony. 75th Graduation Ceremony, Day 2, CoBAMS, CHS and CoNAS. 14th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.

The Makerere University College of Health Sciences (MakCHS), College of Natural Sciences, and College of Business and Management Sciences presented graduands for conferment of degrees on the 14th January, 2025 which was the day 2 of the 75th Graduation Ceremony of Makerere University that commenced on Monday 13th January 2025. 

MakCHS presented a total of 886 graduands including (23) Doctor of Philosophy (PhD), (456) Masters and (407) Bachelors. For the second year, MakCHS produced the researcher with the biggest number of publications, Prof. Moses Kamya and he received an award for the achievement.

PhD recipients on Day2 of the Mak75thGrad Ceremony. 75th Graduation Ceremony, Day 2, CoBAMS, CHS and CoNAS. 14th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
PhD recipients on Day2 of the Mak75thGrad Ceremony.

Speaking to the congregation, Professor Barnabas Nawangwe – Vice Chancellor, Makerere University welcomed everyone to Makerere University’s 75th Graduation. He congratulated the 13,658 graduates, including 143 PhD recipients, 53% female graduates and 47% male graduands who will be awarded degrees through the graduation week. He commended the efforts of staff, parents, and sponsors in supporting the students’ journeys. Professor Nawangwe praised the achievements of Makerere’s Colleges and Schools, he commended MakCHS for the leadership in research and innovation flying the Makerere flag globally. He noted, ‘The College of Health Sciences is our flagship college for research and community engagement. This college accounts for 50% of all research grants won and also 50% of all the publications by the University. The College celebrated 100 years last year, making it the oldest college at Makerere University’.

MakCHS Principal Assoc. Prof. Bruce Kirenga (2nd left) with MakCHS Faculty. 75th Graduation Ceremony, Day 2, CoBAMS, CHS and CoNAS. 14th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
MakCHS Principal Assoc. Prof. Bruce Kirenga (2nd left) with MakCHS Faculty.
Prof. Barnabas Nawangwe speaking during the Graduation. 75th Graduation Ceremony, Day 1, CoCIS, CEES, CoVAB and School of Law. 13th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Prof. Barnabas Nawangwe speaking during the Graduation.

Prof. Nawangwe reiterated Makerere’s transformation to a research-led institution supported by the government funded Makerere University Research and Innovations Fund (Mak-RIF). “We are addressing national priorities, such as improving the Parish Development Model and advancing e-governance,” he stated. The Vice Chancellor also congratulated Dr. Crispus Kiyonga on his appointment as Chancellor and urged graduates to leverage their education to create solutions for societal challenges.

Professor Nawangwe advised the graduands thus, ‘We have equipped you with the knowledge and skills that will make you employable or to create your own businesses and employ others. Do not despair if you cannot find employment, instead reflect on the immense opportunities around you and raise them as an entrepreneur.’

Professor Puleng LenkaBula, Principal and Vice-Chancellor of the University of South Africa (UNISA) delivered the commencement speech where she called on the graduands to remain resilient and emancipate Africa’s people. Her address titled “The Power of Resilience – African Woman, Find Your Generational Mission and Redefine Your Worth”, Professor LenkaBula highlighted the critical role of African women in shaping the continent’s destiny.

Prof. Puleng LenkaBula, Vice Chancellor of the University of South Africa delivering her commencement lecture. 75th Graduation Ceremony, Day 1, CoCIS, CEES, CoVAB and School of Law. 13th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Prof. Puleng LenkaBula, Vice Chancellor of the University of South Africa delivering her commencement lecture.

Professor LenkaBula expressed gratitude for being invited to such a significant occasion and extended greetings from South Africa, including from UNISA’s Chancellor, former South African President Dr. Thabo Mbeki. She praised Makerere University for its legacy of academic excellence and contributions to the African continent, emphasizing its role in anti-colonial struggles, post-colonial development, and its steadfast commitment to African unity. She called for a renewed focus on gender equity in academia and leadership, noting the disproportionate burdens faced by women in society. Citing the achievements of Makerere University in gender mainstreaming, she expressed optimism about the role of young leaders in dismantling patriarchal systems and fostering inclusive development.

Professor LenkaBula concluded her address to graduands with a call to action: “Your graduation is not merely a personal achievement but a contribution to Africa’s collective progress. History has thrust upon you the task of creating a future defined by resilience, innovation, and equality.”

In his remarks, Dr. Crispus Kiyonga – Chancellor, Makerere University congratulated graduands upon making it to the 75th Graduation Ceremony of Makerere University. Dr. Suruma expressed his appreciation of His Excellency the President and First Lady/Minister of Education and Sports for giving him the opportunity to serve Uganda and for the continuous support extended to Makerere University, requesting the congregation to join him and give them a warm applause.  Dr. Kiyonga reiterated President Museveni’s directive to Makerere University to integrate the teaching of political economy across all courses to enhance students’ understanding of the country’s socioeconomic conditions. The directive, welcomed by the university’s top management, will be incorporated into the curriculum to align education with the needs of the people and the nation.

