Child with Cerebral palsy with severe motor impairment in a wheel chair, occupational therapist is on his left and caregiver is on his right demonstrating to the therapist what the child is able to do with his right hand
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”.
The post holder will be required to provide nursing care to patients attending IDC, provide health education and advise to patients and their family members, provide translation whenever necessary, guide in clinical practice and duties of other nurses. Participate in clinical research studies.
Key Responsibilities
Provides nursing care to patients attending the IDC
To provide clinical care including triaging, clinical assessment of patients of patient’s problems, investigations to HIV/AIDS patients attending IDI-supported health facilities in line with standard treatment guidelines.
Assist in management of very sick patients brought in Urgent care with knowledge, skills and Support appropriate referral of complex patients’ through liaison with immediate team members, senior clinicians and other specialized facilities.
Lead education and facility sensitization efforts to continuously build knowledge among clients and the attendants at Urgent care and the general clinic.
Participate in identification, implementation and documentation of continuous quality improvement activities along client care and treatment.
Assists medical doctors in carrying out clinical procedures.
Provides translation services to visiting medical doctors as required
Ensures patient flow in the clinic ( IDC)
Performs quality assurance and quality control (QA/AC) to ensure completeness of source documents.
Participates in giving Medicines when required.
Checks medical supply stock and ensures procedure charts are fully equipped
Guides the clinical practice and duties of other nursing staff
Participates as a full member of the IDC health care team
Attends clinic staff meetings on a daily basis as available
Participate whenever requested to do so in clinic research studies.
Participate in compilation and submission of accurate activity reports according to the set guidelines.
This job description is not exhaustive and the post holder will need to be flexible and to undertake such other duties as may become necessary with the development of the Infectious Diseases Institute.
Academic Qualifications
Diploma or Bachelors Degree in Nursing
Full and active registration with the Uganda Nurses and Midwives council (Valid general practice license).
Person Specification
Completion of Nurses Training in a recognized educational institution with Diploma/ Bachelors
Minimum of 3 years work experience in a clinical setting
Full and active registration with the Uganda Nurses and Midwives council (Valid general practice license).
Self- motivated and capable of meeting deadlines.
Excellent communication skills.
Good interpersonal skills and able to interact productively with other team members.
More details
Job Code: NPCT001 No of Positions: 1 Station: IDI-Mulago Classification: Full-time Duration: 1 Months Reports to: NURSE TEAM LEAD Posted Date: 2026-07-06 09:06:27.000 Closing Date: 2026-07-19 17:00:00.000
Across Kampala, families use saucepans, cooking pots, frying pans, kettles, and pressure cookers every day. Makerere University School of Public Health is now investigating whether some of these items may expose households to lead, a toxic heavy metal that can enter food during cooking if contaminated materials are used to make them.
The year-long study, titled “Assessment of Lead Contamination in Domestic Cookware, Supply Chains, and Exposure Pathways in Informal Settlements of Kampala,” was launched on 11 June 2026 at MakSPH’s ResilientAfrica Network (RAN) in Kololo. Supported through the Lead Exposure Elimination Project (LEEP), with funding from Bloomberg Philanthropies, and led by Mr. Douglas Bulafu, Mr. Tom Okade, and Dr. Rawlance Ndejjo, the study will assess total and leachable lead levels in commonly used cookware, map how the products are sourced, distributed, and sold, and identify feasible interventions to reduce household exposure to lead.
Ms. Prossy Nabaggala, Senior Standards Officer at the Uganda National Bureau of Standards, pictured centre, consults with study co-investigators Mr. Tom Okade and Mr. Douglas Bulafu during the launch of MakSPH’s study on possible lead exposure from domestic cookware in Kampala.
Today, lead remains a major and preventable public health concern globally. WHO reports that no level of exposure is known to be without harmful effects and estimates that lead exposure contributes to more than 3.5 million deaths worldwide, mainly through cardiovascular effects. Children and women of child-bearing age are said to be especially vulnerable, with exposure linked to impaired brain development, reduced learning ability, harm to unborn children, high blood pressure, cardiovascular disease and kidney damage.
In Uganda, lead exposure concerns also extend to household products and informal markets. Aluminium pots and saucepans, particularly low-cost locally fabricated items, may be made from recycled scrap metal. If contaminated materials are used, lead may leach into food during cooking or other food-contact use, creating a possible route of exposure in homes.
During the launch, Assoc. Prof. David Musoke, Head of MakSPH’s Department of Disease Control and Environmental Health, underscored the importance of involving stakeholders throughout the research process. He said engaging stakeholders from the generation of research ideas to implementation and dissemination helps ensure findings do not remain within the University but are translated into evidence that can inform policy, practice, and community action.
“We engage with stakeholders throughout the research process, from developing ideas and designing projects to implementation and dissemination,” Dr. Musoke noted. “I am pleased that this workshop brings together policymakers, the Ministry of Health, non-governmental organisations, Kampala Capital City Authority, academia, staff and students. This helps ensure that research findings do not remain at the University but are beneficial to our stakeholders.”
