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Researchers Recommend Drug to Win the Malaria War in Children

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Malaria is a terrible disease. It affects you beyond discharge. Once treated for malaria, you are susceptible to more infections, and the chances for re-admission are very high.”

Uganda’s fight against malaria has received a boost after medical researchers recommended that a wonder drug that has produced positive results in Uganda, Kenya and Malawi be embraced globally.

Results of the study showed that treatment with Dihydroartemisinin–Piperaquine (DP) should now be the preferred treatment for malaria in both children and adults after discharge. The trials in children indicated reduced number of deaths from severe malaria by 80 per cent. 

The study-the Malaria Chemoprevention in the Postdischarge management of severe Anemia was carried out over a two-year period at Jinja, Kamuli, Hoima, Masaka and Mubende Regional Referral hospitals and studied 1,049 children with severe malaria, which kills nearly a million people each year, mainly young children and pregnant women.

Dr. Robert Opoka, a Senior Lecturer at the Department of Paediatrics and Children Health, College of Health Sciences, Makerere University

“We focused on those hospitals because those are the areas that are most hit with Malaria.We found out that Children who have been hospitalized with severe anemia in areas of Africa in which Malaria is endemic have a high risk of readmission and death within 6 months after discharge,” said Dr. Robert Opoka, a Senior Lecturer at the Department of Paediatrics and Children Health, Makerere University College of Health Science.

Dr. Opoka noted that they allocated children with severe malaria with antimalarial during the first 3months post-discharge at 2,6 and 10 weeks and they were followed for three months and found out that 80 percent of the children on the antimalarial survived.

“It was observed that there was 70% significant reduction in either deaths or re-admissions among the children receiving the antimalarials compared to the group of children who were not on admission,” Dr. Opoka noted.

Dr. Richard Idro, Senior Lecturer, College of Health Sciences, Makerere University
Dr. Richard Idro, Senior Lecturer, College of Health Sciences, Makerere University

The study, whose findings have been published in the latest edition of the New England Journal of Medicine (NEJM), was funded by the Norwegian Research Council. It involved an international consortium of researchers. Some of the members of the research team from Makerere University College of Health Sciences included: Dr. Richard Idro, Dr. Aggrey Dhabangi and Dr. Robert Opoka

Malaria is caused by parasites that are injected into the bloodstream by infected mosquitoes. Severe malaria is often the main reason why children are admitted to hospital in sub-Saharan Africa, and one in 10 of these children die.

The Ministry of Health 25th Health Sector Joint Review report 2018/2019 showed that malaria was still the leading cause of admissions for all ages accounting for 32.9 per cent of all admissions.

Dr. Aggrey Dhabangi, Lecturer, College of Health Sciences, Makerere University

“The drug has a huge impact on reducing mortality and morbidity in children under five-years recovering from severe malaria. The children who were not on antimalarials developed respiratory distress, complicated seizures, movement disorders, vision impairment, speech and language impairments, cognitive deficits, epilepsy and destructive behavior,” said Dr. Aggrey Dhabangi, a Lecturer at the Makerere University College of Health Sciences.

Dr. Dhabangi noted that DP is available in both private and public pharmacies. And a dose goes for UGX 3,000 for children and UGX 3,500 for adults and it is supposed to be taken for 3days in a month. “(DP) is a reliably oral effective drug, and it is given to children according to weight and it should be given 14days after discharge and later after a month,” Dhabangi noted.

During the meeting held on 3rd December 2020, Dr. Richard Idro, a Senior Lecturer at the Makerere University College of Health Sciences, revealed that further studies in Malawi have demonstrated that delivery of the drugs using community-based approaches is associated with much higher adherence 24% than hospital-based approaches.

Dr. Charles Olaro, Director of Curative Services, Ministry of Health

“These children are readmitted or die because by the time they are discharged from the hospital they have not fully recovered so when they go back home especially to places with high infections, they get attacked again, but with the antimalarial they get protected until they recover and gain their immunity,” Dr. Idro noted. The researchers recommended that after discharge, the children should be given Multi-Vitamin supplementation and use mosquito nets. 

