The Department of Epidemiology and Biostatistics

Project

Summary

Promoting Self- management of Type 2 Diabetes (SMART2D)

Type 2 diabetes mellitus (T2DM) and pre-diabetes are becoming a major problem in both developing and developed countries. It is projected that by 2035, cases of diabetes will have increased to 41 million. The SMART2D study aims to empower an individual with T2DM, or an individual with pre-diabetes and their family to live a quality life with their chronic condition through supported self-management. In addition diabetes care delivery at health facilities has been optimized to improve patient management.

Type 2 Diabetes challenge

This is one of the 17 capacity building projects at Makerere University supported by Sida for the period 2015 to 2020. The aim of the project is to strengthen capacity for chronic care (both prevention and management), through education, training at the doctoral and post- doctoral levels, and research evidence generation. The project is addressing two objectives; To contribute to capacity building at Makerere University and Mbarara University of Science and Technology through doctoral and post-doctoral training in a multi-institutional, multi- disciplinary research team environment.

Fish Landing Sites and HIV

Studies conducted in fishing communities along Lake Victoria in Uganda found that being a member of a fishing community per se (regardless of occupation whether fisherman or not) carried a 3 - 4 fold risk of getting infected with HIV compared to someone in the general Ugandan population. Studies also found that up to 63% of new HIV infections in fishing communities are attributable to alcohol drinking.

These findings confirmed an earlier belief that the fishing communities in Uganda are one of the most-at-risk (key) populations for HIV. Their assessment of HIV incidence, retention and willingness to participate in HIV vaccine trials shows that fishing communities are potential populations for HIV vaccine efficacy trials.

Performance Monitoring and Accountability (PMA2020/UGA) www.pma2020.org

The London Summit of 2012 reinvigorated family planning (FP) as a health and development issue of global importance, particularly in low resource settings. The routine family planning, monitoring and evaluation data systems had limitation to monitor the goals for Family Planning by the year 2020 (FP2020) adequately. The aim of this project is to collect a nationally representative sample of data from households and service delivery points in selected sites, to estimate the use of modern contraception and related indicators on an annual basis, and to explore factors associated with non-uptake/discontinuation of contraceptives in areas with stagnation or declining use and reasons for increased uptake for regions with an improvement in utilization. This data set is much needed since most sources only collect data on a 5-year basis. PMA2016/R4 Uganda survey was conducted by Makerere University School of Public Health with support from the Uganda Bureau of Statistics, Ministry of Health, Bill & Melinda Gates Institute for Population and Reproductive Health (Johns Hopkins University), with funding support from Bill & Melinda Gates Foundation.

PMA 2020 Schistosomiasis, Uganda

PMA2020 undertook module Schistosomiasis (PMA 2020 Schisto) under WASH with the goal of generating the first nationally representative prevalence rate of Schistosomiasis, a parasite disease [caused by trematode worms of genus Schistoma], and measure schistosomiasis infection status one year after treatment, among all people who receive deworming medication in Uganda. The key collaborators are the Ugandan Bureau of Statistics (UBOS) and Ministry of Health Vector Control Division, and the study executed by investigators from the Makerere University

CCA testing kit

This is a randomized controlled trial examining the effect of umbilical cord cleansing with 4% chlorhexidine, an antiseptic, on omphalitis, septicaemia and neonatal mortality. Annually, nearly all the estimated worldwide 2.7 million neonatal deaths occur in low- and middle- income countries. Infections, including those affecting the umbilical cord (omphalitis), are a significant factor in approximately a third of these deaths. In fact, the odds of all-cause mortality are 46% higher among neonates with omphalitis than in those without. A single application is programmatically much simpler to implement than daily applications for 7 days. Therefore, our CHX study compares umbilical cord cleansing with a single application of 4% CHX at birth with dry cord care among Ugandan babies born in health facilities, on the risk of omphalitis and severe neonatal illness. The CHX study is a facility-based, individually randomized controlled trial that will be conducted among 4760 newborns in Uganda. This study will provide novel evidence, from a Sub-Saharan African setting, of the effect of umbilical cord cleansing with a single application of 4% CHX at birth and identify modifiable risk factors for omphalitis.

The BCG Study

This study will compare BCG vaccination at birth with BCG vaccination at 14 weeks of age in HIV-1- exposed infants. This is an individually randomized controlled trial in 2200 HIV- 1-exposed infants. The intervention is BCG vaccination within 24 hours of birth while the comparator is BCG given at 14 weeks of age.

This trial could inform the development of appropriate timing of BCG vaccination for HIV- 1- exposed infants.

EDEAN Project in Karamoja

In May 2016 Makerere University signed an MOU with Georgetown University’s Institute for Reproductive Health in New York to carry out a baseline and endline evaluation of a project on Fertility Awareness for Community Transformation (FACT) in Karamoja Sub- region of Uganda. In Nga Karamojong the project was dubbed EDEAN (Emorikinos Daadang Etogogogitoth Alatanakithi Ngidwe). The baseline was carried out in July 2016 and the endline in Jan 2017. It’s hoped that the results of the evaluation will bring in new information for implementation of reproductive health programs in the sub-region

Alcohol Policy and Legislation Study in Uganda

IDRC Canada through University of Cape Town sponsored a study on alcohol policy and legislation, which mainly involved literature review, observations and many key informant interviews. Key outputs were current state of policy and legislation regarding alcohol consumption in Uganda. Other issues include barriers, what works and what does not, in regard to policy implementation. Work from this study has been disseminated in international meetings.

Cerebral Palsy in Uganda: Epidemiology, Risk Factors and Intervention Project (CURIE)

The CURIE study with the main objective of obtaining information regarding the epidemiology of Cerebral palsy (CP) in Uganda, ascertain the risk factors, clinical sub types, functional severity level (gross and fine motor), comorbidity, explore the conditions of life for children suffering from this condition and develop and evaluate a community-based rehabilitation program is being carried out at the Iganga/Mayuge Health.