Health
Mak Launches COVID Convalescent Plasma Investigational New Drug and Trial
Coronavirus Disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus. First reported in early December 2019 in Wuhan China, it has since spread across all continents. Over 21 million cases have been reported, and more than 700,000 deaths have been recorded. The first case of COVID-19 in Uganda was reported on 21st March, 2020 and since then, more than 5,000 cases have been reported, with more than 60 deaths recorded.
There is no vaccine available for COVID-19, and treatments are only starting to emerge. There is emerging evidence to support use of COVID Convalescent Plasma (CCP) for treatment of COVID-19 especially among severe and critical patients. Plasma is the straw colored liquid portion of blood that remains after red blood cells, white blood cells, platelets and other cellular components of blood are removed.
Wednesday, September 16th 2020 was yet another day of great achievement to Makerere University in Kampala Uganda. On this day, Uganda’s Minister of Health; Hon. Dr. Jane Ruth Aceng officially launched the Uganda Coronavirus Convalescent Plasma Investigational New Drug and the CCP trial to assess the safety and efficacy of CCP in treatment of COVID 19 in Uganda. The launch was held at Makerere University’s Main Hall. Prof. William Bazeyo, the session chair and also Principal Investigator of the project gave welcome remarks on behalf of Makerere University’s Vice Chancellor. He thanked the government of the Republic of Uganda for funding this project and several others (now totaling to over 500 multidisciplinary projects) through Makerere University Research and Innovations Fund (MAK-RIF) https://rif.mak.ac.ug/ . He also thanked Hon. Dr. Aceng who graced the occasion as Chief Guest for the continued support from the Ministry. He ended by assuring the Hon. Minister that Makerere University Medical School is working hard to become number one in Africa after being ranked second for so long. He noted this was possible with more support from the Government of the Republic of Uganda.
Dr. Bruce Kirenga; the Director Makerere University Lung Institute http://mli.mak.ac.ug and also Principal Investigator of this project mentioned that despite evidence of possible efficacy of CCP in treatment of COVID-19, very few African countries have undertaken the collection and processing of CCP. He mentioned the aim of the project was to assess the feasibility of collecting, processing and storing of CCP for treatment of COVID-19 in Uganda. He emphasized the need to collaborate and collate all the related scientific facts throughout the collection, processing and storage of Convalescent Plasma.
The team approached COVID-19 recovered individuals who had been managed and discharged at the treatment centers across the country. To be included, participants needed to provide written informed consent, have documented evidence of SARS-CoV-2 infection by PCR, have documented evidence of full recovery from COVID-19, be at least 18 years old and meet all criteria for blood donation set by Uganda National Blood Transfusion Services in order to be eligible.
Dr. Bruce Kirenga said 87% of the 186 individuals who came to the center, qualified to donate. The donors were received from all regions of Uganda except Karamoja that had not registered an infection by commencement of the study. The median age of the donors was 33 years and 3.7% were females. A significant finding was that all the samples donated had enough antibodies to warrant use in treatment of COVID-19 patients.
In her address, Hon. Dr. Aceng thanked the scientists for the innovation and gave the green light to commence the CCP trial with immediate effect, now that the product was available. The Minister appealed to the general public to continue observing the COVID-19 Standard Operating Procedures as scientists continue to innovate, find treatment and cure for the deadly virus. She said the country had reached phase 4 of the pandemic and the virus was now killing on average 2-3 people a day. This she noted was indicative of widespread community transmission of COVID-19 meaning that the spread can no longer be controlled but can only be mitigated. She emphasized that COVID-19 in Uganda is real so anything proven that can be done to save life is highly welcome and appreciated.
The project was conducted by COVID Research (COVIDRES); a multi-disciplinary research group coordinated by the Makerere University Lung Institute (http://mli.mak.ac.ug). Other partners on the project are: Uganda People’s Defense Forces Medical Services, Mulago National Referral Hospital, Joint Clinical Research Center and Uganda Blood Transfusion Services. The team is now moving forward to undertaking the CCP trial.
