Project Title

Strengthening Malaria Epidemiological, Pathophysiological and Intervention Studies in Highly Endemic Eastern Uganda

EDCTP Project Call

Senior Fellowship (SF)

Project Objectives

1. To conduct epidemiological studies on acute kidney injury in childhood severe malaria at Mbale Regional Referral Hospital to characterise the disease over a period of 48months. 2. To describe the pathophysiology of haemoglobinuric malaria at Mbale Regional Referral Hospital to understanding the disease process. a. To explore the dose and effect of paracetamol in treatment of renal impairment in children with haemoglobinuric malaria. b. To train two junior researchers in malaria research including clinical trials. 3. To study safety and early efficacy of paracetamol in ameliorating acute kidney injury in children with severe malaria.

Study Design

Prospective cross sectional studies are being conducted for malaria epidemiological and pathophysiological studies. Phase I/II randomised clinical trial will be conducted for evaluation of feasibility, safety and early effectiveness of paracetamol for treatment of AKI

Project Summary

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.mcru.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 a publication on malaria epidemiology, pathophysiology, acute kidney injury in severe malaria, outcomes of phase I/II study on paracetamol in acute kidney injury in severe malaria and 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.

Host Organisation

Sites

Current Organisation

Busitema University/Mbale Clinical Research Institute

Current Job Title

Professor/Clinical Scientist

Biography