Responding to the findings, Dr. Charles Olaro, the Director of Curative Services at the Ministry of Health, said that he was happy with the research findings and promised to translate the research findings into policy so that Children in Uganda are saved.

Dr. Sabrina Kitaka, College of Health Sciences, Makerere University

“Malaria is still one of the diseases burdening clinical services, so we still need more research and innovations in that area. We need to start up a package where health workers do not only stop at discharging patients but also educate them about the post discharge,” Dr. Olaro, noted. He assured the public that the Ministry of Health had stocked enough Dihydroartemisinin-Piperaquine (DP) for public hospitals.

The Vice Chancellor of Makerere University, Prof. Barnabas Nawangwe who was represented by Dr. Sabrina Kitaka from the College of Health Sciences commended the research team comprising Makerere University researchers for creating a paradigm shift that focuses on only treatment of malaria to a preventive approach that will save lives.  The Vice Chancellor expressed Makerere University’s readiness to review the curricula to include prevention of malaria and chemo prevention in the management of malaria. Noting that the researchers focused on three (3) months after discharge, he appealed to research team to consider an option of extending the period of follow up to six (6) months so that more lives are saved.

Dr. Jimmy Opigo, Assistant Commissioner-Health Services, National Malaria Control Division (NMCD), Ministry of Health

Dr. Jimmy Opigo, the Assistant Commissioner-Health Services at the National Malaria Control Division said: “We are happy that this PMC study has enabled people to realise that treatment of malaria and discharge is not enough. There is need for longitudinal management of those discharged. The medical team and health care workers should add patient education and improve health care practices in the management of malaria.”

Article by Mak Public Relations Office

Mark Wamai

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Makerere University Public Health students recount hands-on experience in Ebola case finding in Uganda

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By AFENET

The first day of the case-finding activity began with an orientation session at the Emergency Operations Center (EOC) offices at the Ministry of Health (MoH). The briefing was led by Dr. Wenani Daniel, Lubwaama Bernard, and Mr. Daniel Kadobera, who provided an overview of the current status of the Ebola Virus Disease (EVD) outbreak caused by Sudan ebolavirus (SEBV) in central Uganda. A key focus of the session was adherence to strict infection prevention and control (IPC) measures including maintaining a safe distance, avoiding direct contact, refraining from entering homes, and not eating or drinking in the field.

To enhance efficiency, the team was divided into three groups, ensuring that each group included at least one clinician for proper assessment of inpatient department (IPD) registers and patient files. The groups were then deployed to their respective sites: Saidinah Abubakar Islamic Hospital, Mulago National Referral Hospital, and a buffer zone within a 2km radius around Saidinah Hospital.

Read full article on AFENET

About AFENET

The African Field Epidemiology Network (AFENET) is a not-for-profit networking and service alliance of FE(L)TPs, and other applied epidemiology training programs in Africa. Makerere University School of Public Health (MakSPH) is one of four founder members of the network that has since grown to 40 members spanning Anglophone, Francophone, and Lusophone Africa.

Mak Editor

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Meet Laura Silovsky, a Makerere University Graduate with Refugee Roots Bridging Continents

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Laura Silovsky (Right) at the graduation ceremony alongside fellow graduands Juma Said Tusubila and Ssali Abdallah Yahya on Day 2 of the 75th Graduation Ceremony. 75th Graduation Ceremony, Day 2, CoBAMS, CHS and CoNAS. 14th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.

On Tuesday January 14, 2025, under the radiant rays of the Ugandan sun, Laura Silovsky crossed the stage at Makerere University’s 75th Graduation Ceremony to receive her master’s degree in Public Health Disaster Management (MDM). Hers is a story of passion, dedication, and curiosity to rewrite the narrative of global education. Among 1,813 master’s graduates, Laura’s story stood out, as a blend of refugee roots, firefighting bravery, and a drive to decolonize learning.