Project details are shared and accessible here
Media Coverage of the COVID-19 Convalescent Plasma Investigational Drug launch
Broadcast Media
- NTV Uganda https://youtu.be/31DM3zeJqdM
- Uganda Radio Network https://ugandaradionetwork.net/story/makerere-starts-using-recovered-patients-blood-for-treating-covid-19-
- UBC September 17, 2020 – https://youtu.be/yxqxWl6iblk
- CGTN Television-an international English-language news channel based in Beijing owned by China Central Television, a state-owned broadcaster- September 17, 2020- https://drive.google.com/file/d/1xAhA1yg2aU64X_WyBdr3I2rs35Nuc2tB/view?usp=sharing
Print Media
- The Independent https://www.independent.co.ug/makerere-scientists-big-move-on-covid-19-treatment/
- Makerere University Vice Chancellor’s Diary https://news.mak.ac.ug/2020/09/launching-covid-19-convalescent-plasma-drug/
- Uganda Update https://www.ugandaupdatenews.com/uganda-starts-plasma-based-treatment-trial-for-covid-19/
- The New Vision of September 17, 2020 page 3-See attached
- Daily Monitor of September 17, 2020 page 3-See attached
Pictures shared on https://we.tl/t-T99Kxua9nl
‘We Build for the Future’ ‘For God and My Country’
Compiled By: Musoki Walter Jack, 3rd Year Medicine and Surgery Student at Makerere University and
Harriet Adong, Communications Officer, Makerere University Research and Innovations Fund (Mak-RIF)
Health
Mak Researchers Partner with Safe Bangle Technologies to Roll out a Real-Time Domestic Violence Reporting Bracelet
By Joseph Odoi
A Consortium of Researchers from Makerere University School of Public Health/Resilient Africa Network (MakSPH/RAN), Medical College of Wisconsin (MCW), Somero Uganda together with Safe Bangle Technologies have rolled out a real time domestic violence reporting bracelet.
This roll out was made possible with support from the United States Agency for International Development (USAID) under the PARTNERSHIPS FOR ENHANCED ENGAGEMENT IN RESEARCH (PEER) program and the National Academies of Sciences.
Dr. Juliet Kiguli, the Principal Investigator from Makerere University, along with Dr. Roy Mayega, Deputy Chief of Party at RAN, and Dr. Agnes Nyabigambo, the study coordinator, initiated the PEER program to identify entry points for testing SafeBangle Technologies (a social enterprise based at Resilient Africa Network (RAN) with a mission to create a safer and more secure environment for women and children through innovative, affordable, and creative technology solutions to curb GBV in Africa.) wearable safety bracelet in the informal settlements. This decision stemmed from findings of increased intimate partner violence (IPV) and gender-based violence (GBV) in three informal settlements in Kampala, Uganda, following a longitudinal study, geospatial mapping, and interviews. The project, titled ‘The Impact of the COVID-19 Pandemic on Gender-Based Violence among Women and Girls in Informal Settlements in Kampala,’ highlighted the urgent need for affordable and immediate reporting mechanisms for violence.”
‘’While carrying out a study after the Covid-19 Pandemic, we identified gaps when it comes to reporting and response to Gender Based Violence (GBV) among women in informal settlements. Therefore, we used incorporated the SafeBangle intervention to solve the problem of lack of affordable and immediate reporting mechanisms for violence using a bracelet that reports violence in real time’’ explained Dr. Kiguli.
Innovation details
According to Saul Kabali and Messach Luminsa, the innovators behind SafeBangle from SafeBangle Technologies, hosted at the Resilient African Network Lab. ‘’The inspiration behind SafeBangle came from a deeply personal place. ‘’We heard countless stories of women who couldn’t call for help during moments of danger. We were deeply affected by the story of Aisha, a young woman in a rural village who was attacked while walking home alone at night. With no way to call for help, she felt helpless and vulnerable. This incident made us realize the critical need for immediate reporting alert tools, accessible to women like Aisha. We knew technology could play a crucial role and this incident awakened a strong desire in us to create a solution’’
“While developing SafeBangle, we tested with the users in both rural and urban contexts. We piloted the innovation around Kampala with support from Digital Human Righs Lab and Naguru Youth Health Network as well as it in five districts of Karamoja region with support from Save the Children and Response Innovation Lab. Right now it has become handy in Kamapala‘s informal settlements. We envision a future where SafeBangle becomes a standard tool in the fight against GBV, ensuring every woman feels safe and secure as it has the potential to transform how we respond to GBV in Africa” added Kabali.
