Health
Researchers Recommend Drug to Win the Malaria War in Children
“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.
“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.
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.
“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.
“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, 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
Health
Makerere Researchers Find Psychological Therapy Effective in Improving Diabetes Care in Uganda
By Nelson Bahati
Researchers from Makerere University‘s School of Psychology have found that psychotherapy intervention can improve the well-being of adults living with Type II diabetes mellitus, opening the door for integrating psychosocial support into diabetes care in Uganda.
The findings were disseminated on 16 June 2026 during a research dissemination workshop held at the Physiology Lecture Theatre at the College of Health Sciences, Mulago Hospital.
Led by Professor Peter Baguma, the study titled “The Effectiveness of Cognitive Behavioural Therapy for Diabetes Distress, Depression, Health Anxiety, Quality of Life and Treatment Adherence among Adult Patients with Type II Diabetes Mellitus” investigated whether Cognitive Behavioural Therapy (CBT), a psychological treatment that has proven effective in Western countries, could also work in the Ugandan context.
Presenting the findings, Professor Baguma said the study was motivated by the growing burden of diabetes and the psychological challenges that often accompany the disease but are rarely addressed in routine healthcare.
“Diabetes affects many people in Uganda and across the world. It kills, and those who live with it face many challenges. While psychological interventions have been developed and applied in the Western world, we did not know whether these approaches could work in Uganda. That is why we decided to undertake this study,” he said.
He explained that Cognitive Behavioural Therapy focuses on changing negative thoughts and behaviours that affect people’s wellbeing and ability to manage chronic illnesses.
The researchers sought to determine whether CBT could reduce psychological distress among diabetes patients and improve treatment outcomes.
The controlled study involved 200 adult participants with Type II diabetes mellitus. One hundred participants received the CBT intervention while another 100 formed the control group. Participants in the intervention arm attended eight counselling sessions over four months, with each session lasting between one and one-and-a-half hours.
The therapy covered several modules, including psychoeducation on diabetes, cognitive restructuring, medication adherence, problem-solving, coping strategies, physical exercise, relaxation techniques and strategies for maintaining treatment.
According to Professor Baguma, the findings showed that psychotherapy significantly improved participants’ wellbeing.
“The group that received the intervention experienced reduced stress levels and lower blood sugar levels compared to those who did not receive the therapy. We conclude that CBT is effective and should be adopted as part of diabetes care,” he said.
The study also yielded another important discovery.
“We have discovered that CBT as practised in the Western world is somewhat narrow. Their manual contains only eight elements. In Africa, we found that three additional components are necessary: effective communication between patients and health workers, goal setting, and instilling hope among patients. We call this African CBT,” Professor Baguma explained.
He added that the findings had also revealed the need to incorporate psychosocial care into the management of chronic illnesses and to train healthcare workers to address the psychological dimensions of disease.
Professor Andrew Marcel Otim, one of the co-investigators and founder of the Uganda Diabetes Association, said the study had brought to the fore an aspect of diabetes care that has long been neglected.
“There have been many efforts to address the physiological effects of diabetes, but we have largely ignored the psychological part of the disease. Yet the psychological aspect is huge,” he said.
He added that, diabetes management should go beyond medication but rather intergrate other components of care.
“Education, nutrition, exercise and self-monitoring are extremely important. Even simply knowing what to do is a very powerful intervention. Psychological distress and depression can increase blood sugar levels, so we need to help patients remain calm and hopeful,” he said.
Drawing from his experience as a clinician and educator, Professor Otim encouraged people living with diabetes to embrace physical activity.
“I tell my students and my patients to put on some music, dance, sweat and enjoy themselves. Nutrition, education and exercise remain central to managing diabetes.”
Dr. Wilber Karugahe, a counselling psychologist at Makerere University‘s School of Psychology and one of the co-investigators, said the findings demonstrate the need to integrate psychological care into the management of chronic diseases.
“A lot of studies focus on physical illness and not the psychological conditions that accompany these illnesses. This study confirms that diabetes has a significant psychological aspect and that patients need psychological interventions as part of their care,” he said.
Explaining the essence of Cognitive Behavioural Therapy, Dr. Karugahe noted that the approach helps people restructure their thoughts and behaviours.
“Imagine putting a sticker on your fridge that reminds you that some foods are not good for you and that healthier options are better. That is CBT. It helps people change the way they think and behave, and it can be used to address many behavioural challenges.”
The dissemination workshop was also attended by officials from the Ministry of Health, including Mrs. Christine Ninsiima Ahimbisibwe, Senior Programme Officer for Mental Health and Substance Abuse Control, and Mrs. Patience Butesi from the Department of Mental Health and Drug and Substance Abuse.
Mrs. Ahimbisibwe welcomed the findings and emphasised the need to integrate the study’s recommendations into Uganda’s clinical guidelines to enable healthcare workers to provide psychosocial support to patients living with chronic illnesses such as diabetes.
The human impact of the intervention was perhaps best illustrated by testimonies from participants who underwent the psychosocial training.
Tebugulwa Josephine, a retired teacher and employee at Mulago National Referral Hospital, said the intervention restored hope in her life.
“When we first joined the programme, we thought we were moving dead people. But now we have hope. I have hope of reaching 90 years. We were taught how to exercise and take care of ourselves. Even our families no longer treat us as sick people because we can now walk and participate in daily activities.”
Another participant, Bunje Joice, described the intervention as life-changing.
“People had already given up on me and were waiting for me to die. I could hardly walk, but now I can walk long distances and my diabetes levels have improved. Physical exercise has become my first medicine.”
Kyomuhendo Kate said the programme helped her manage stress and improve her health.
“I was so stressed and my legs were swelling, but after attending the treatment sessions, I am now much better.”
Sebuliba Bernard said the training transformed how he manages his condition.
“They taught us how to exercise, how to live and how to eat. If we follow what we were taught, we can change our lives.”
Based on the findings, the researchers recommended scaling up the intervention to district, regional and national referral hospitals, integrating psychosocial interventions into the training of health workers, and undertaking policy reforms to strengthen mental health support for people living with chronic illnesses.
The study was funded by the Makerere University Research and Innovations Fund (Mak-RIF) and brought together researchers from psychology and medicine, including co-investigators: Dr. Fredrick Nakwagala, Dr. Wilber Karugahe and Dr. Anne Ampaire.
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