Laura’s journey began long before her arrival in Kampala. Born in the UK to a father who fled from Czechoslovakia’s dictatorship in the 1970s, she grew up understanding displacement intimately. “My father was a refugee. Why would I fear refugees?” she once asked during her research fieldwork in Uganda’s West Nile, where her empathy bridged divides.

“People in Uganda may not expect that a muzungu could be the child of a refugee, but my family experienced displacement from (what was then) Czechoslovakia as well as the effects of the protracted conflict in Northern Ireland. Fortunate to have been born in the UK, I was raised to appreciate that disasters can affect anyone, anywhere, anytime.

After studying Sustainable Development at the University of Edinburgh, I worked on a behavior change project tackling non-communicable diseases in Scotland,” Laura says.

Laura Silovsky outside MakSPH on graduation day. 75th Graduation Ceremony, Day 2, CoBAMS, CHS and CoNAS. 14th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Laura Silovsky outside MakSPH on graduation day.

Her journey twisted through battling Australia’s bushfires and volunteering in a COVID pandemic, but it was Uganda’s welcoming refugee policies and Makerere University’s academic excellence that pulled her in next.

“In 2020, I relocated to Australia, just after the worst bushfires since records began and before the COVID-19 pandemic. The following two years, I qualified as a firefighter and supported bushfire recovery by volunteering with a community-based organization. After gaining some insight into these different disasters, I made the decision to return to higher education, and so I applied for the MDM programme at Makerere in 2022,” says Laura.

Armed with experience in emergency response, Laura was drawn to the field’s multidisciplinary nature and was convinced she needed to expand her expertise beyond immediate recovery efforts. She aimed to explore the full disaster management cycle and the intricate connection between health and environment.

“I needed to combine gaining academic knowledge with developing practical skills, so the field placement offered within the master’s degree in Public Health Disaster Management programme was a major motivator for me,” she shared.

The love for Uganda

Studying at the University of Edinburgh, Laura took a class in Kiswahili, that included a field-based short course on the Tanzanian shores of Lake Victoria. This experience sparked a desire to spend more time in the region, but she knew she needed to expand her skill set in order to genuinely add value to an organisation, if she was on the continent.

“I hoped studying at an East African university would teach me invaluable soft skills needed to work more effectively as an international team member. Makerere University School of Public Health (MakSPH) has a strong reputation, and I wanted to study somewhere that was locally grounded but globally recognized. Uganda’s progressive refugee policies were an added incentive to learn from experts here,” Laura says.

Laura’s intentional choice to decolonize her education

“I came to Uganda to learn from the experts here,” Laura declared, rejecting Eurocentric frameworks. “A big factor for me wanting to study at Makerere University was to decolonize my education, to recognize that the knowledge about responding to public health disasters and supporting refugees is here in Uganda,” she says.

She adds, “When I first arrived, I was quite vocal with my classmates about wanting to challenge that bias and truly acknowledge the wealth of knowledge within institutions like Makerere. The expertise here is invaluable, and I was intentional about decolonizing my education.”

Laura Silovsky with some of the 2022 MDM cohort outside MakSPH building after an exam. 75th Graduation Ceremony, Day 2, CoBAMS, CHS and CoNAS. 14th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Laura Silovsky with some of the 2022 MDM cohort outside MakSPH building after an exam.

At MakSPH, Laura immersed herself in courses like epidemiology, struggled briefly with statistics, but thrived on critical discussion groups and consultation with lecturers.

Collaborating with classmates from Uganda and across East Africa, she learned Luganda phrases and Somali proverbs, and built a “family” united by late-night study sessions and shared ambitions.

Beyond expectations

For Laura, studying at MakSPH was the best decision she could have made. She is still struck by the faculties’ wealth of academic and professional experience in public health and disaster management.

