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Researchers call for interventions to support HIV/AIDS prevention among University Students

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Researchers at Makerere University College of Health Sciences have given recommendations on how the education and health sectors can support HIV/AIDS prevention among students.

The researchers advised that the health sector should develop communication strategies and materials specific to university students and increase support to provide youth-friendly HIV prevention services at universities. The education sector working with University management should include: life skill programs during orientation of new students; HIVST delivery through peers and freshman orientations; Increase sensitization & access to PEP/PrEP by high-risk students; and update and disseminate institutional HIV policies.

The recommendations were made at a dissemination meeting for a study titled ‘HIV risk and factors associated with use of novel prevention interventions among female students at Makerere Universityheld on the 30th September 2022 at the Food Science & Technology Hall, Makerere University Campus.The study funded by Government of Uganda through the Makerere University Research & Innovations Fund (MakRIF) was conducted by Dr. Lorraine Oriokot (Principal Investigator), Dr. Ivan Segawa, Dr. Sabrina Bakeera-Kitaka, Dr. Andrew Mujugira and Ms. Sharon Okello.

The objectives of the study were: to know the percentage of female students at risk of HIV; and to know the characteristics of students that have used the newer HIV prevention methods, which are HIV self-testing; Pre-exposure prophylaxis; and Post-exposure prophylaxis.

A total of 534 female students with an average age of 22years completed the survey. The results and findings of the study were:

  • Behavioural characteristics (12% of the respondents were in multiple sexual relationships; 21% of the respondents had a partner ≥ 10 years from their age; 29% of the respondents used emergency contraceptive (in the past 6 months); 21% of the respondents had never tested for HIV; and 10% of the respondents believed that they were at high risk for HIV)
  • The study considered a person was high risk if they: Had a partner who was HIV positive; Had multiple sexual relationships, anal or transactional sex; Used drugs especially injectable drugs; Had 2 or more sexually transmitted episodes in one year; Were pregnant or breast feeding; Were or had partners who sex workers, fishermen, long-distance truck driver, boda-boda rider, or army officers
  • Overall, 21% students were deemed high risk for HIV; 19% of students had ever used HIV self-test kits; 64% had ever heard of oral HIVST; 93% were willing to use HIVST; HIVST was more likely to be used by older students; HIVST can bridge the HIV testing gaps among students
  • 80% had ever tested for HIV far below the global targets of 95%; Self-test kits are freely available at the University Hospital; Test kits can be purchased over-the-counter in pharmacies
  • For PEP it was found that:3% of students had ever used PEP; 9% among those eligible for PEP; 70% had ever heard of PEP; 65% were willing to use PEP; PEP use was linked to having a partner and high-self risk perception; PEP is currently the only way to reduce the risk of HIV infection in an individual who has been exposed to HIV; PEP is available at Makerere University Hospital at no cost
  • For PreP it was found that:1% of students had ever used PrEP; 2% among high-risk students; 45% had ever heard of PrEP; 52% were willing to use PrEP; PrEP has been linked with decreased new infections of HIV; PreP is currently available as oral tablets. Vaginal rings and injectable forms are being tested for wide roll out; and PrEP is available at KCCA health facilities and facilities offering HIV care.

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MNCH e-Post Issue 122: Integrated Intervention Package Increases Health Facility Births – New Study

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Pregnant woman with midwife. Photo by Iwaria Inc. on Unsplash

By Joseph Odoi

In a significant stride towards improving maternal healthcare outcomes, a recent study conducted by researchers has shown that an integrated intervention consisting of peer support, mobile phone messaging, and provision of mama kits at the household level is successful in increasing the proportion of facility-based births. This groundbreaking research comes at a time when Uganda is still grappling with a very high maternal mortality ratio estimated at 336 deaths per 100,000 live births and neonatal mortality rate also at 22/1000 live births.

