ONGOING STUDY:

MEPIE Study

MEPIE Study

Research Details

The World Health Organization’s (WHO) 2020 World Malaria Report highlighted an increase in malaria cases from 227 million in 2019 to 241 million in 2020 across 85 endemic countries

In Sub-Saharan Africa, Plasmodium falciparum malaria is the deadliest form, spread by mosquito bites. It causes common flu like symptoms such as fevers, headache, and chills. In about one in ten patients with malaria it causes severe symptoms that can quickly lead to body organ failure and death, especially in children and pregnant women. This form of malaria also causes epidemics.

Despite being a frequent cause illness, hospital admissions and deaths, there were few data on severe Plasmodium falciparum malaria in Eastern Uganda before this study. The MEPIE Study aimed to improve malaria research by focusing on the disease determinants and distribution, disease mechanisms, and intervention strategies, while also training junior researchers. Over six years, the project advanced understanding of malaria patterns, disease mechanisms, and tested paracetamol as a treatment for acute kidney injury (AKI) in malaria patients.

The study was conducted in phases. Initially, we did a surveillance of severe malaria cases, leading to the largest series of such cases ever studied in the region, with 1378 participants. This included pioneering research on AKI in children with severe malaria in the region. Further, the study explored the abnormalities in the body function due to malaria presenting with dark urine scientifically called haemoglobinuric malaria. This aspect built on previous research gaps that the senior fellow identified during his PhD Study. The study also tested the safety and effectiveness of paracetamol in treating AKI in children with severe malaria, that has now shown promising early results.

In addition to research, the project focused on training, initially aiming to train two junior researchers but successfully training a total of nine. These fellows are now engaged in research in Eastern Uganda, showcasing the project’s success in capacity building and retention of trained personnel. The study also fostered significant networking with local and international institutions, enhancing collaboration and support for ongoing malaria research.

Study Summary

Senior Fellow
Prof. Peter Olupot-Olupot
MB.ChB, MPH, PhD, SRF, FUNAS, FRCP

Grant Acronym: MEPIE Study

Duration: 72 months

Participants:
Mbale Regional Referral Hospital (MRRH), Uganda

Action Title:
Strengthening Malaria Epidemiological, Pathophysiological and Intervention Studies in High Endemic Eastern Uganda – MEPIE Study

Grant number:
TMA2016SF-1514

REC Approval No.:
MRRHREC-OUT003/2019

UNCST Approval No.: HS2555

Reigstered as: ISRCTN84974248

CTA No.: CTA0166

Overview of exploitation of results and outputs:

The Malaria Epidemiological studies in Eastern Uganda, notably the MEPIE study, offer key exploitation avenues to enhance public health, policy, academia, and clinical practice. Opportunities include informing malaria control policies, targeted health education campaigns, and improved hospital diagnostic protocols. Updated treatment guidelines for children, further research, and academic collaborations are crucial.

Community outreach, stakeholder workshops, and technological advancements like telemedicine and mHealth can boost early diagnosis and treatment. Training programs and fellowships will build capacity, while strategic grants and efficient resource distribution will enhance healthcare infrastructure. Disseminating findings through publications and conferences will share knowledge globally and foster collaborations.

Further Malaria Research Training in Eastern and Northern Uganda.

WhatsApp-Image-2024-06-06-at-12.36.05

Mentorship of  PHD Fellows by the Senior Fellow.

WhatsApp-Image-2024-06-06-at-12.37.53-3

Research Training of Staff.

WhatsApp-Image-2024-06-06-at-12.36.10

Training of Malaria Research Team.

Overview of work done during the action:

The project employed a “Target-Indicator-Activity” framework with clear milestones focused on malaria epidemiology, pathophysiology, and trialling paracetamol for AKI. In addition, the fellowship sought to build research capacity by providing hands-on training and mentorship to nine master’s students in malaria research. This has resulted in a vibrant research team in Eastern Uganda.

The research project was conducted in three arms: malaria epidemiology, pathophysiology of AKI in childhood severe malaria, and a nested clinical trial (PARIST) on the feasibility of using paracetamol to alleviate AKI in children with severe malaria. Each of these study areas served as practicum training for the master’s students (Junior Fellows) involved. By training master’s students and conducting hands-on research, the project has achieved a skilled research team that is advancing valuable insights for enhancing malaria control and management strategies in the region and country at large.

Part of the data have been published and disseminated as follows: five key papers covering various aspects of malaria research, including epidemiology, pathophysiology, and outcomes of severe malaria. In addition, a protocol paper on a clinical trial of paracetamol has been published

Study Metrics

1378: Participants were studed

250: Pathophysiology of Acute Kidney Injury (AKI) in childhood severe malaria study participants.

40: Phase I/II clinical trial (PARIST) study participants.

Meet the Fellows

Two Junior Fellows were fully sponsored and trained under this grant

Dr. Cate Namayanja

Dr. George Paasi

Other Fellows

In addition, this Fellowship also supported 7 other junior fellows through their master’s studies. These include:

  • Dr. Emma Egiru Isaiah Eregu
  • Dr. William Okiror
  • Dr. Okalebo Benard Charles
  • Dr. Ronald Oker
  • Dr. Ketty Naizuli
  • Mr. Ocen Emmanuel
  • Mr. Kabaka Mumali Richard

About

Denis Amorut serves as the Study Site Coordinator at the Mbale Clinical Research Institute’s Soroti Site. He is a qualified Registered Nurse with a Bachelor of Science in Health Services Management from the Islamic University in Uganda and a Diploma in Comprehensive Nursing from Soroti School of Registered Comprehensive Nursing. Additionally, he is currently pursuing an Advanced Postgraduate Diploma in Clinical Research & Quality Assurance at James Lind Institute, showcasing his commitment to advancing his expertise in clinical research. Denis has an extensive professional background with 12 years in clinical nursing practice and 11 years dedicated to clinical research. He is registered with the Uganda Midwives and Nurses Council, highlighting his professional standing in the healthcare sector.
 