“I anticipated the programme would focus on applying the knowledge we gain to real-world scenarios. Of course, there were cultural differences that took me time to adjust to. I am grateful to faculty members such as Prof. Christopher Garimoi Orach, for his dedication and support, Prof. Elizeus Rutembemberwa for leading by example and valuing students’ time, and Dr. Justine Bukenya and Dr. Simon Kibira for offering their extensive support as my dissertation supervisors.”

The Fieldwork Attachment that Transformed Laura’s Research Experience

At Rhino Camp refugee settlement in West Nile, Laura’s work took on new meaning. Partnering with the Uganda Red Cross Society, she helped digitize data tools and walked long distances through Tika Zone, inspecting latrines and speaking with South Sudanese girls about their challenges in managing their menstrual health through their project that focused on schools.

Laura Silovsky conducting focus group discussions in a school in Rhino Camp in Northern Uganda with a team from the Uganda Red Cross Society. 75th Graduation Ceremony, Day 2, CoBAMS, CHS and CoNAS. 14th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Laura Silovsky conducting focus group discussions in a school in Rhino Camp in Northern Uganda with a team from the Uganda Red Cross Society.

“That experience in West Nile influenced my own research ideas, and it was a privilege to later return to Rhino Camp for data collection. I will always remember the long days walking with my research assistants through villages and being graciously welcomed by so many respondents,” she recalls, noting that the experiences crystallized her resolve to advocate for refugee dignity globally.

Life in Kampala  

Life in Kampala, with its vibrant energy and unique challenges, was truly a ‘full sensory experience’ for Laura. “My parents live in a small village, so Edinburgh felt like a big city when I moved there. And Edinburgh is much smaller and quieter than Kampala! But on weekends, I loved going downtown to shop at Owino Market or heading to Kyadondo Rugby Club for some pork.”

These spaces were perfect for Laura, offering new cultural experiences, including matooke, a starchy dish not found in the UK, which is mainly eaten in Uganda as a local delicacy and staple meal. Despite the differences in culture, sharing meals with classmates provided Laura with a comforting sense of connection.

Back to academics, navigating the university administrative processes wasn’t seamless initially for Laura, though. She says administrative hurdles such as paper-based systems, could change for the university to comfortably enjoy its strong reputation.

She recalls, right at the beginning, when she couldn’t find sufficient information online to support her to complete her application to join Makerere University. However, she later received support from the University’s International Office that deals with the welfare of international students.

Other university officials, from finance, librarians, program administrators, to academic registrars, played a key role in supporting her in her research and postgraduate training. “The system relies on dedicated individuals,” she noted, calling for digital reforms while praising MakSPH’s “atmosphere of innovation.”

“From my experience, such as when obtaining my transcript, the system relies heavily on individual staff members working around these administrative challenges. I’m grateful for those who helped me navigate this, and I’m interested to see how the university continues its digital transition, as it could greatly streamline processes in the future,” says Laura.

A Bittersweet Graduation Day

On graduation day, Laura’s pride mingled with melancholy. Watching families cheer on graduates, she reflected on classmates sidelined by finances or family crises.

Having gone through the course and interacted with Ugandan students, Laura hints on the common financial and personal challenges preventing many from graduating: family illness, new children, sponsorship falling through.

“I know so many of my classmates had worked so hard and were almost over the finish line but, due to financial challenges or other commitments at home, it wasn’t possible for them to graduate this year,” she says.

“For me, I was able to make the choice to pursue this program before having children, so I had fewer responsibilities at home, and I had also been saving for many years to get the money to pay tuition. Because I knew I had the money for tuition before I started, I could focus on studying. As you know, the reality for many people is that that’s not always possible.

“Small supports can transform student experiences,” Laura emphasized, advocating for systemic empathy. She sees great potential for more pastoral support at the university, citing peers from UCU and Kyambogo who benefited from accommodations like private breastfeeding spaces and flexible deadlines in special circumstances. Such initiatives, alongside financial aid, could significantly improve student welfare.