Hon. Dr. Crispus Kiyonga addresses the congregation. 75th Graduation Ceremony, Day 1, CoCIS, CEES, CoVAB and School of Law. 13th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Hon. Dr. Crispus Kiyonga addresses the congregation.

He expressed appreciation that the government has pledged to bolster Makerere’s research funding and he encouraged the University to strengthen partnerships with the private sector to commercialize innovations developed at the institution.

The new Chancellor pledged support to the University management in saving its land and urged that an agro-industrial park be established. “This park would serve three purposes: teaching, generating income, and acting as a demonstration site for communities across the country,” Dr. Kiyonga noted. He also emphasized the urgency of addressing Uganda’s food insecurity, highlighting that 40% of children in the Rwenzori region are stunted, with malnutrition affecting most regions of the country.

Dr. Kiyonga also pointed out Africa’s underperformance despite its vast resources, describing it as a contradiction. “It is our responsibility to change the conditions of our people and ensure Africa rises to its potential,” he urged.

The ceremony was graced by Hon. Joyce Moriku Kaducu, Minister of State for Primary Education, who represented the First Lady and Minister of Education and Sports, Hon. Janet Kataaha Museveni. Other dignitaries included members of Parliament, the judiciary, the diplomatic corps, and academics.

The Minister lauded Makerere University for its dedication to academic excellence and innovation. “Today reflects the resilience, hard work, and commitment of our graduates, supported by the university staff, management, and parents,” she said. The Minister commended the Vice Chancellor and management for fostering research and innovation while urging them to maintain robust quality control systems to uphold the institution’s integrity.

Min. Kaducu representing the Minister of Education. 75th Graduation Ceremony, Day 1, CoCIS, CEES, CoVAB and School of Law. 13th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
The Minister of State for Primary Education Hon. Dr. Joyce Moriku Kaducu represented the Minister of Education and Sports, Hon. Janet Kataaha Museveni.

She also reflected on Makerere’s recent milestones, including the commissioning of a new the launch of the School of Graduate Studies and Research. “Your achievements stem from hard work, transparency, and accountability. They set Makerere apart as a leader in higher education,” she noted. Addressing the graduates, Hon. Kaducu encouraged them to apply their skills to solve societal challenges. “Makerere has equipped you with critical thinking and creativity. Use this to seize opportunities, make a difference, and shine wherever you go,” she concluded. During the 75th graduation ceremony held from the 13th -17th January, 2025, a total of 13,658 graduands were awarded degrees and diplomas in various disciplines. Of these, 143 received PhDs, 1,813 Masters Degrees, 243 postgraduate Diplomas, and 11,454 Bachelor’s Degrees. 53% of the graduands are female and 47% are male.  44% of the PhD graduands are female. A total of 491 graduands received first class degrees. 

Zaam Ssali

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Certificate in Water, Sanitation and Hygiene 2025

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The Head, Department of Epidemiology and Biostatistics-Prof. Nazarius Mbona Tumwesigye (6th L) and the Head, Department of Disease Control and Environmental Health-Dr. Esther Buregyeya (4th L) pose with 25 graduands of the WASH Short Course on 20th July 2018, MakSPH, Mulago Campus, Makerere University.

Course Objectives

The course is intended to strengthen the capacity of practicing workers to successfully identify and manage Water, Sanitation and Hygiene (WASH) opportunities and problems by facilitating the acquisition of adequate knowledge, development of skills and attitudes through understanding and use of the 6 essential services of WASH. These are to:

  1. Monitor WASH status to identify and solve community environmental health problems.
  2. Diagnose and investigate WASH problems and health hazards in the community.
  3. Inform, educate and empower people about WASH issues.
  4. Mobilise community partnerships and actions to identify and solve WASH problems.
  5. Evaluate effectiveness, accessibility and quality of personal and population-based WASH services.
  6. Research for new insights and innovative solutions to WASH problems.

Course Structure

The course is an 8-weeks programme of study. Participants will spend 3 weeks (full-time) at Makerere University School of Public Health (MakSPH) while 4 weeks will be spent at suitable workplaces / field sites. The final week of the course will be spent at MakSPH for presentation of project / field work, final examination, and the certificate awarding ceremony. This is a day programme and will run from 26th May to 18th July 2025.

Course Modules

  • Water Resources Management
  • Environmental Sanitation
  • Hygiene Promotion
  • WASH Policy, Planning and Financing
  • Field / Project Work

Mode of delivery of the course includes lectures, tutorials, seminars, practicals and field work.

Dates26th May to 18th July 2025
FeesUgandansInternationals
 UGX 900,000USD 500
Dates and Fees for the Certificate in Water, Sanitation and Hygiene 2025

Who should apply?

  1. Practicing officers in the WASH sector including those working in local government, non governmental organizations (NGOs) or the private sector.
  2. Environmental Health workers who wish to broaden their knowledge and skills as a form of Continuous Professional Development (CPD) so as to be better equipped to implement WASH activities.

