Uganda

Health indicators are improving in certain regions of Uganda, yet many deaths are caused by preventable diseases such as malaria and HIV/AIDS. According to WHO, HIV/AIDS has a national prevalance of 5.4% and is the leading cause of death among adults, followed by tuberculosis (TB) and malaria. In addition, UNAIDS reports that HIV/AIDS is responsible for nearly half of the Ugandan orphan population, which exceeds an estimated two million. Uganda is one of 15 US President's Emergency Plan for AIDS Relief (PEPFAR) focus countries currently receiving support for comprehensive HIV/AIDS prevention, treatment and care programs.

CCGHE RESPONDS

CCGHE has partnered with Medical Education Services to All Ugandans (MESAU), a consortium of five Ugandan medical schools, to provide support among five strategic areas: monitoring and evaluation, research capacity building, IRB strengthening, curriculum development and information technology (IT)/distance learning. Accordingly, CCGHE and colleagues in Uganda have engaged in a number of in-country education, distance learning and mobile technology initiatives, including development of mHealth tools to optimize HIV prevention efforts, continuing clinical education conferences and courses, building in-country capacity in curriculum development and distance learning, and interprofessional team-building among physicians, nurses, pharmacists, medical students and administrators.

CCGHE-UGANDA ACTIVITIES

Community Health Workers, mHealth, and Combination HIV Prevention in a Hotspot: A Randomized Trial (mLAKE)

Post Date: 
2015-04-01
Country: 
Led by Dr. Larry Chang, the mLAKE study in Uganda is examining whether community health workers equipped with cellphones and the emocha Mobile Health platform are able to successfully promote HIV treatment and prevention services in households in a fishing community in East Africa with a very high...

PreventionRx Study: Home-based Counseling and Testing in Uganda

Post Date: 
2014-08-27
Country: 
A ‘platform’ for evaluating combination HIV prevention & care-HIV counseling & testing is essential to optimize HIV services. In collaboration with the University of Washington and the Integrated Community Based Initiatives (ICOBI) NGO in Uganda, CCGHE has adapted the emocha ® platform to...

Evaluating Demand Generation (Stylish Man) for HIV/Family Planning Services, Rakai, Uganda

Post Date: 
2014-08-01
Country: 
Dr. Larry Chang is co-investigator of this effort to test a novel approach to promoting HIV services in Rakai, Uganda. The Stylish Man Program, attempts to “demedicalize” HIV prevention and care in a public health campaign designed to normalize HIV care as part of self care for African men. The...

A5288: MULTIOCTAVE, Management Using the Latest Technologies in Resource-limited Settings to Optimize Combination Therapy After Viral Failure

Post Date: 
2012-07-16
The study is being done to test a strategy of using a resistance test to choose anti-HIV drugs. Resistance tests look at the HIV in your blood to see which drugs might work best to lower your HIV infection. see how well combinations of new anti-HIV drugs work to lower HIV infection see if taking...

Analysis of Data Collected from the Evaluation of Community-Based Education, Research and Service (COBERS)

Post Date: 
2012-06-12
Country: 
Makerere University College of Health Sciences (MakCHS), the Medical Schools at Gulu University (GU), Mbarara University of Science and Technology (MUST), Kampala International University (KIU) and Busitema University (BU) came together with Johns Hopkins University (JHU) in 2010 to form Medical...

P1077BF: Breastfeeding Version of the PROMISE Study (Promoting Maternal and Infant Survival Everywhere)

Post Date: 
2010-02-02
1077BF is a randomized strategy trial, which is part of the PROMISE studies (1077BF, 1077FF, P1084s, and 1077HS). The Promoting Maternal and Infant Survival Everywhere (PROMISE) Protocol is a research protocol of the IMPAACT network designed to address in an integrated and comprehensive fashion...

P1077FF: Formula Feeding Version of the PROMISE Study (Promoting Maternal and Infant Survival Everywhere)

Post Date: 
2010-02-02
1077FF is a randomized strategy trial, which is part of the PROMISE studies (1077BF, 1077FF, P1084s, and 1077HS). The Promoting Maternal and Infant Survival Everywhere (PROMISE) Protocol is a research protocol of the IMPAACT network designed to address in an integrated and comprehensive fashion...

A5225: Phase I/II Dose-Finding Study of High-Dose Fluconazole Treatment in AIDS-Associated Cryptococcal Meningitis

Post Date: 
2009-04-22
A5225/HiFLAC is a Phase I/II dose escalation and validation study of the safety, tolerability, and therapeutic effect of an induction-consolidation strategy of high-dose fluconazole alone for the treatment of cryptococcal meningitis (CM) in HIV-infected participants.