Still, the ceremony’s electric energy—watched via livestream by her parents in Europe—symbolized hope. “Uganda taught me that collaboration transcends borders,” she reflected.

Laura Silovsky (Right) at the graduation ceremony alongside fellow graduands Juma Said Tusubila and Ssali Abdallah Yahya. 75th Graduation Ceremony, Day 2, CoBAMS, CHS and CoNAS. 14th January 2025, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Laura Silovsky (Right) at the graduation ceremony alongside fellow graduands Juma Said Tusubila and Ssali Abdallah Yahya.

“You could feel this sense of how hard everyone had worked to reach up to that point and that this was really an opportunity for them to celebrate, particularly by having family and friends around to be able to see. I love the PhD awards, when you see the PhD students coming out and their families rushing up to greet them. To me, that’s the best part of the ceremony, because a PhD requires so much work and commitment, and I think it’s really emotional to see everyone share this moment with their support networks,” she says.

Adding that; “…I was so grateful that the ceremony was streamed online. My family were watching live at home in Europe and it was so special that they could see me on camera and participate in the ceremony that way as well.”

Laura noted striking similarities between Makerere and Edinburgh’s ceremonies, especially the moment when students were asked to turn and thank their families, an emotional and powerful tradition.

Looking Ahead

Now in Tanzania, Laura eyes roles with international NGOs, armed with Ugandan-taught pragmatism and a zeal to challenge Europe’s refugee policies. “MakSPH gifted me more than a degree—it reshaped my worldview,” she says.

“As a muzungu with a Ugandan postgraduate education, I feel privileged to have benefitted from different educational perspectives, and I hope that the skills and knowledge I acquired during my time at Makerere will help me to secure a role with an international NGO. After witnessing the incredible support that Uganda provides to refugees, I also hope to advocate for more dignified policies concerning refugees in Europe,” she shares.

“There’s a spirit of innovation and dedication at Makerere, particularly when passionate lecturers like Prof. Orach, Dr. Roy Mayega, or Dr. Victoria Nankabirwa engaged students through discussion and sharing lived experiences. You could really see a different level of engagement within the students as well. Overall, I’ve had such a fantastic experience at Makerere University.”

“I wouldn’t change a thing,” she smiles.“Except maybe convince more Europeans to study here. Africa’s wisdom is the future.”

Davidson Ndyabahika

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Exciting PhD Opportunity in Health Innovation – Starting 2025

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The NTU-Mak delegation posing with some of the community health workers at the field office in Nakawuka, Wakiso district.

We are happy to share this exciting PhD studentship opportunity through the NTU-Makerere University partnership under the theme Health Innovation. Starting in 2025, this project will focus on One Health drivers of antibiotic-resistant bacterial infections in rural Ugandan communities.

The research will combine microbiological and public health approaches to explore the prevalence, transmission, and contributing factors of antibiotic-resistant bacteria in these communities. Key research questions include:

  • What human, animal, and environmental factors contribute to the spread of antibiotic-resistant bacteria?
  • How can Community Health Workers (CHWs) help mitigate their spread?

Requirements:

  • Essential: Willingness to spend time in both Uganda and the UK during the project and proficiency in Luganda.
  • Desirable: Wet lab microbiology skills.

For full details, visit:
<https://www.ntu.ac.uk/study-and-courses/postgraduate/phd/phd-opportunities/
studentships/health-innovation-phd-studentships/one-health-drivers-of-antibi
otic-resistant-bacterial-infections-in-rural-ugandan-communities
> NTU Health Innovation PhD Studentships.

Application Deadline: Friday, 14 February 2025.

For inquiries, contact Dr. David Musoke at dmusoke@musph.ac.ug or Jody Winter at jody.winter@ntu.ac.uk.

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