Entry requirements for admission to the course are Uganda Advanced Certificate of Education (UACE) or its equivalent with at least 1 year working experience in WASH.

How to apply?

Application forms and procedure can be obtained from the Department of Disease Control and Environmental Health, Makerere University School of Public Health, New Mulago Hospital Complex or from the website below:
https://sph.mak.ac.ug/academics/water-sanitation-and-hygiene-wash

The deadline for receiving applications is Wednesday 26th March 2025.

For further details, contact:

Course Administrator
Ms. Irene Nassazi
Makerere University School of Public Health
New Mulago Hospital Complex
E-mail: inassazi@musph.ac.ug Tel. +256771671354

Course Coordinator
Dr. David Musoke
Makerere University School of Public Health
New Mulago Hospital Complex
E-mail: dmusoke@musph.ac.ug Tel. +256788572129

Co-Course Coordinator
Mr. Allan Ssembuusi
Makerere University School of Public Health
New Mulago Hospital Complex
E-mail: assembuusi@musph.ac.ug Tel. +256759955067

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New Principal at MakCHS

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Left to Right: Mr. Evarist Bainomugisha, Mr. Deus Tayari Mujuni, Mr. Simon Kizito, Prof. Damalie Nakanjako, Prof. Bruce Kirenga, Dr. David Patrick Kateete (Rear), Prof. Henry Alinaitwe, Dr. Richard Idro (Rear), Mr. Patrick Akonyet and Prof. Annettee Nakimuli at the handover ceremony on 2nd December 2024. Handover of Principal Office by Prof. Damalie Nakanjako to Assoc. Prof. Bruce Kirenga, 2nd December 2024, College Boardroom, College of Health Sciences (CHS), Makerere University, New Mulago Hospital Complex, Kampala Uganda, East Africa.

On 2nd December 2024, Assoc. Professor Bruce Kirenga officially took over as Principal of the College of Health Sciences, Makerere University (MakCHS) in a handover ceremony held in the College Board Room. Dr. Kirenga succeeds Professor Damalie Nakanjako, who successfully completed her four-year term.

The ceremony was attended by members of the MakCHS Administrative Board and key university leaders, including Ag. Deputy Vice Chancellor (Finance and Administration) Professor Henry Alinaitwe, Chief of Human Resources, Mr. Deus Tayari Mujuni, & Deputy University Secretary Mr. Simon Kizito, among others.

Prof. Damalie Nakanjako (2nd Left) shows of her plaque as Ag. DVCFA-Prof. Henry Alinaitwe (2nd Right), Deputy US-Mr. Simon Kizito (Left), Dr. David Patrick Kateete (Right) and Dr. Richard Idro (2nd Right) witness. Handover of Principal Office by Prof. Damalie Nakanjako to Assoc. Prof. Bruce Kirenga, 2nd December 2024, College Boardroom, College of Health Sciences (CHS), Makerere University, New Mulago Hospital Complex, Kampala Uganda, East Africa.
Prof. Damalie Nakanjako (2nd Left) shows of her plaque as Ag. DVCFA-Prof. Henry Alinaitwe (2nd Right), Deputy US-Mr. Simon Kizito (Left), Dr. David Patrick Kateete (Right) and Dr. Richard Idro (2nd Right) witness.

In her remarks, Professor Nakanjako reflected on her time in office with gratitude and pride since she assumed office in December 2020. She expressed her full support for MakCHS in contributing towards training and research in Makerere University.

Professor Nakanjako thanked the university top management for the support rendered to during her term of office as Principal. I thank family, friends and colleagues who supported and allowed me share my time with the college, especially beyond official hours.

Assoc. Prof. Bruce Kirenga delivers his acceptance remarks. Handover of Principal Office by Prof. Damalie Nakanjako to Assoc. Prof. Bruce Kirenga, 2nd December 2024, College Boardroom, College of Health Sciences (CHS), Makerere University, New Mulago Hospital Complex, Kampala Uganda, East Africa.
Assoc. Prof. Bruce Kirenga delivers his acceptance remarks.

Dr.  Kirenga, a pulmonologist, researcher, and founding director of the Makerere University Lung Institute, expressed his heartfelt gratitude to the Makerere leadership and the search committee for entrusting him with the responsibility of steering the college. He noted; “It’s a true honour to have been entrusted with this role. The search process was rigorous, but I learned so much from the ideas shared by my colleagues—it was a truly honourable competition.”

With a vision for collaboration and growth, Dr. Kirenga outlined his priorities, including improving staffing, improving relationships with teaching hospitals, and addressing infrastructure needs. He emphasized a leadership style rooted in inclusivity and teamwork, saying, “Let’s create a common vision through consultation and work together. I’ll visit every unit in the college to hear directly from staff about their challenges, needs, and ideas for moving forward.”

Dr. Kirenga also shared plans to establish a forum of past leaders to harness their collective wisdom and ensure continuity in leadership.

Zaam Ssali

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