ACCESS Research and International Program

This encompasses ACCESS research and collaborations, arranges for international student exchange and volunteer capacity building.

Ongoing Research at ACCESS

  1. The Rural Uganda Non-Communicable Disease (RUNCD) Study. PIs (Felix Knauf, Trishul Siddharthan and Robert Kalyesubula
  2. “Use of incentives in increasing uptake and continuation of family planning methods in rural Uganda” PI-s Anne Dougherty and John Mundaka
  3. The Pocket Doktor the role of VHTs in NCD care and management
  4. Understanding Barriers to Uptake of Family Planning among Youth in Nakaseke District.

ACCESS received a 3 year grant from the EKFS (ELSE KRONER-FRESENIUS-STIFTUNG) foundation. This grant will help ACCESS working in collaboration with Johns Hopkins University, Erlangen University in German and Makerere University to conduct an NCD census in 3 sub counties of Nakaseke providing data on over 15,000 adults in the community. It is also planned that this grant will help support the setup of a center of excellence for non-communicable disease care through exploration of community models that work through patient centered care. Over the three year period 6 fellows will be trained from the three countries, medical students will visit German and USA and a training program for NCD management at lower levels will be developed in collaboration with Nakaseke District and the Ministry of Health.

This grant will help set up a research center at ACCESS and provide an opportunity for collaboration on research in NCD and other chronic diseases.

ACCESS continues to collaborate with the University of Vermont, Sacred Heart University and the University of British Columbia in Canada to have mutual exchanges of students and faculty in global health training as well as research.

 

 

 

Capacity and Linkages with other studies at ACCESS

  1. Research to investigate COPD in people living with HIV/AIDs in rural Uganda.

In this study funded by the National Institutes of Health, USA from July 2016 to July 2017, we conducted a cross sectional survey in which 795 HIV-infected individuals were screened for COPD at Nakaseke HIV/AIDs treatment centers using spirometry and standard questionnaire for COPD diagnosis i.e. the BOLD questionnaire. This study reported a 6.2% prevalence of COPD in HIV. IN this study, we found that in well-controlled HIV, known risk factors for COPD associated with COPD were not significant predictors of COPD prevalence and severity.

  1. Research to investigate ambulatory blood pressure in People living with HIV/AIDs in rural Uganda.

In this study funded by the National institute of Health, USA from September 2017 to September 2018, we conducted a cross sectional study to determine variations in ambulatory blood pressures in people living with HIV/AIDs. We screened a total of 200 participants attending HIV/AIDs treatment center in Nakaseke General Hospital. We have completed the recruitment phase and now we are analyzing the data.

  1. Global excellence in COPD management (GECO) Research

This is an implementation trial funded by MRC, in collaboration with UCL and Johns Hopkins University. It’s evaluating the feasibility of using a 5-item questionnaire for diagnosis of COPD and cost effectiveness of self-management action plans for COPD in low and middle income countries like Uganda. It started in February 2017 and is to end in February 2020. We aim to screen a total of 3,500 participants to get atleast 100 COPD patients, who will then be followed up for 1 year.

  1. The Lung Microbiome Project for investigating HIV-associated COPD

In this study funded by the GlaxoSmithkline (GSK) pharmaceutical company. We are investigating the association between altered lung microbiome and HIV-associated COPD in rural Uganda. Utilizing the HIV-COPD cohort, we will induce sputum, extract bacterial genomic DNA and perform 16SrRNA sequencing using MiSeq platform to determine microbial communities in these individuals. We hope to identify unique biomarkers associated with COPD in our cohort.

Completed Research

  1. The Nakaseke Census on NCDs
  2. Challenges to hypertension and diabetes management in rural Uganda: Perspectives from patients, village health team members, and health care professionals. PIs Haeyoon Chang and Tracy Rabin
  3. Knowledge and Use of Family Planning among Men in Rural Uganda. PIs (Robert Kalyesubula and Anne Dougherty 
  4. Elimination of Malaria-Related Mortality in Children Under Five Years.

