Dr. Richard Idro makes his presentation at the National Dissemination and Policy Dialogue on Post Discharge Malaria Chemoprevention, 3rd December 2020, Golden Tulip Hotel, Kampala Uganda.
“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
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.
“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.”
Makerere University is pleased to announce a vacancy for the position of Assistant Administrative Officer (REC Administrator) within the School of Biomedical Sciences Research Ethics Committee (MakSBSREC). This is an excellent opportunity for qualified individuals to contribute to the ethical oversight of research involving human participants.
Duration: 1 Year, renewable upon satisfactory performance
Duty Station: Kampala
Qualifications, Desired Skills, and Experience:
Bachelor’s degree in Social Sciences and Humanities, Medicine and Surgery, Ethics and Human Rights, or any related field.
Master’s degree in Bioethics (an added advantage).
Up-to-date training in Human Subject Protection or Good Clinical Practice.
Proficiency in English (both spoken and written).
Prior experience in regulatory work in research studies or projects.
Excellent communication, organizational, and interpersonal skills.
Ability to work independently with minimal supervision and meet deadlines.
How to Apply:
Qualified and interested candidates are invited to submit a soft copy of their application documents and a motivation letter to deansbs.chs@mak.ac.ug with the subject line “Application for the position of Assistant Administrative Officer (REC Administrator)”. Address your application to the Dean, School of Biomedical Sciences.
Deadline for submission: July 2, 2024, by 5:00 pm Ugandan time.
Please provide a reliable 24-hour phone contact. Only short-listed candidates will be contacted for interviews.
The Makerere University College of Health Sciences (MakCHS) in conjunction with the Uganda National Association for Community and Occupational Health (UNACOH) announces the 18th Joint Annual Scientific Health Conference (JASHC), the 30th UNACOH Conference, the 22nd Mathew Lukwiya Lecture scheduled to take place from 16th – 18th October 2024, at Hotel Africana, Kampala – Uganda.
Conference Theme: Global Health Security: Partnerships for Epidemic Response and Control in Sub-Saharan Africa
Researchers, health workers, policymakers, students, and public/civil society members are invited to submit abstracts.
Deadline for submission of Abstracts: August 15th 2024
See the Downloads for more information
For more information contact Conference Secretariat: Makerere University College of Health Sciences, 1st Floor, Pathology Building, School of Biomedical Sciences, Dean’s Office, P.O. Box 7072 Kampala, Uganda. Email: jashc2024@gmail.com Website:https://chs.mak.ac.ug/jash2024 Tel: +256784574544/+256759287297
The Monitoring and Evaluation Technical Support (METS) Program is a 5-year CDC-supported collaboration of Makerere UniversitySchool of Public Health (MakSPH), the University of California San Francisco (UCSF) and Health Information Systems Program (HISP Uganda).
Highlights of the METS May 2024 Newsletter
Enhancing Response to Sexual and Gender-Based Violence
Responding to and preventing Sexual and Gender-Based Violence (SGBV) and Violence Against Children (VAC) are critical components of Uganda’s national HIV prevention program. METS developed a new app designed to improve support for SGBV survivors. This followed an assessment in December 2022, that revealed gaps in service access and coordination in Fort Portal and Kampala Regions.
The METS team, in collaboration with regional implementing partners, is scaling up the app’s use in pilot districts such as Masaka, Kiryandongo, Fort Portal, and Mubende. The team visited facilities and police stations to install the app and train selected focal persons on its use.
Assessing Readiness for Integrated HIV and NCD Care Services
METS supported the Ministry of Health to conduct a site readiness assessment for integrated delivery of HIV and Non-Communicable Diseases (NCD) services from 22nd to 26th April 2024, in collaboration with the US Centers for Disease Control and Prevention (CDC), and various implementing partners. The activity was conducted in selected health facilities in Acholi, Mubende, Kayunga, and Rwenzori regions to determine their feasibility for participating in a comprehensive NCD evaluation.
The 48 facilities visited have already integrated NCD services (mental Health, diabetes, and hypertension). Of these, 78% have integrated mental health services in their PMTCT clinics. 40% of the facilities have a dedicated NCD services physicians /doctor in the ART Clinic, 29% have doc have dedicated physicians in the PMTCT clinics. 90%. Most of the facilities have clinical and nurses in the ART than PMTCT facilities but more nurses offering NCD services in PMTCT sites.
Digitalizing the health sector through strategic partnerships
In collaboration with CDC and METS, the MoH organized a national Electronic Medical Records (EMR) stakeholders meeting to orient stakeholders on the national EMR agenda and transition towards a comprehensive digital health facility package. Key actions discussed included expanding the rollout of the EMR and Community Health Information System (eCHIS) and urging development partners to support prioritized health information and digital health investments.
The introduction of electronic medical records (EMRs) in health facilities aims to improve the quality of health service delivery by providing real-time accountability transparency, and traceability of medical supplies, monitoring health worker absenteeism, enhancing patient satisfaction through efficient care provision, reducing unnecessary or duplicate diagnostic tests, and offering easy access to management reports for decision-making. Additionally, EMRs will lay the foundation for the implementation of national health insurance.
UgandaEMR+ Implementation Showcased at Kisenyi HCIV
METS and Reach Out Mbuya (ROM) showcased the implementation of UgandaEMR+ to representatives from the USG and the Ministry of Health (MoH) at Kisenyi HCIV. The visit was aimed at providing a clear understanding of the system’s functionality at the health facility, which serves over 1,200 outpatients daily and supports over 1600 clients on ART.
Dr. Peter Akonyera, the ART Clinic In Charge shared positive end-user experiences, noting simplified data use and analysis, efficient data retrieval, and the system’s popularity among users despite existing challenges. He appreciated METS’ support in maintaining system synchronization. The data visualization tools have been particularly useful for clinicians to manage patient schedules and workload distribution effectively, ensuring timely and efficient healthcare delivery.
METS Showcases Research at INTEREST 2024 Conference in Benin
The International Conference on HIV Treatment, Pathogenesis, and Prevention Research (INTEREST) brought together global scientists to share cutting-edge knowledge in HIV diagnosis, treatment, and prevention. The conference also aimed to build a community of African physicians and scientists to develop local solutions for managing HIV and preventing its transmission.
METS submitted an abstract titled “Enhancing HIV Case Identification through a National HIV Testing Services (HTS) Continuous Quality Improvement” based on support to the Ministry of Health (MoH) in designing, implementing, and evaluating initiatives to increase the identification of HIV-positive clients, crucial for achieving the global target of 95% of people living with HIV (PLHIV) knowing their status.
Gallery
New CDC Director meets Country implementing partner Executive Directors
UgandaEMR+ support supervision at Kisenyi HCIV visit