The Regional / Country Coordinator in Uganda Marion Achieng Kariuki.
Infectious Disease Institute (IDI)
Location: Kampala, Uganda
Site Principal Investigator(s): Barbara Castelnuovo, MD; Aggrey Semeere, MMED
Data Manager: John Matovu
The Infectious Disease Institute is a regional center of excellence for HIV/AIDS treatment, research and training in sub-Saharan Africa. With initial support from Pfizer, the Infectious Disease Institute was established by the Academic Alliance for AIDS Care and Prevention in Africa, a prominent group of infectious disease experts from Uganda and North America. The Infectious Disease Institute clinic provides comprehensive HIV care to adults in the age range 16 -84 with a median age of 38 year. They provide special services for high-risk groups or those requiring specialized care. At the moment, specialized clinic are run for young adults (ages 16 -24). Since 2004, over 37,700 HIV-positive patients have registered for care at IDI, and over 96 percent are receiving anti-retroviral therapy as of March 31,2016. Just over 1,000 patients were receiving second-line ART at the clinic; making it one of Africa’s largest cohorts of patients receiving second-line therapy. More than 300 receive more complex ART drug regimens, either due to co-current opportunistic infections other medical problems (such as kidney disease) or failure of second-line ART treatment.
The Infectious Disease Institute (IDI) also supports the provision of HIV prevention, care and treatment services through outreach activities at Kampala City Council clinics and in several districts in South-western Uganda. By the end of September 2015, Infectious Disease Institute had supported the enrollment of over 100,000 active HIV positive individuals into HIV care across its supported outreach projects. The clinic also serves as a platform for IDI’s research and training activities. There is an increasing emphasis on developing models of care for co-morbidities of HIV—such as TB and Kaposi’s sarcoma. The range of services include: HIV patients; integrated TB-HIV clinic, sexual and reproductive health (SRH) services, adolescents’ clinic, discordant couples clinic, senior citizens clinic, mental health clinic, non-communicable diseases (NCDs) clinic and Kaposi’s sarcoma(KS) clinic.
Masaka Regional Hospital HIV Care Clinic
Location: Masaka, Uganda
Site Principal Investigator(s): John Ssali
Data Manager: Matthew Ssemakadde
Located in western part of Central Uganda and just over 120 Km from Kampala City, Masaka, Regional Referral Hospital was established in 1927 and serves as a referral hospital for seven districts which include Masaka, Lyantonde, Rakai, Kalangala, Sembabule Lwengo and Kalungu. It has a catchment’s population of over 3 million and bed capacity up to 450. Being the only government hospital in Masaka District, the facility also serves as the general hospital as well as the health center for Masaka Municipality.
The range of services offered at this clinic include: VCT / RCT (Voluntary Counseling and Testing / Routine Counseling and Testing), psycho social Support, provision of anti-retroviral therapy (ART), treatment of opportunistic infections (OIs), CD4 counts, viral loads and other laboratory investigative services, family planning, prevention of mother-to-child transmission (PMTCT), palliative care, and social economic empowerment for the clients (SEEP), all free of charge.
The HIV clinic at Masaka Regional Referral Hospital provides comprehensive HIV care to adults and children, male and female, in age range less than one year to 96 with a median age of 35. The site has cumulatively enrolled over 27,340 patients of which about 6 percent are children and over 13,000 patients of those are active in care as of March 31, 2016. This clinic maintains an electronic database for the patients based on the Open MRS application.
Mbarara University ISS Clinic
Location: Mbarara, Uganda
Site Principal Investigator(s): Mwebesa Bosco Bwana, MBChB, MPH
Co-Investigator: Winnie Muyindike, MBChB, MMED
Data Manager: Michael Kanyesigye
The Immune Suppression Syndrome (ISS) Clinic in Mbarara, Uganda, is a prototypical municipal HIV/AIDS clinic in Western Uganda. The ISS Clinic provides comprehensive HIV care for only adult male and female patients of age range 14 – 84 with a median of 40, having enrolled over 27,000 HIV-infected adults since it began in 1998. As at March 31, 2016, just over 10,000 patients are in active follow-up.
The experience of this clinic, including basic epidemiologic, clinical, and laboratory parameters, is captured in an electronic medical record system which uses OpenMRS. The Core, as part of the Joint CFAR International Collaboration with Harvard, the University of California San Francisco (UCSF) and Mbarara University of Science and Technology (MUST), has had a prominent role in the development of the ISS Clinic Cohort.
Services include: clinical care consultations, counseling services. laboratory services, Biopsy services for the diagnosis of KS, ART for all patients who qualify, treatment of opportunistic infections, platform for training/ teaching medical students , referral of women for cervical cancer screening, provision of basic care kit including safe water vessels, water guard, condoms, and insecticide treated mosquito nets.
Rakai Health Sciences Program (RHSP)
Location: Rakai, Uganda
Site Principal Investigator(s): Fred Nalugoda, PhD, MHSc
Co-Investigators: Steve Reynolds, MD, MPH
Data Manager: Francis Xavier Wasswa
The Rakai Health Sciences Program (RHSP) was established in 1987 as collaboration between researchers at Makerere, Columbia Universities and the Uganda Virus Research Institute of the Ministry of Health. Subsequently, the collaboration extended to Johns Hopkins University, and in 2002, to the Division of Intramural Research (DIR) at the National Institute of Allergy and Infectious Diseases, U.S. National Institutes of Health (NIH). In that year, the RHSP was designated by the DIR as one of only three International Centers for Excellence in Research (ICER).
The ART Program at RHSP sees adults and children of ages less than one year – 84 years, both male and female, with a median age of 36 years. Since 2004, the Rakai Program has provided HIV care to infected persons via a central clinic in the Rakai Health Sciences Centre in Kalisizo and through 17 mobile clinics which visit communities bi-weekly. In 2013, all HIV programming in the Rakai district was integrated with the Uganda Ministry of Health services in a district-led approach with technical support from RHSP. Currently HIV services are offered through 34 health facilities also known as health centers (HCs) including two general hospitals, one HC level IV, 22 HC level IIIs, and nine HC level IIs.
As of December 2015, approximately over 21,870 (95 percent adults, 5 percent children) individuals were active in HIV care and treatment. Services offered by the program include; comprehensive HIV care and treatment, TB/HIV services; HIV counseling and testing for adults, adolescents and pediatrics, prevention of mother-to-child transmission (PMTCT), laboratory services and safe male circumcision.