HOW THE SAFEBANGLE TECHNOLOGY WORKS
The SafeBangle is wearable technology similar to a smartwatch that sends an alarm by SMS to people chosen by a woman herself if she feels threatened.
In terms of the acceptability of the SafeBangle innovation as a solution to GBV among at-risk women in informal settlements Of the 72 adolescent girls and women who received the SafeBangle, 22 activated the reporting button, resulting in 19 receiving immediate and appropriate support, including counseling, police intervention, and health services.
All adolescent girls and women who experienced GBV received a phone call from Somero Uganda to discuss the most appropriate intervention, including counseling, police cases being handled by the probation office, referral for health services, and post-exposure prophylaxis. All the GBV survivors received support and are still receiving continuous follow-up.
Researchers conducted a survey among 644 girls and women in Kinawataka (Nakawa Division) and Bwaise (Kawempe Division) to gain insights into awareness and understanding of sexual and gender-based violence among adolescent girls and women in informal settlements. The survey measured socioeconomic factors, mental health symptoms, and exposure to GBV. Focus group interviews were conducted with a separate sample of women over 18 in the settlements to explore responses to GBV.
A tabular representation of the key findings and lessons learned from your study on gender-based violence (GBV)
| Key Findings | Lessons learned |
| Prevalence of GBV. – Overall prevalence: 34.1% of women and girls reported experiencing GBV. – Among adolescents (15-19 years): Over 50% reported experiencing GBV. | – The pandemic highlighted the need for accessible and comprehensive support services for GBV survivors. – Schools emerged as crucial safe spaces for girls, emphasizing their well-being during crises. – Economic independence proved crucial, enabling women to leave abusive environments. – Involving men and boys as allies in GBV prevention efforts is essential. |
| Age-related trends | – GBV prevalence tends to decrease with increasing age. |
| Physical and health consequences. | – Women and girls suffered physical violence, injuries, and deaths, primarily from domestic violence and unsafe abortions due to limited healthcare access. – GBV resulted in unintended pregnancies, unsafe abortions, and increased risk of sexually transmitted diseases (STIs) like HIV/AIDS. |
| Social and economic impact. . | – GBV contributed to family breakups, strained marriages due to financial stress. – Economic hardships forced some women and girls into transactional sex, exposing them to further health risks and exploitation. – Pandemic-related job losses and economic constraints increased financial dependence on abusers, trapping women in violent situations. – School closures and increased household responsibilities limited women’s job opportunities and subjected them to sexual harassment. |
| Psychological effects | – Survivors experienced guilt, shame, anxiety, fear, and suicidal thoughts due to ongoing abuse. |
| Long-term effects | – Post-COVID-19, survivors faced disrupted education, early marriages, pregnancies, social stigma, and persistent mental health issues. |
Reproductive Health Consequences: GBV resulted in unintended pregnancies, unsafe abortions, and increased risk of sexually transmitted diseases (STIs) like HIV/AIDS.
Family Breakdown: The rise in GBV led to family breakups as women fled abusive relationships. Marriages were strained due to increased financial stress.
Transactional Sex for Survival: Desperate for basic needs due to job losses and economic hardship, some women and girls resorted to transactional sex, exposing them to further health risks and exploitation.
One study participant stated, “The time of COVID-19 was so terrible for some of us. We in fact got a lot of diseases from it because you would want to get food and didn’t have money. That way you would be forced to get a man who would use you and pay.” – (FGD_Girls_19–24years_Kinawataka).
Economic Effects: COVID-19 restrictions caused job losses and limited economic opportunities, particularly for women in the informal sector. This increased financial dependence on abusers and trapped women in violent situations.
Limited Access to Employment: School closures and increased household chores limited women’s ability to seek employment, perpetuating gender inequality in the workforce. Some faced sexual harassment from potential employers.