Assoc. Prof. David Musoke delivers remarks during the study launch, emphasising sustained stakeholder engagement to ensure research findings inform policy, practice and community action.
He observed that the study was timely, as it addresses an important yet under-examined public health concern, arguing that while lead exposure from paint, pipes and drinking water has received considerable attention, exposure through cookware remains less understood despite its widespread use in many households. He added that the new research builds on MakSPH’s broader work in disease control and environmental health and will generate critical evidence to inform action on lead exposure risks in Uganda. Dr. Musoke also commended the study team for initiating this work.
Previously, MakSPH researchers Mr. Abdullah Ali Halage, Mr. Tom Okade, Dr. James Muleme and Dr. Juliet Kiguli, together with Mr. Ahmada Zziwa and Mr. Robert Mugabi, assessed knowledge, perceptions and practices related to heavy metal contamination and health risks among residents living near Kiteezi in Kampala, Katikolo in Mukono and Nkumba in Entebbe. The study, done in 2024, reached 505 residents and captured community and frontline perspectives from people living and working around the dumpsites. It showed how daily contact with dumpsite environments may expose communities to toxic heavy metals such as lead, arsenic, cadmium, and mercury through soil, water, air, food crops, animal products and waste-handling practices.
Evidence from the study, funded by the Government of Uganda through the Makerere University Research and Innovation Fund (MakRIF) and disseminated on 26 June 2025, showed that heavy metal exposure risks around the three municipal dumpsites within the Kampala Metropolitan Area were shaped by both environmental conditions and community behaviour.
Dr. Sabrina Kitaka, Member of the MakRIF Grant Management Committee, pictured centre, with research team members including Mr. Abdullah Ali Halage, Mr. Tom Okade and Dr. Juliet Kiguli, following the dissemination of findings on heavy metal exposure risks around Kampala Metropolitan dumpsites on 26 June 2025.
Although residents lived near dumpsites where waste can release heavy metals into soil, water and food chains, 76.4 per cent could not define heavy metals, and only 45.9 per cent had adequate knowledge of contamination and related health risks. Gaps extended to daily exposure pathways, with 38.4 per cent unaware that vegetables grown near dumpsites may contain high heavy metal levels and 39.8 per cent unaware that milk or meat from animals grazed near dumpsites may also be contaminated. More than half viewed dumpsite soils as fertile, 50.7 per cent considered such milk safe, and 51.3 per cent believed dumpsite waste could be used as manure.
The study recommended stronger risk communication, environmental monitoring, safer land-use enforcement and community education. The work on lead in domestic cookware now extends this focus from dumpsite-related heavy metal exposure to a possible household pathway. Mr. Douglas Bulafu, an early-career researcher and Principal Investigator of the study, said the team will examine whether commonly used cooking pots, saucepans and related utensils contribute to exposure, and generate evidence to guide safer cookware use, standards and market oversight.
“Lead contamination has been documented from sources such as paint, fuel and air pollution, but less attention has been given to cookware as a potential pathway of exposure. That is the gap this study seeks to address,” Mr. Bulafu said. “We focused on Kampala because it has many informal settlements, small-scale cookware workshops and a large consumer market where low-cost cookware is widely produced, sold and used. When people buy these products, they often do not know where they were made, what materials were used, or whether they contain lead. The supply chains are also poorly understood, meaning households could be exposed without knowing.”
Mr. Douglas Bulafu, Principal Investigator, speaks during the launch of the MakSPH study on possible lead exposure from domestic cookware in Kampala, highlighting the need for evidence to guide safer cookware use, standards and market oversight.
The study will use a cross-sectional, mixed-methods design to connect laboratory evidence with supply-chain realities in Kampala’s informal settlements. The team will purchase about 100 cookware samples from open-air markets, roadside vendors, retail shops and supermarkets in Kisenyi, Katanga, Bwaise, Namuwongo, Banda and Kasubi, test them for total and leachable lead, and conduct about 30 key informant interviews across the supply chain to understand how cookware is sourced, produced, distributed and used.
Findings will be validated with stakeholders and used to identify feasible interventions, including stronger regulation and enforcement, raw-material control, better manufacturing practices, market surveillance and consumer awareness. The evidence is expected to support standards development, product testing, policy uptake, safer manufacturing practices and public guidance on cookware choices, helping reduce household exposure to lead and associated health risks.
Speaking on behalf of the Ministry of Health, Dr. Didacus Namanya, a health geographer and environmental health expert, welcomed the study, saying scientific evidence on lead exposure is critical because public health decisions can have lasting consequences for life and wellbeing.
Dr. Namanya implored the research team to ensure the evidence from the study informs decisions beyond academia, shaping policy, strengthening public health practice and guiding practical measures to reduce lead exposure in communities. He emphasised that research should not remain in the “ivory tower” but reach decision-makers and the public, so that evidence from the study translates into policy, practice and stronger protection for communities.
