Uganda

Uganda

Site: Kampala, Uganda         

Focus: Lung Health

Affiliation: Makerere College of Health Sciences; Walimu; Yale University

Lead mentor: J. Lucian (Luke) Davis, MD, MAS, lucian.davis@yale.edu

Local contacts: Achilles Katamba, MBChB, PhD, akatamba@yahoo.com

Projects: The Makerere University College of Health Sciences and Yale University host a long-standing collaboration in lung disease research. The program focuses on tuberculosis (TB) and other pulmonary complications of HIV, with an emphasis on diagnosis and active case finding of TB. Active projects fall under several umbrellas. The Uganda TB Surveillance Project (UTBSP) uses implementation science approaches to design, introduce, and evaluate novel approaches to improve TB services in clinic and community settings. Walimu, a Uganda-registered non-governmental organization, uses implementation science to improve the quality of severe illness management in health facilities across Uganda. Additional projects look at non-communicable diseases including asthma and COPD. The Makerere School of Medicine Research Ethics Committee and the Uganda National Council for Science and Technology provide strong ethical oversight for these sites. Makerere has a strong tradition of highly successful Fogarty sponsored research training programs; all of the current mentors at the site are former Fogarty trainees now faculty at Makerere. The site has well-established research offices and clinical sites in multiple locations in Uganda.

On-going projects include:

  1. Mobile Health for Implementation of Home-based TB Contact Investigation in Uganda (NIH R01AI104824). Screening household contacts of new tuberculosis (TB) patients is an efficient way to find undiagnosed TB patients before they become ill and spread TB to others, but traveling to clinics for confirmatory testing is costly and difficult for poor patients. This research will test if home sputum collection with mobile-phone follow-up can treat more TB patients, reduce unnecessary clinic visits, and provide a model for finding and eliminating TB in high-burden countries. If effective and scalable, this approach would benefit both patients and public health.
  2. International Research Training on TB and Other Pulmonary Complications of HIV (NIH D43TW009607). The University of California, Berkeley / Yale University / Makerere College of Health Sciences Fogarty TB and other Pulmonary Complications of AIDS Research Training (PART) Program will train medical doctors, scientists, laboratory technicians, and other research personnel at the Makerere University College of Health Sciences and Mulago National Referral Hospital in translational research methods for the study of TB and other pulmonary complications of HIV. This will strengthen institutional capacity to conduct high quality, innovative, and locally relevant HIV/AIDS research.
  3. Pediatric TB Evaluation and Management Guideline Implementation Support – (USAID/NIH PEER Health Program) – The International Union Against TB and Lung Disease has disseminated consensus guidelines on evaluation of pediatric TB but uptake of these guidelines in routine setting is low. In this project, UTBSP is using mixed methods to identify barriers to the delivery of quality-assured care in TB and design targeted interventions to address these barriers.
  4. Severe Illness Management Support (Private Foundation) - Severe Illness Management Support (SIMS) is an intensive, multi-modal severe illness quality-improvement program for district and regional hospitals in Uganda. Using the principles of implementation science, Walimu, a Uganda-registered NGO, gives doctors, nurses and managers novel approaches to improve severe illness management.
  5. Practical Approach to Lung Health - WHO’s Practical Approach to Lung Health seeks to improve the quality of care for patients presenting with chronic cough who prove not to have tuberculosis by enhancing diagnostic services for asthma, COPD, and other causes of lung conditions. The Uganda TB Surveillance Project provides a robust platform for data collection, audit, and feedback on these conditions as the basis for implementation science and quality improvement activities.

Webpages for sites and research programs: Walimu: www.walimu.org