In the 2024 BMJ Published study titled “Can an integrated intervention package including peer support increase the proportion of health facility births? A cluster randomized controlled trial in Northern Uganda by researchers namely;  Dr. Victoria Nankabirwa and a team including David Mukunya, Grace Ndeezi, Beatrice Odongkara, Agnes A Arach, Vicentina Achora, Levi Mugenyi, Mohammad Boy Sebit, Julius N Wandabwa, Paul Waako, Thorkild Tylleskär, and James K Tumwine, sought to evaluate the effect of the integrated intervention package on increasing the proportion of health facility births compared to routine government health services. Read More

Click here to View the full MNCH e-Post Issue 122

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CALL for Applications for the SMART4TB Early-Stage Investigator (ESI) Scholar Program

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CALL for Applications for the SMART4TB Early-Stage Investigator (ESI) Scholar Program.

SMART4TB Early-Stage Investigator (ESI) Scholar Program
Cohort 2 Phase 1 Now Open for Applications
Applications Due March 14 2024
Call for applications

Supporting, Mobilizing, and Accelerating Research for Tuberculosis Elimination (SMART4TB) is an initiative made possible by the generous support of the American people through the United States Agency for International Development (USAID) that aims to transform TB prevention and care. SMART4TB has launched an important capacity strengthening activity, the Early-Stage Investigator (ESI) Training and Mentorship Program. The program’s main objective is to train and support young investigators to develop, implement, and lead their own studies aligned with their national and local TB research priorities.

Investigators within 10 years of receiving their most recent degree or who are new to TB research, based at an institution participating in SMART4TB studies, and supported by their local institutional leadership will be eligible for participation in the program. The program has 4 sequential phases, each with specific eligibility criteria and deliverables required before advancing to the next phase.

Completion of all 4 phases will require the ESI to commit to an intensive training curriculum that includes: 1) Specific courses focused on competencies required for the design, implementation, and analyses of TB research 2) Close 2:1 mentorship from both a local and a SMART4TB faculty research mentor; and 3) Access to technical support consultations from SMART4TB experts.

Progress from one Phase of training to the next Phase will be a competitive process and is not guaranteed. ESI who successfully complete all Phase 1 requirements (Scholars Program) will be eligible to apply and compete for Phase 2 (Fellowship Program). Phase 2 applicants that are approved by SMART4TB and USAID will be required to identify a local senior research mentor. ESI enrolled in Phase 2 will also be matched with a SMART4TB faculty co-mentor. The SMART4TB Training and Mentorship Committee (TMC) will monitor the ESI’s progress throughout the program and assess the quality of the training and mentorship provided to the ESI. In Phase 2, each SMART4TB Fellow will be mentored to develop a full research proposal for which they will serve as lead investigator. ESIs who receive approval and support to initiate their research project can apply for Phase 3 and Phase 4 of the program.

Prerequisite
Phase 1 Eligibility and Application Process ESI interested in applying for Phase 1 of this program must meet the following criteria:

  • Having a PhD as the most recent degree or are new to TB research; and
  • Be from a National TB Program (NTP) or institution/site participating in SMART4TB
  • USAID-approved studies; and
  • Have a letter of support from their local SMART4TB site/institutional leadership (signed on institutional letterhead).

All applications will be reviewed by the SMART4TB ESI Mentorship Advisory Committee. Final selection of Phase 1 participants will require USAID approval. Selected ESI will be notified by email.

The Secretariat, SMART4TB Early-Stage Investigator (ESI) Scholar Program Walimu
Unit 4, Plot 5-7, Coral Crescent
P.O Box 9924 Kampala-Uganda
Deadline for receiving applications: 14th March 2014 by 5pm.
Only short-listed candidates will be contacted.

Additional information
To apply for Phase 1 of this program,
please click: https://jhmi.co1.qualtrics.com/jfe/form/SV_0NiIqASiPJ92GRE
For details about the Phase 1 curriculum and the progress report from the first Cohort, please see the attachments.