P1070: Dose-Finding and Pharmacogenetic Study of Efavirenz in HIV-Infected and HIV/TB Co-Infected Infants and Children ≥ 3 Months to < 36 Months of Age

Post Date: 
2008-12-05
Efavirenz (EFV) is an anti-HIV medicine that is commonly used to treat HIV infection in adults and children older than 3 years of age. This study is being conducted to look at the safety of EFV, blood levels of EFV, genetic factors that may affect blood levels of EFV, and how easy it is for infants...

Peer Community-based Assistant in REtention: Effect of Peer Health Workers on People Living with HIV Not on Antiretroviral Therapy—A Randomized Operations Research Trial

Post Date: 
2007-03-29
Country: 
Human resource limitations, long travel times, and a weak health care infrastructure pose significant challenges to the delivery of anti-retroviral therapy (ART) in rural settings such as the Rakai District in southwestern Uganda. HIV increases demand for health services and also impacts the health...

P1060: Phase II, parallel, randomized, clinical trials comparing the responses to initiation of NNRTI-based antiretroviral therapy in HIV-infected infants who have not previously received Single dose Nevirapine for prevention of Mother-to-child HIV...

Post Date: 
2006-03-27
A single dose of nevirapine (SD NVP) given to an HIV infected pregnant woman followed by a single dose to her infant has been shown to be an effective way of reducing the risk of mother-to-child transmission (MTCT) of HIV. The purpose of this study was to compare the effectiveness of a non-...

Group mentorship model to enhance the efficiency and productivity of PhD research training in Sub-Saharan Africa

Post Date: 
2018-05-04
Publication: 
Annals of Global Health
Country: 
Annals of Global Health : Systems capacity building approach to PhD training allowed strong outputs at lower cost and with relatively few additional mentors to train independent scientists able to conduct original research and mentor others.

HIV prevention efforts and incidence in HIV in Uganda

Post Date: 
2017-11-30
Publication: 
New England Journal of Medicine
Country: 
In a large study in Uganda, Dr. Larry Chang and colleagues found that combination HIV prevention has population level implications, reducing new infections by 42%.

Impact of a community health worker HIV treatment and prevention intervention in an HIV hotspot fishing community in Rakai, Uganda (mLAKE): study protocol for a randomized controlled trial

Post Date: 
2017-10-23
Publication: 
Trials
Country: 
Abstract Background: Effective yet practical strategies are needed to increase engagement in HIV treatment and prevention services, particularly in high-HIV-prevalence hotspots. We designed a community-based intervention called "Health Scouts" to promote uptake and adherence to HIV services in a...

Design and implementation of a community health worker HIV treatment and prevention intervention in an HIV hot spot fishing community in Rakai, Uganda

Post Date: 
2017-05-22
Publication: 
Journal of the International Association of Providers of AIDS Care
Country: 
Abstract Innovative approaches are needed to increase engagement in HIV treatment and prevention services, particularly in HIV hot spots. Here, we detail our design, training approach, and early implementation experiences of a community-based HIV intervention called "health scouts." The...

Cost-effectiveness of CRAG-LFA screening for cryptococcal meningitis among people living with HIV in Uganda

Post Date: 
2017-03-23
Publication: 
BMC Infectious Diseases
Country: 
Background : Cryptococcal meningitis (CM) constitutes a significant source of mortality in resource-limited regions. Cryptococcal antigen (CRAG) can be detected in the blood before onset of meningitis. We sought to determine the cost-effectiveness of implementing CRAG screening using the recently...

Qualitative insights into implementation, processes, and outcomes of a randomized trial on peer support and HIV care engagement in Rakai, Uganda

Post Date: 
2017-01-10
Publication: 
BMC Infectious Diseases
Country: 
BACKGROUND: People living with human immunodeficiency virus (HIV) who have not yet initiated antiretroviral therapy (ART) can benefit from being engaged in care and utilizing preventive interventions. Community-based peer support may be an effective approach to promote these important HIV services...

Heterogeneity of the HIV epidemic in agrarian, trading, and fishing communities in Rakai, Uganda: an observational epidemiological study

Post Date: 
2016-08-15
Publication: 
The Lancet HIV
Country: 
Background : Understanding the extent to which HIV burden differs across communities and the drivers of local disparities is crucial for an effective and targeted HIV response. We assessed community-level variations in HIV prevalence, risk factors, and treatment and prevention service uptake in...

