Progress on Specific Aims

We have appointed the first four MURTI Fellows in the areas covered by our Specific Aims as described below. See Table 1 above, also.

AIM 1: To develop junior faculty research expertise in HIV prevention and treatment, particularly in rural southwestern Uganda

In Year 01, the MURTI appointed one Fellow in this research area. Dr. KabandaTaseera is a Physician and Clinical Microbiologist whose research interests are HIV-associated opportunist infections, particularly cryptococcal meningitis and tuberculosis. In the MURTI program, he is working on two related seed-grant projects with Drs. Mark Siedner from MGH, David Boulware from University of Minnesota, Conrad Muzoora and Joel Bazira from MUST as mentors. In the first, “Relation of fungal strain genotype to neurological complications in patients with HIV associated cryptococcal meningitis: A retrospective multi-site study,”he aims to explore the influence of Cryptococcal molecular type on the development of neurological complications in patients with Cryptococcal meningitis using

data collected during the Cryptococcal Optimal Antiretroviral Timing (COAT) trial (clinicaltrials.govNCT01075152). He is awaiting Research Ethics Committee permission to utilize the data set. This will lead to his second project that aims to evaluate the trends of gene transcription following Cryptococcal meningitis. It is a pilot that is aimed at optimizing methods for in-vivo isolation and storage of messenger rRNA and using this to compare gene expression in CM patients with and without neurological complications in order to decipher the role of particular genes in disease severity, development of drug resistance as well as immune response. The results will be used to identify drug targets, predict and modify treatments, and predict onset of drug resistance. Data will also be used to evaluate the role of personalized treatment in improving health outcomes. These data from the second project also will be used to explain findings from the first. He hopes to develop this idea to a PhD level.

AIM 2: To develop the capacity of Ugandan junior faculty to develop novel, evidence-based diagnostic and treatment strategies for cardiovascular diseases (CVD) in rural populations to address priority health needs.

We did not plan to recruit a CVD Fellow in Year 01, but aim to do so in Year 02.

AIM 3: To prepare junior faculty for research careers addressing mental health disorders in rural Uganda.

We have appointed one Fellow in this area, a female Physiatrist, Dr. Scholastic Ashaba, who is completing her PhD. She is mentored by Drs. Eugene Kinyanda from Makerere University; Christine Cooper-Vince and Lynn T. Matthews from MGH; and Angela Kaida from Simon Fraser University (SFU), Canada.

Her research focus is on “Association between depression, stigma and discrimination, bullying and victimization, social support among children and adolescents infected and affected by HIV.” Dr. Ashaba received ethical clearance from MUST Research Ethics Committee and Uganda National Council for Science and Technology; completed data collection; and is now reviewing the transcripts as well as validating the Beck Depression Inventory tool. She has submitted two abstracts: one to the 21st International AIDS conference to be held in Durban South Africa July 18-22, 2016 titled “Validity and reliability of the HSCL-25 among HIV positive adults in rural Uganda,” and the other to the MUST Reproductive Health Research Conference scheduled May 26, 2016 titled “Understanding coping strategies during pregnancy and the postpartum period: a qualitative study of women living with HIV in rural Uganda”. They were both accepted.

AIM 4: To develop the capacity of Ugandan junior faculty to develop novel, evidence-based diagnostic and treatment strategies for CVD, and mental health as well as for use of neuro-radiology in rural populations to address priority health needs in rural populations to address priority health needs.

Two Fellows were selected under this aim. Dr. Doreen Nakku is an ENT Surgeon with a research focus on “Sensory and neural hearing loss among HIV positive children between 6-12 years at Mbarara Regional Referral Hospital.” She is mentored by Dr. Francis Bajunirwe from MUST and Drs. Brian Westerberg and Heather Southam from University of British Columbia (we did not find a good mentor match for her from MGH). Dr. DorahNampijja is a Pediatrician focusing on “Patterns of Cardiac Disease and their relationship to Neurocognitive Development Among Children Attending Mbarara Regional Referral Hospital.” She is mentored by Drs. Frances Aboud from McGill University, Canada and Charles Mondo from Uganda Heart Institute/Makerere University.

Dr. Nakku will use the PATH Sentiero equipment for advanced audiological tests to carry out Otoacoustic emissions and Auditory Brainstem Response (OAE and ABR respectively) during data collection. She will receive training on how to use the equipment when she travels to attend the advanced audiology training May 31 to June 17, 2016 at the School of Human

Communication Disorders, Dalhousie University in Halifax, Nova Scotia. Dr. Nampijja will use the Bailey’s III kit for assessing development in children as well as the ECG machine during data collect; she received training on how to use the tools, and is beginning data collection.

AIM 5: To equip junior faculty with the administrative, research ethics, and research communication capacities necessary to succeed as the next generation of independent investigators in Uganda

In addition to our focus on the four MURTI Fellows appointed each year (who are required to take all core courses, an advanced research methods course, and relevant elective courses), the program is committed to building the research capacity of junior faculty and research administrators at MUST.

Examples of significant outcomes thus far in Year 01 from MURTI courses and other capacity-building activities are the following:

  • During the manuscript writing training, Dr. Doreen Nakku (MURTI Fellow) developed a manuscript and submitted to BMC Journal Ear, Nose and Throat Disorders titled “A case control study of the factors associated with occurrence of aerodigestive foreign bodies in children in a regional referral hospital in South Western Uganda..)”.It was accepted and published online 2016 Mar 15 PMC4792106.

  • Dr. Scholastic Ashaba (MURTI Fellow) also developed a manuscript, during the training titled “Understanding coping strategies during pregnancy and the postpartum period: a qualitative study of women living with HIV in rural Uganda,”mwhich is under review at BMC Journal Pregnancy and Childbirth. Dr. Ashaba has three more manuscript under development with support from her mentors.

  • As a result of training in how to conduct systematic reviews and meta-analysis of literature, 8 teams were formed and are working on protocols to conduct systematic review research projects that they hope to register with the Cochrane database e the leading resource of systematic reviews in health care –tby December 2016.

  • The EndNote training resulted in 35 EndNote and 10 STATA licenses were purchased and distributed to junior faculty who are now using EndNote referencing manager when writing research proposals and manuscripts.

  • The MUST ORA website is under development to strengthen research communication at MUST. The website is in the final stages of development and will be operational at the beginning of MURTI Year 02.

  • 379 MUST faculty are registered on the Research Africa Platform (see Section B.2.1.4.above), which provides access to funding opportunities as well as news and analyses on topics giving African researchers, students and policymakers an edge in the competition for research funding. We anticipate that more than half of the faculty registered on the platform will write and submit a research grant application by the end of the program.

  • Eleven junior faculty submitted concepts to the Sida program of the Swedish government for funding to pursue PhD and Masters Programs. Five faculty were given 4-year PhD Scholarships and six were given Masters Scholarships to study at Makerere University and MUST, respectively. One MURTI key personnel (Joel Bazira MD, PhD) applied and was also given a postdoctoral fellowship at Makerere University under the same Sida arrangement.

In summary, as a result of the training provided to MUST junior faculty through the MURTI, there is likely to be an increase in the number of grant applications and publications in peer-reviewed journals from the institution. The MURTI training sessions generated increased interest applying for grants, and the MUST ORA is supporting junior faculty in identifying and

applying for funding opportunities on the Research Africa professional platform through the MUST subscription.