Peer reviewed publications

  1. Robertson NM, Nagourney EM, Pollard SL, Siddharthan T, Kalyesubula R, Surkan PJ, Hurst JR, William Checkley W, Kirenga BJ. Urban-rural disparities in chronic obstructive pulmonary disease management and access in Uganda. Chronic Obstr Pulm Dis. 2019; 6(1): 17-28. doi: http://doi.org/10.15326/jcopdf.6.1.2018.0143
  2. Dougherty A, Kayongo A, Deans S, Mundaka J, Nassali F, Sewanyana J, Migadde E, Kiyemba R, Katali E, Holcombe SJ, Heil SH, Kalyesubula R. Knowledge and use of family planning among men in rural Uganda. BMC Public Health. 2018 Nov 26;18(1):1294.
  3. Mitra Sadigh, Jamie Sarfeh, Robert Kalyesubula. The retention of ACCESS nursing assistant graduates in rural Uganda. Journal of Nursing Education and Practice Vol 8, No 1 (2018)
  4. Morgan BW, Siddharthan T, Grigsby MR, Pollard SL, Kalyesubula R, Wise RA, Kirenga B, Checkley W. Asthma and Allergic Disorders in Uganda: A Population-Based Study Across Urban and Rural Settings. J Allergy Clin Immunol Pract. 2018 Jan 17
  5. Siddharthan T, Rabin T, Canavan ME, Nassali F, Kirchhoff P, Kalyesubula R, Coca S, Rastegar A, Knauf F. Implementation of Patient-Centered Education for Chronic-Disease Management in Uganda: An Effectiveness Study. PLoS One. 2016 Nov 16;11(11)

Abstracts and oral conference presentations

  1. Nassali F, Weswa I, Munana R, Migadde E, Mugirigi R Sewanyana J, Katali E and Kalyesubula R. Family planning in Nakaseke; Lessons Learned from ACCESS Uganda. Oral presentation, Metropol Hotel, Kampala Uganda 11-12 Oct 2018.
  2. Migadde E, Weswa I, Nassali F, Mugirigi R Sewanyana J, Katali E, Munana R and Kalyesubula R. Family planning and the Future; Village Health Team (VHT) experience. Oral presentation, Metropol Hotel, Kampala Uganda 11-12 Oct 2018.
  3. Samantha Perry, BA, Cynthia Fair, LCSW, MPH, DrPH, Sahai Burrowes, PhD, MALD, Sarah Jane Holcombe, PhD, MPPM, MPH and Robert Kalyesubula, MBBCh, Mmed, Village Health Teams’ Understanding and Practices Regarding Patients’ Rights in Uganda: A Qualitative, Cross-sectional Study. American Public Health Association (APHA), San Diego, 10-14 Nov 2018
  4. Samantha Perry, Sarah Holcombe, Robert Kalyesubula, Sahai Burrowes ; “Outsiders, Insiders, and Intermediaries: Village Health Teams’ negotiation of roles to provide high quality HIV care in Nakaseke, Uganda” accepted for 22nd International AIDS Conference (AIDS 2018), Amsterdam, Netherlands, 23-27 July 2018.
  5. Deans S, Dougherty A, Kayongo A, Mundaka J, Nassali F, Sewanyana J, Miggade E, Kiyemba R, Katali E, Holcombe S, Kalyesubula R, Heil S.  “Male and female knowledge, attitudes and use of family planning in rural Nakaseke District, Uganda” Ninth Annual Consortium of Universities for Global Health Conference, New York, USA. March 2018.
  6. Deans S, Dougherty A, Kayongo A, Mundaka J, et al. “Knowledge, attitudes, and use of family planning among rural women and men in Nakaseke District, Uganda” University of Vermont Global Health Day, April 2017.
  7. Trishul Siddharthan, Faith Nassali, Robert Kalyesubula, Steve Coca, Asghar Rastegar, Tracy Rabin, Felix Knauf. An educational booklet for patient-centred health education about a non-communicable disease in low-income and middle-income countries. Lancet Global Health. 2016
  8. Jain, K. Dewar, B. Schwartzentruber, S. Ruscheinsky, V. Kapoor, J. Sewanyana and R. Kalyesubula. The global health initiative and ACCESS Uganda partnership program: Developing health seminars for community health workers and evaluating nutritional knowledge and education practices in rural Uganda. Feb 2015 · Annals of Global Health
  9. Sadigh, J. Sarfeh and R. Kalyesubula. Evaluating the impact of a nursing assistant training program in rural Uganda. Feb 2015 · Annals of Global Health, USA.
  10. Sadie St. Denis, Angela N Semanda, Christine A. Namayanja and Robert Kalyesubula. Leadership symposium for Nurses. 22 April, 2016. Makerere University, Kampala, Uganda.
  11. Robert Kalyesubula (speaker), Estherloy Katali, Global Health; a View from Uganda, University of Vermont USA, April 2016
  12. Ruscheinsky, B. Schwartzentruber, R. Jain, K. Dewar, J. Sewanyana, R. Kalyesubula and V Kapoor. EVALUATING COMMUNITY HEALTH WORKERS’ NUTRITIONAL KNOWLEDGE AND EDUCATION PRACTICES IN RURAL UGANDA. Jan 2015 · Journal of Investigative Medicine
  13. Robert Kalyesubula, Primary Health care in rural communities, Rose Charities International conference, March 7-9, 2013, Metropole Hotel, Kampala, Uganda,

The Census Program