Community-based interventions to improve and sustain antiretroviral therapy adherence, retention in HIV care and clinical outcomes in low- and middle-income countries for achieving the UNAIDS 90-90-90 targets

Post Date: 
2016-07-30
Publication: 
Current HIV/AIDS Reports
Country: 
Little is known about the effect of community versus health facility-based interventions to improve and sustain antiretroviral therapy (ART) adherence, virologic suppression, and retention in care among HIV-infected individuals in low- and middle-income countries (LMICs). We systematically searched...

Association of medical male circumcision and antiretroviral therapy scale-up with community HIV incidence in Rakai, Uganda

Post Date: 
2016-07-12
Publication: 
JAMA
Country: 
IMPORTANCE: Medical male circumcision (MMC) and antiretroviral therapy (ART) are proven HIV prevention interventions, but there are limited data on the population-level effect of scale-up of these interventions in sub-Saharan Africa. Such evaluation is important for planning and resource allocation...

Empirical tuberculosis therapy versus isoniazid in adult outpatients with advanced HIV initiating antiretroviral therapy (REMEMBER): a multicountry open-label randomised controlled trial

Post Date: 
2016-03-19
Publication: 
The Lancet
Background: Mortality within the first 6 months after initiating antiretroviral therapy is common in resource-limited settings and is often due to tuberculosis in patients with advanced HIV disease. Isoniazid preventive therapy is recommended in HIV-positive adults, but subclinical tuberculosis can...

Effectiveness of peer support on care engagement and preventive care intervention utilization among pre-antiretroviral therapy, HIV-infected adults in Rakai, Uganda: a randomized trial

Post Date: 
2015-08-14
Publication: 
AIDS and Behavior
Country: 
442 pre-ART, HIV-infected adults were randomized to peer support consisting of structured home visits to promote clinic attendance and preventive care intervention use or standard of care. At baseline, 62 % reported previously visiting an HIV clinic, 45 % reported taking cotrimoxazole prophylaxis,...

Impact of patient-selected care buddies on adherence to HIV care, disease progression and conduct of daily life among pre-antiretroviral HIV-infected patients in Rakai, Uganda: a randomized controlled trial

Post Date: 
2015-06-01
Publication: 
Journal of Acquired Immune Deficiency Syndromes
Country: 
Background: Data are limited on effects of household or community support persons ("care buddies") on enrollment into and adherence to pre-antiretroviral HIV care. We assessed the impact of care buddies on adherence to HIV clinic appointments, HIV progression, and conduct of daily life among pre-...

Durable suppression of HIV-1 after virologic monitoring-based antiretroviral adherence counseling in Rakai, Uganda

Post Date: 
2015-05-26
Publication: 
PLOS One
Country: 
Objectives: HIV viral load is recommended for monitoring antiretroviral treatment and identifying treatment failure. We assessed the durability of viral suppression after viral load-triggered adherence counseling among patients with HIV viremia 6 months after ART initiation. Design: Observational...

Predictors and outcomes of mycobacteremia among HIV-infected smear- negative presumptive tuberculosis patients in Uganda

Post Date: 
2015-02-15
Publication: 
BMC Infectious Diseases
Country: 
Background : Sputum smear microscopy for tuberculosis (TB) diagnosis lacks sensitivity in HIV-infected symptomatic patients and increases the likelihood that mycobacterial infections particularly disseminated TB will be missed; delays in diagnosis can be fatal. Given the duration for MTB growth in...

Is CD4 monitoring needed among Ugandan clients achieving a virologic and immunologic response to treatment?

Post Date: 
2014-11-15
Publication: 
AIDS Patient Care and STDs
Country: 
It is unclear whether ongoing CD4 monitoring is needed following immunologic and virologic response to antiretroviral therapy (ART). We investigated the proportion of clients who achieved a virologic and immunologic response and then had a subsequent CD4 count <200 cells/μL despite continued...

Diagnostic accuracy of a rapid urine lipoarabinomannan test for tuberculosis in HIV-infected adults

Post Date: 
2014-07-01
Publication: 
Journal of Acquired Immune Deficiency Syndromes
Objective : In settings of high HIV prevalence, tuberculosis control and patient management are hindered by lack of accurate, rapid tuberculosis diagnostic tests that can be performed at point-of-care. The Determine TB LAM Ag (TB LAM) test is a lateral flow immunochromatographic test for detection...

