Uganda

Site: Kampala, Uganda

Focus: Lung Health

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

Lead mentor: J. Lucian (Luke) Davis, MD, MAS

Local contacts: Achilles Katamba, MBChB, PhD

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 Implementation Research Consortium (U-TIRC) 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 Public Health Higher Degrees, Research and 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. Human-centered Design and Communities of Practice to Improve Delivery of Home-based Tuberculosis Contact Investigation in Uganda (NIH R01AI104824) Screening close contacts of new TB patients is an efficient way to find undiagnosed TB patients before they become ill and spread TB to others but implementation of contact investigation often results in suboptimal rates of TB evaluation completion. This research will use the principles of Human-Centered Design in conjunction with Communities of Practice to create and test an intervention aimed at improving the implementation of contact investigation and increasing the proportion of close contacts successfully screened for TB. 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. Interrupting HIV and TB Stigma in the Household during TB Contact Investigation in Uganda (NIH R21TW011270) Household contacts of TB patients are at high risk for both HIV and TB in Uganda. However, stigma can prevent household contacts from seeking out appropriate evaluation and treatment for both diseases. This research aims to develop an intervention that will reduce perceptions of stigma associated with HIV and testing for HIV in the household. The overall goal of this project is to increase the uptake of home HIV testing and linkage to HIV care.