Developing capacity for implementation and evaluation of vaccine trials in Uganda: Perspective of the Makerere University Walter Reed Project

Introduction: Infectious diseases and neglected tropical diseases continue to be a major challenge in resource limited settings, causing significant morbidity and mortality. Although vaccines are a key biomedical prevention tool, resource limited settings often lack the infrastructure, regulatory frameworks, and skilled human resource to conduct vaccine clinical trials. To address this gap, the Makerere University Walter Reed Project (MUWRP) was established and has contributed to vaccine research in Uganda and globally. Methods: This was achieved through training a strong vaccine clinical trial workforce; development of requisite clinical trial infrastructure for research activities and management of investigational products; conducting phase I-III vaccine trials and contribution to national ethical and regulatory frameworks that protect participants. Results: As of 2022, MUWRP had successfully conducted and completed five phase I/II HIV vaccine clinical trials, five for Ebola and Marburg, while one phase I/II Schistosomiasis and one phase III COVID-19 vaccine clinical trial are ongoing. Discussion: The completed vaccine trials provided critical scientific knowledge on the safety and immunogenicity of investigational products which informed the design of better vaccines for diseases of global health importance. Conclusion: Academia, through establishment of appropriate partnerships can contribute to the identification of solutions to complex public health challenges

Knowledge of HIV by health professionals in Kampala; Uganda

Deficiencies in HIV knowledge among health care professionals is of concern because they play an instrumental role in counselling patients to reduce risk behaviours. We report here on the results of a pretest questionnaire which we administered to assess baseline levels of HIV knowledge among a group of health care providers in Kampala; Uganda; our educational intervention; and the results of the post-test questionnaire which we administered to detect changes in the level of HIV knowledge following intervention. Pre-test results indicated that the greater deficiencies in knowledge related to transmission and prevention and clinical manifestations of disease. Scores on the post-test; administered following a 15-hour course; indicated a significant improvement in knowledge of clinical manifestations and overall knowledge. Our findings underscore the need for ongoing HIV educational programs for health care workers

Spontaneous sputum examination for early diagnosis of pneumocystis carinii in Ugandan AIDS patients

Whereas Pneumocystis carinii pneumonia (PCP) is one of the major complications and causes of death in patients with the Acquired Immunodeficiency Syndrome (AIDS); patients show that mycobacterium tuberculosis (MTB) is a commoner cause of HIV-associated pneumonia than PCP. Most methods used to diagnose PCP entail invasive and expensive techniques which are beyond the facilities available in developing countries. This study; was therefore designed to evaluate spontaneous sputum examination as a cheaper method for the diagnosis of PCP. Sputum specimens collected in 1987 from 54 AIDS Patients in Mulago Hospital were stained using a modified Gram stain and read by a competent technician. None of the 54 slides contained evidence of P.carinii. These results were consistent with other studies in Africa which show that PCP is rare among AIDS patients. However; because of lack of other definitive diagnostic evidence for the presence or absence of PCP; it was not possible to conclusively assess the usefulness of spontaneous sputum examination. Further studies are needed to determine the presence or absence of PCP among AIDS patients in Africa; and to evaluate cheaper and invasive diagnostic tools for developing countries