Optimisation of the Medical Education Partnership Initiative to address African health-care challenges

Post Date: 
2014-06-25
Publication: 
The Lancet Global Health
Country: 
The Medical Education Partnership Initiative (MEPI) is an innovative and potentially transformative 5-year programme, established by the US Government in 2010, to increase the number of doctors to meet crucial human resource needs in sub-Saharan Africa.1 MEPI allows African institutions that are...

Comparative performance of urinary lipoarabinomannan assays and Xpert MTB/RIF in HIV-infected individuals

Post Date: 
2014-06-01
Publication: 
AIDS
Country: 
Background : Xpert MTB/RIF ('Xpert') and urinary lipoarabinomannan (LAM) assays offer rapid tuberculosis (TB) diagnosis, but have suboptimal sensitivity when used individually in HIV-positive patients. The yield of these tests used in combination for the diagnosis of active TB among HIV-infected TB...

A consortium approach to competency-based undergraduate medical education in Uganda: process, opportunities and challenges

Post Date: 
2014-05-15
Publication: 
Education for Health
Country: 
Background: Uganda, like the rest of Africa, is faced with serious health challenges including human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS), other infectious diseases and increasing non-communicable diseases, yet it has a significant shortage of health...

Socioeconomic determinants of mortality in HIV: evidence from a clinical cohort in Uganda

Post Date: 
2014-05-15
Publication: 
Journal of Acquired Immune Deficiency Syndromes
Country: 
Objective: To delineate the association between baseline socioeconomic status (SES) indicators and mortality and lost to follow-up (LTFU) in a cohort of HIV-infected individuals enrolled in antiretroviral therapy (ART) in urban Uganda. Design: Retrospective cohort study nested in an antiretroviral...

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A Cluster-Randomized Trial to Promote Combination HIV Prevention Using M-health-Supported CHWs in a High-Prevalence Fishing Community: Design and Baseline Characteristics of the mLAKE Trial in Rakai, Uganda

Post Date: 
2016-07-21
Presentation Location: 
Durban, South Africa
Country: 
Event & Convener: 
21st International AIDS Conference. International AIDS Society.
Abstract Presentation. Chang L, Mbabali I, Kong X, Hutton H, Long A, Thomas A, Bugos E, Ssekasanvu J, Kennedy C, Amico R, Nalugoda F, Reynolds S, Quinn T, Serwadda D, Wawer M, Gray R, Nakigozi G.

Combination HIV Prevention and HIV Incidence in a Ugandan Hotspot Fishing Community

Post Date: 
2016-02-23
Presentation Location: 
Boston, MA
Country: 
Event & Convener: 
Conference on Retroviruses and Opportunistic Infections 2016
Poster Presentation. Session: HIV Testing and Prevention. Kagaayi J, Grabowski MK, Nakigozi G, Kigozi G, Nalugoda F, Ssekubugu R, Gray RH, Serwadda D, Wawer MJ, Chang L.

Migration, HIV Infection, and Combination HIV Prevention Access in Rakai, Uganda

Post Date: 
2016-02-23
Presentation Location: 
Boston, MA
Country: 
Event & Convener: 
Conference on Retroviruses and Opportunistic Infections 2016
Poster Presentation. Session: Populations at Risk. Grabowski MK, Lessler J, Bazaale JM, Chang L, Nabukalu D, Wawer M, Nalugoda F, Ssekubugu R, Nakigozi G, Gray RH.

Rakai Health Sciences Program: Social, Behavioral, and Biomedical Research in HIV Dynamics, Prevention, and Care

Post Date: 
2015-10-30
Presentation Location: 
Baltimore, MD
Country: 
Event & Convener: 
CFAR National Social and Behavioral Sciences Research Network Annual Meeting
Presentation

Global Teaching of Global Health Competencies for Medical Students in Uganda

Post Date: 
2015-07-15
Presentation Location: 
Harare, Zimbabwe
Country: 
Event & Convener: 
Medical Education Partnership Initiative (MEPI) Innovation Session
Presentation

mHealth Research: A Case Study from Uganda

Post Date: 
2012-04-05
Presentation Location: 
Baltimore, MD
Country: 
Event & Convener: 
Special Studies and Research: Advanced Topics in Mobile Health (mHealth). Johns Hopkins Bloomberg School of Public Health
Presentation

Use of a Smartphone Application (eMOCHA) to Provide Targeted HIV Prevention Referrals in Rural Uganda

Post Date: 
2010-11-08
Presentation Location: 
Washington, DC
Country: 
Event & Convener: 
mHealth Summit Technology Demonstration
Presentation
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