Dr. Didacus Namanya, speaking on behalf of the Ministry of Health, delivers remarks during the study launch on 11 June 2026, urging the research team to ensure evidence on lead exposure informs policy, practice and practical community protection measures.
Kampala — On Saturday, a car park on the campus of Makerere University in Kampala became the stage for a continental emergency response. Delegates, dignitaries and diplomats gathered in the tent outside the Infectious Diseases Institute (IDI), a research institute owned by the university, for the formal launch of the Continental Incident Management Support Team (IMST), a joint Africa Centres for Disease Control and Prevention (Africa CDC) and World Health Organization (WHO) operation racing to contain the Bundibugyo strain of Ebola sweeping through the Democratic Republic of the Congo and, increasingly, Uganda. After the ribbon-cutting, guests were led inside to tour the team’s new home at IDI’s McKinnell Knowledge Centre, where the command offices have now been set up.
Dr Chris Baryomunsi joins delegates for a group photograph at the IMST launch, Infectious Diseases Institute, Makerere University.
The numbers explain the urgency. As of 21 June, more than 1,000 confirmed cases and 269 deaths had been recorded across the two countries, the vast majority in Ituri Province in eastern DRC. Uganda’s tally stood at 20 cases and two deaths, almost all traced to cross-border movement from the DRC. Eighty-two health workers have been infected, 18 fatally, a toll that helped push the WHO to declare a Public Health Emergency of International Concern in May, mirrored days later by Africa CDC’s own continental emergency declaration.
Prof Henry Mwanaki Alinaitwe, Deputy Vice Chancellor for Finance and Administration at Makerere University, with the acting US Ambassador to Uganda and Prof Samuel Luboga, IDI board chair, at the IMST launch.
Until now, the international response has been coordinated remotely, a patchwork of video calls and scattered logistics that officials admit slowed decision-making. The Kampala launch marks a shift from that fragmented model to a single, physically co-located command centre housed at IDI’s McKinnell Knowledge Centre, bringing case management, surveillance, logistics and risk communication specialists under one roof. From there, the convoy of delegates moved on to Kajjansi, on the outskirts of Entebbe, for the formal activation of the IMST’s regional logistics hub, the facility tasked with staging and rapidly deploying protective equipment and medical supplies across the outbreak zone.
Dr Chris Baryomunsi inspects the newly activated IMST logistics hub at Kajjansi, near Entebbe.
For Uganda’s health minister, Dr Chris Baryomunsi, the symbolism was as important as the logistics. Speaking at the launch, he argued that no nation can consider itself protected until its neighbours are equally prepared, framing cross-border solidarity as an operational necessity rather than an aspiration. He also announced a new memorandum of understanding with the DRC establishing joint Ebola treatment centres and laboratory services in the border towns of Aru and Kasenyi, warning that outbreak response cannot succeed while transmission continues unchecked on one side of a shared frontier.
Dr Chris Baryomunsi speaks as the guest of honour at the launch of the Continental Incident Management Support Team, Infectious Diseases Institute, Makerere University.
The WHO’s regional emergency director, Dr Marie-Roseline Belizaire, described the unified command structure as transformative, saying it would pool resources across agencies, cut duplication and keep field decisions anchored to scientific evidence. Africa CDC’s Dr Tolbert Nyenswah confirmed the team, specialists in case management, infection prevention, logistics and contact tracing, has now relocated physically to Kampala to work closer to the epicentre. Eleven epidemic-prone African nations, including Rwanda, Burundi, Angola and the Central African Republic, are participating in the preparedness effort even though most have not registered a single case.
Dr Marie-Roseline Belizaire, WHO AFRO’s regional emergency director, speaks at the launch of the Continental Incident Management Support Team in Kampala.
For IDI and Makerere University, hosting the command centre carries weight beyond the immediate crisis. IDI’s executive director, Dr Andrew Kambugu, said the institute had provided a fully equipped space, now installed at the McKinnell Knowledge Centre, enabling real-time communication between field teams, regional governments and international partners in Geneva, and framed the moment as proof that academic institutions can engage directly with pressing societal problems rather than observe from the sidelines.
Dr Andrew Kambugu delivers welcome remarks at the launch of the Continental Incident Management Support Team, Infectious Diseases Institute, Makerere University.
That framing matters for a continent whose research infrastructure has often been treated as peripheral to its own health emergencies. By anchoring the IMST’s command function within a Ugandan public university rather than in a foreign capital, the launch signals a modest but symbolic rebalancing: an African-led institution taking custody of an African-led response. The day’s itinerary made the point physically as well as symbolically: from the ribbon-cutting in Makerere’s car park, to the tour of the new command offices, to the drive out to Kajjansi to switch on the logistics hub, delegates traced the full chain of the response they had just committed to running.
Dr Chris Baryomunsi poses with the IMST logistics hub team at Kajjansi, following the hub’s formal activation.
Fred Ouma is the Corporate Communications Specialist, Infectious Diseases Institute (IDI).
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