For an overview of SMART4TB,
please click here: https://tbcenter.jhu.edu/smart4tb/
For more information about SMART4TB Capacity Strengthening Activities,
please click: https://tbcenter.jhu.edu/wp-content/uploads/2023/03/TA6 Overview.pdf

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Makerere University Research shows challenges facing Forcibly Displaced Persons (FDPs) with Chronic Disease in Northern Uganda

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Left to Right: Dr. Esther Nanfuka Kalule, a postdoc fellow on this study; Emma Ikwara, a researcher at CHDC; PhD student Onesmus Kamacooko at CHDC and Dr. Ritah Nakanjako interacting after the colloquium.

By Agnes Namaganda

Preliminary findings from a study by Child Health and Development Centre (CHDC) -Makerere University have revealed several challenges faced by Forcibly Displaced Persons (FDPs) with chronic diseases like diabetes, hypertension and cardiovascular diseases. This study is specifically looking at FDPs in northern Uganda. Accessing food, water, medicine, clothing, toilet facilities, privacy and support is a challenge for healthy FDPs but for those with chronic diseases, these provisions may mean the difference between life and death.

According to Drs, Ritah Nakanjako and Esther Nanfuka Kalule, who are post-doc fellows at Makerere University, FDPs with chronic diseases are unable to access facilities with medicines. Speaking at the February monthly colloquium of CHDC, Dr. Nanfuka said, “Medicines and medical forms are sometimes forgotten by these patients yet some do not know the names of their medicines. For others, these medicines get finished along the way due to the abrupt movements.” These disturbances in the continuity of care affects their health and wellbeing.

Left to Right: Dr. Esther Nanfuka, Dr. Ritah Nakanjako, Dr. Godfrey Siu who is giving the presenters feedback about their presentation and Dr. Aggrey Dhabangi.
Left to Right: Dr. Esther Nanfuka, Dr. Ritah Nakanjako, Dr. Godfrey Siu who is giving the presenters feedback about their presentation and Dr. Aggrey Dhabangi.

As an example, she referred to the constant need to monitor blood pressure or blood sugar for these FDPs. “Even when facilities are available, you may not have the money to refill medicines or you may not remember the name of the medicine.” She added that the stress and trauma of this kind of situation usually exacerbates these conditions.

Speaking about the rationale for doing this research, Dr. Nakanjako said that non-communicable diseases (NCDs) are largely unrecognized and inadequately addressed in humanitarian settings, something which the Red Cross calls ‘a neglected crisis’.  Yet, studies conducted among refugees and asylum seekers across the world report a high burden of NCDs. Uganda hosts over 1.5m refugees, the highest proportion in sub-Saharan Africa with the majority comeing from South Sydan.

“The objective of this study is to examine the experiences of FDPs- which will contribute to knowledge on innovative ways of chronic disease care. This will also contribute to the management of NCDs in humanitarian, low resource settings,” Dr. Nakanjako explained.

Dr. Godfrey Siu (Left) and Dr. David Kyaddondo who is the Principal Investigator of this project interacting with other members of CHDC after the CHDC monthly colloquium which takes place every last Wednesday of the month.
Dr. Godfrey Siu (Left) and Dr. David Kyaddondo who is the Principal Investigator of this project interacting with other members of CHDC after the CHDC monthly colloquium which takes place every last Wednesday of the month.

This 5-year study that started in 2022 will run till 2026 and is funded by the Novo Nordisk Foundation under the Mobility-Global Medicine and Research Fund. It is a collaboration between three institutions; Makerere University, the University of Copenhagen, Denmark and the Sudan Centre for Strategic and Policy Studies in South Sudan. This research is taking place in Nyumanzi Reception Center in Adjumani district; Nyumanzi Refugee Settlement also in Adjumani district; IDP Settlements in South Sudan; and the Bidi Bidi Refugee Settlement in Yumbe District.

Other challenges revealed by the FDPs with chronic diseases include the fear of drinking recommended amounts of water before or during travel to manage urine and to avoid stop-overs for security reasons.

After arrival at Nyumanzi Reception Centre in Uganda, these FDPs with chronic diseases do not receive any special care. It is only those with communicable diseases like TB. Cholera or Covid19 that get special care. Other challenges include; “a limited range of drugs, maintenance of cold chains for insulin, rationed water, lack of drinking water, lack of sanitary facilities and the congestion.

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