Psychological Effects: Survivors of GBV experienced guilt, shame, anxiety, fear, and even suicidal thoughts due to the constant threat and unpredictability of abuse.
Post-COVID Effects: GBV survivors faced long-term consequences, including disrupted education, early marriage, early pregnancy, social stigma, and persistent mental health issues.
Lessons learned
The pandemic highlighted the need for accessible and comprehensive support services for survivors of GBV, the significance of schools as safe spaces for girls, and the need to prioritize their well-being during crises. Economic empowerment emerged as a significant protective factor for women and girls. Those with greater economic independence were better equipped to leave abusive environments and secure their safety and well-being, while dependent ones suffered abuses. Engaging men and boys as allies in the fight against GBV and involving them in prevention efforts can help promote positive behavior change and foster more equitable relationships.
Recommendations
To address GBV against women and girls, the researchers recommend the following moving forward;
- There is need to integrate technology-driven solutions like SafeBangle into national GBV prevention and response strategies. SafeBangle can be a valuable tool for policymakers as cases of violence that would have gone unreported will be brought to light and the would-be victims will be able to get immediate help from trusted relatives and friends.
- Provide economic opportunities and vocational training for women and girls to enhance their financial independence and reduce vulnerability to violence. There is therefore a need to introduce education and training programs that empower women and girls, by providing them with skills, resources, and opportunities to start their own ventures and to participate fully in community affairs.
- Strengthen and enforce existing laws and policies related to GBV, including laws against domestic violence, child marriage, and sexual assault without discrimination be it for law enforcers, leaders, and employers where such cases were suffocated. Ensure that perpetrators are held accountable through swift and fair legal processes that have no room for corruption.
- Establish and promote effective, accessible, and confidential reporting mechanisms for GBV incidents that provide confidence and can be trusted by survivors to enhance reporting of such incidences of GBV. Community Engagement and Involvement: Involve community leaders, religious leaders, and elders in discussions about GBV to promote gender equality, change social norms, and reinforce the message that violence against women and girls is unacceptable.
- Launch extensive public awareness campaigns to challenge harmful gender norms, report cases of GBV, raise awareness about the consequences of GBV, and promote positive behaviors and attitudes towards women and girls.
- Implement comprehensive sexuality education in schools and communities, educating young people about healthy relationships, consent, and reproductive rights to be able to make informed decisions about their own lives and well-being.
- Engage men and boys as allies in the fight against GBV, encouraging them to challenge harmful masculinity norms and behaviors. This will help minimize GBV because mostly they are the perpetrators. Strengthening Support for Survivors: Provide ongoing support and follow-up services for survivors of GBV mostly counselling services to aid their recovery and facilitate their reintegration into society.
- Provide ongoing support and follow-up services for survivors of GBV, mostly counseling services to aid their recovery and facilitate their reintegration into society.
- Provide avenues to seek free or subsidized services by survivors of GBV medical services and legal processes by survivors of GBV to enhance reporting of GBV cases, access to medical care, counseling, legal support, and other essential services.
- Encourage and support more research and innovations like SafeBangle to curb incidents of GBV.
- A comprehensive and inclusive approach is required. The efforts should involve government institutions, civil society organizations, community leaders, and individuals working together to address the root causes and provide support to survivors.
- Involve media in GBV prevention activities and for enhancing campaigns against GBV mostly on radio and TV.
MORE ABOUT THE STUDY
The core project team, included researchers at Makerere University School of Public Health (MakSPH), Medical College of Wisconsin (MCW) led by Prof. Julia Dickson-Gomez, SafeBangle Technologies, and Somero Uganda, a community-focused NGO, began the project by designing their research protocol and taking a CITI Program course on human subjects social/behavioral research. Team members also met with the Ministry of Gender, Labour, and Social Development (MGLSG) in support of the gender-based violence policy process, Ministry of Health and local government. They also established relationships with the Kampala Capital City Authority (KCCA) and Nakawa and Kawempe probation offices to support legal processes for the GBV survivors. SafeBangle Team also received an award from Defenders Protection Initiative.
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