MEPIE

Severe malaria remains a public health problem despite intense implementation of multipronged preventative methods and effective antimalarial drugs in the past decade. In the sub Saharan Africa, the disease killed an estimated 475,000 children in 2013, especially in the under 5year olds. Malaria research is priority in the draft Uganda National Research Agenda (2015).

However, capacity to initiate and conduct high quality clinical research on malaria in Uganda still lags behind that in other areas such as HIV. There is a paucity of data especially from applied malaria research. These trends suggest limited capacity to conduct comprehensive high quality malaria research. Evidently, trials in general constitute only 16% of all clinical research conducted in Uganda, and about 5% of all research registered by the Uganda National Council for Science and Technology (UNCST). Trials on malaria remain among the least in number. Of these malaria trials, research questions are often formulated with little involvement of the local Uganda collaborators, or consultation of the country’s research.

The methods in this Senior Fellowship include a number of approaches.

Firstly, to systematically deliver on the research aims and objectives of this project.

Secondly, in a “Target-Indicator-Activity” framework, I will work with my mentors to strengthen my research capacity on malaria through achievement of clear milestones on specifically needed skills and competences on epidemiology, pathophysiology and conduct of Phase I/II clinical trials.

And lastly, to build research capacity through hands-on mentorship training of 2 masters’ students selected to tackle complementary fields in malaria research with the aim of contributing to the building of a vibrant research team in Eastern Uganda (www.mcri.ac.ug).

Using this framework we will conduct studies on:
(i) Malaria epidemiology.
(ii) Epidemiology and Pathophysiology of Acute Kidney Injury (AKI) in childhood severe malaria, and
(iii) A nested clinical trial on feasibility of use of paracetamol in ameliorating AKI in children with haemoglobinuric severe malaria.

We will use each of the above (i) – (iii) study areas as practicum training areas for hands-on mentorship of two masters students on malaria and clinical trials.

We target 5 key publications from our work including:
(i) A publication on malaria epidemiology
(ii) Pathophysiology
(iii) Acute kidney injury in severe malaria
(iv) Outcomes of phase I/II study on paracetamol in acute kidney injury in severe malaria
(v) Methods of capacity building through hands-on training in resources limited setting.

These publications will inform academia, practice and design of future clinical trials on malaria. The Senior Fellow will in addition acquire skills in advanced research methods and applied epidemiology.

RESEARCH ACTIVITIES

SEVERE MALARIA SURVEILLANCE

Status:Ongoing
About the study:Malaria epidemiological study through a surveillance of all admissions of severe malaria at Mbale Regional Referral Hospital. During this study, prevalence and pathophysiology of acute kidney injury are being undertaken at Mbale Regional Referral Hospital that allows collection of phenotypic and laboratory data for characterization of this condition in Eastern Uganda.
Mbale Regional Referral Hospital Research Ethics Committee Approval #: MRRH REC OUT 003/2019 Uganda National Council for Science and Technology Approval #: HS 2555

ACUTE RENAL INJURY IN CHILDHOOD SEVERE

Status:Under approval process
About the study:About the study: This is a nested clinical trial on the use of paracetamol in ameliorating Acute Kidney Injury (AKI) in haemoglobinuric malaria.
Sponsor: Mbale Clinical Research Institute, www.mcri.ac.ug
Insurance Policy Number: 051-HO-506963-19
Mbale Regional Referral Hospital Research Ethics Committee Approval #: MRRH REC OUT 002/2019
Uganda National Council for Science and Technology Approval #: Pending
National Drug Authority Approval #: Pending

PUBLICATIONS

1.Manuscript 1: Developing Research Capacity Through EDCTP Senior Fellowship in Eastern Uganda.
2.Manuscript 2:Risk Factors and Outcomes of Blackwater Fever in Eastern Uganda