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Improving Anemia identification in vulnerable populations in South-Western Uganda

The General Population Cohort (GPC) platform is a robust infrastructure designed to facilitate population-based research by providing longitudinal data sourced from a diverse community. With over 22,000 community members contributing to studies over the span of 35 years, the GPC platform stands as a cornerstone in the Unit’s research, providing researchers with a comprehensive understanding of community health dynamics. The longitudinal nature of this platform allows researchers to observe trends, identify risk factors, and assess the impact of interventions. Findings from studies conducted within the GPC have informed the development of government programs for HIV prevention and control not only in Uganda but also regionally and worldwide.
FOPA Study

Scientists at the GPC have recently partnered with Liverpool School of Tropical Medicine and London School of Hygiene and Tropical Medicine to implement a study titled, "Feasibility of using Point of Care Machines in Diagnosing Anaemia among Pregnant Women and Children (FoPA) that seeks to evaluate the effectiveness of point-of-care machines in identifying anemia among pregnant women and children under 5 years of age. The one-year-long study will be conducted using the Unit’s rich population research cohort of over 22,000 potential research participants in Kyamulibwa subcounty, Kalungu district, Southwestern Uganda.

Dr. Joseph Mugisha, head of the GPC platform at the Unit and Study Principal Investigator (P.I) said “Point of care tests are important in enabling clinicians make decisions on treatment options for patients at the point of care.  Anaemia is an important cause of morbidity in children and pregnant women in Uganda.  This grant will enable us to compare a point of care test for haemoglobin against a gold standard of full blood count. The results from this study will enable clinicians at lower health care levels to manage anaemia promptly, a significant health concern in Uganda.”

According to Rogers John Mukasa, a laboratory technologist at the Unit and Co-Principal Investigator (Co-P.I), “The study will commence with mobilization activities conducted by qualified field team personnel to engage communities and hold sensitization meetings to educate potential participants about anemia, its diagnosis, and related tropical disease. The study will then employ a hub-based system within Kyamuliibwa health facilities for participant engagement. Activities will include consenting, standardized questionnaire administration, and sample collection, followed by comparison of data generated by point-of-care machines with laboratory-based gold standards.”

Anticipated impact:

This study stands out for its comprehensive comparison of point-of-care testing with laboratory-based gold standards under conditions mirroring routine clinical practice. Its findings could potentially contribute significantly to understanding the performance and implications of point-of-care testing in anemia diagnosis, particularly in resource-limited settings. Findings from the study could enhance understanding about the level of agreement between the Hb hemocue and the laboratory-based gold standards at different thresholds but also different working conditions of the POCT equipment. The study, once complete could also be vital in informing clinicians about the outcomes of POCT measurements and how these results should be interpreted as management of different types of anaemias differs.

The study is generously funded by the Medical Research Council (MRC) through Liverpool School of Tropical Medicine (LSTM) in the Tropical Infectious Disease Consortium (TIDC)MRC Impact Accelerator Account (MRC IAA) 2023.

About the Funders:

Medical Research Council

The Medical Research Council (MRC) is a national funding agency dedicated to improving human health by supporting research across the entire spectrum of medical sciences, in universities and hospitals, in MRC units, centres and institutes in the UK, and in MRC units in Africa.

Liverpool School of Tropical Medicine (LSTM)

Liverpool School of Tropical Medicine (LSTM) was founded in 1898 as the first institution in the world dedicated to research and teaching in the field of tropical medicine. The institution works across the world, often in very difficult circumstances, to reduce the burden of sickness and mortality in disease endemic countries through the delivery of effective interventions which improve human health and are relevant to the poorest communities.

Tropical Infectious Disease Consortium (TIDC)

The Tropical Infectious Disease Consortium (TIDC) leads the way in turning fundamental discoveries into improvements in human health and economic benefit for tropical diseases since its establishment in 2013. The Consortium brings together much of the UK’s expertise in tropical infectious diseases into a single translational partnership from Liverpool School of Tropical Medicine (LSTM), London School of Hygiene and Tropical Medicine (LSHTM), the Jenner Institute at Oxford University (Jenner) and Public Health England (PHE). TIDC is strategically placed to deliver an unprecedented portfolio of domain specific expertise in all the key research areas of interest.

MRC Impact Accelerator Account (MRC IAA) 2023.

The MRC Impact Acceleration Account (IAA), previously known as Confidence in Concept, is intended to support the translation of fundamental science into new therapies, diagnostics, medical devices and technologies to benefit human health. The fund is part of the UKRI IAA funding programme 2022 - 2025.

About the Implementing Institution:

The Medical Research Council/Uganda Virus Institute/ London School of Hygiene & Tropical Medicine Uganda Research Unit (MRC/UVRI & LSHTM

The MRC/UVRI & LSHTM Uganda Research Unit is an internationally recognized centre of excellence for research and training. Its mission is to conduct high-quality research that adds knowledge and leads to improved control of infectious and non-communicable diseases in Uganda, Africa and globally, through translation of scientific findings into policy and practice, and rigorous research capacity building.

Uganda Virus Research Institute (UVRI)

UVRI is a world-class center of excellence in health research pertaining to human infections and disease processes associated with or linked to viral etiology and provides expert advice, enables partnerships and communication, and serves as a center for training and education. It contributes to knowledge, policy, and practice and builds capacity.

ABOUT THE KEY SCIENTISTS:

Dr. Joseph Mugisha (Study P.I) is the head of the General Population Cohort (GPC) platform a one stop center for population-based studies.

Dr. Joseph Mugisha is a clinical epidemiologist with an MSc in Clinical epidemiology and Biostatistics from Makerere University, a doctorate in epidemiology and population health from the University of London, at London School of Hygiene and Tropical Medicine and a post-doctorate from the University of Missouri, Columbia USA. Dr. Mugisha also trained and qualified as a medical doctor from Mbarara University of Science and Technology, and prior to his research career, he practiced medicine at Masaka Regional Referral Hospital.

Since 2016, he has been involved in surveys on disability to assess the prevalence of functioning difficulties under a number of domains and to look at needs of assistive devices among people with functioning difficulties.

Dr. Mugisha’s research interest lies in the health and wellbeing of older people in low- and middle-income countries, and how NCDs and HIV impact on ageing. He has previously led a cohort study of older people living with and without HIV in Uganda. Also, his PhD thesis focused on the epidemiology of anemia among old people in rural Uganda and how anemia impacts on functioning in older people.

Rogers John Mukasa (Study Co P.I) is a laboratory technologist at the Unit under the NCD theme with a Bachelor’s degree in Biomedical Laboratory Technology from University of Kisubi.

He is a researcher in training with an ambition of growing a fully-fledged research career in the line of non-communicable diseases particularly diabetes and hypertension. He began his career in research as an intern at the MRC/UVRI & LSHTM Uganda Research Unit in 2019 and worked on a number of NCD studies such as OPTIMAL study, Young-onset Diabetes in Sub-Saharan Africa (YODA) study and professionally as a Laboratory Technologist on the Diabetes in low-resource Populations (DOP)study in 2022. He has gained certification and training in short courses such as GCP, GCLP and grants writing which are key for a growing research career.

Read more about the Unit’s science.

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