Rakai Health Sciences Program (RHSP) Uganda 1988-2011 Population-based Research on HIV, other Infectious Diseases, Reproductive Health and Service delivery.

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Presentation transcript:

Rakai Health Sciences Program (RHSP) Uganda Population-based Research on HIV, other Infectious Diseases, Reproductive Health and Service delivery

Current studies and services Research studies RCCS and nested studies Circum and related studies Acyclovir prophylaxis in HIV- 1/HSV-2 co-infected patients Rakai Youth Project Malaria-Home and facility based surveillance Other lab-based studies Services alongside research HIV/AIDS care and treatment HIV Pre-ARV HIV antiretroviral therapy pMTCT General Health Care (Mobile & static) Male circum roll out and training Health Education Voluntary HIV testing and counseling

RHSP HIV/AIDS Care Program Since June 2004 has provided HIV/AIDS Care to approximately 5600 clients Enrollment through RCCS and Walk-in until 2008 Until January 2011 all clients received CD4 and HIV VL monitoring every 6 months, now performed annually due to budget issues Clinical and laboratory data maintained in database at RHSP headquarters

HIV/AIDS Care (ARV) Numbers AdultschildrenTotal Ever Pre-ART Currently Pre-ART Ever started on ART Currently on ART Lost to follow-up62567 Dead

Home Based Malaria Surveillance Funded by Division of Intramural Research, NIAID/NIH Active home based monthly surveillance of 360 households, approximately 1700 individuals in 2 Rakai communities Focus on malaria rates among children (6 months-10 years) and adult caregivers Initiated April 2011

Home-based Malaria Progress Two communities from each of 2 clusters –2 high and 2 low malaria endemic communities Enrollment completed in 40 homes 152 Adult and children clients so far enrolled Rapid diagnostic testing done on all febrile participants to determine immediate need for treatment, blood smear done on all participants

IeDEA Facility Based Malaria Study Objectives To estimate the proportion of febrile illnesses (body temperature >=38 0 c) with malaria parasites on a blood smear among all patients presenting to outpatient clinic at Kalisizo hospital To estimate the prevalence, presentation, and treatment outcomes of severe malaria amongst HIV-infected and uninfected children aged <5 years admitted to Kalisizo and Bikira hospitals in Rakai district, Uganda.

IeDEA Facility Based Malaria Study Retrospective review of all lab records at 2 health facilities to answer first objective Prospective enrollment of 3000 children less than 5 years and the same facilities to measure the prevalence of outpatient malaria, presentation and outcomes Planned to start enrollment week of May 9 th 2011

IeDEA Facility Based Malaria Study Progress All IRB approvals (UVRI-SEC, UNCST & WIRB-Indiana) obtained and on file 4 Lab techs trained in Kisumu; to re-train in few months Protocol discussion & training with facility staff & RHSP GCP training for facility based staff in April 2011 HSP re-training for all staff on IeDEA Supplies delivered to facilities Enrollment to start Monday May 16 th 2011

IeDEA Facility Based Malaria Study Challenges Facility based staff transferred frequently – requires training and re-training Poor record keeping– Introduced and trained methods of records management