Throughout his career, Denis has held significant positions such as Trial Manager since November 2021 and previously as Study Site Coordinator at Soroti Regional Referral and Teaching Hospital from 2008 to October 2021. He also serves as a member of the Medicine and Therapeutic Committee at the same hospital since 2018. Denis has enriched his knowledge and skills through numerous online courses and certifications in areas like research ethics, data management for clinical studies, Good Clinical Practice (GCP), and managing health emergencies like Covid-19. His involvement in various research studies, including the TRACT study, and his roles in hospital committees further demonstrate his dedication to both practice and research in healthcare, focusing on improving patient care through evidence-based practices.

About

Ms. Linda Isabirye serves as the Public and Community Engagement Officer at MCRI, where her role encompasses a variety of tasks aimed at enhancing the Institute’s interaction with both internal and external communities. Her work is divided into two primary focuses: public engagement, where she communicates the Institute’s research and ideas to the public, and community engagement, where she assists others in conducting research and achieving their objectives.

In her community engagement efforts, Linda is involved in developing and sustaining a public engagement and involvement framework for the research program. She identifies local opportunities for community collaboration, nurturing relationships with MCRI’s research scientists, staff, and the broader community.

With over two years of experience, she has worked extensively with diverse community stakeholders. Her responsibilities include coordinating activities for the Community Advisory Board (CAB), designing, and overseeing the execution of Community Engagement (CE) initiatives. These initiatives are crucial for identifying, recruiting, and retaining volunteers, engaging community leadership, and supporting the formation and operation of community peer groups. This includes working with study participants, family support groups, and youth and adolescent groups, among others.

About

Rita Muhindo holds a MSc. Molecular Biology from Staffordshire University, UK. She attained her BSc. Biomedical Laboratory Science and Technology degree from Makerere University and an Advanced Diploma in Health Services Management from Islamic University in Uganda. She joined Mbale Clinical Research Institute in July 2011 as a laboratory technologist participating in setting up various laboratory assays for all clinical trials at the MCRI.

She is currently the laboratory manager of MCRI, a role which involves supervision all laboratory research activities at MCRI main and satellite laboratories. She has over twelve years of experience in managing laboratory clinical research and diagnostics service delivery across several key disciplines including molecular, immunology, hematology, microbiology and clinical chemistry.

She has keen interest in understanding the prevalence of red cell polymorphisms present in Ugandan donor populations. Her main focus of her MSc project was on the prevalence of Glucose-6-Phosphate dehydrogenase deficiency, α-thalassaemia and Haemoglobin S among Ugandan donors. Rita is also keen to explore the effects of these polymorphisms on the resolution of severe anaemia.

About

Dr. Charles Benard Okalebo is a highly qualified professional with a B. Pharm, an MPH, and currently a fellow in Infectious Disease and Field Epidemiology under the EDCTP-funded IDEA fellowship. His background as a pharmacist and public health specialist, combined with his role as a Quality Assurance Officer, has provided him with extensive experience in clinical research. This diverse training has honed his skills in assessing healthcare gaps, identifying problems, and designing projects to address these deficiencies. Dr. Okalebo values accuracy, integrity, quality, and career growth above all.
 
He is an experienced and determined professional in conducting clinical trials for both infectious and non-infectious diseases. With eight years in the research field, he has served as a Pharmacist and Quality Assurance Officer at the Mbale Clinical Research Institute, focusing on various types of clinical trials related to infectious diseases. His involvement spans across all phases of clinical trials (I-III), including protocol design, review, and implementation; navigating regulatory approval processes; managing investigational medicinal products (IMP); monitoring studies; establishing and implementing Quality Management processes; pharmacovigilance; and leading training sessions on the ethical conduct of research. The trials he has participated in include TRACT (ISRCTN84086586), GASTROSAM (ISRCTN76149273), PAC (ISRCTN11594437), FLACSAM (ISRCTN18051843), MIMBLE (ISRCTN10309022), and TABS (ISRCTN49726849) studies.
 
Dr. Okalebo is a dedicated researcher with a keen interest in advancing his career in pharmaco-epidemiology, statistics, and pharmacovigilance.

About

Felix Opio joined the Mbale Clinical Research Institute (MCRI) in April 2014 as Data Manager under the REACH (Realizing Effectiveness Across Continents with Hydroxyurea) ClinicalTrials.gov NCT01966731) which is a prospective, Phase I/II open-label trial of hydroxyurea designed to evaluate the feasibility, safety, long-term risks and benefits of hydroxyurea treatment for children with SCA in four sub-Saharan African countries (Mable Uganda,Kilifi Kenya, Luanda Angola and Kinshasa DRC).

He holds a Bachelor of Science in Computer Science from Gulu University, a post graduate diploma in Monitoring and Evaluation from Uganda Management Institute (UMI), Certificate in Project Management Professional from Devimpact Institute Kenya and various other certification in Clinical database development.

He Has 9 years of experience in Clinical Database design and Management, He is Currently overseeing data management work for the REACH study and all the day to day activities of the Project, He is also a member of the internal Clinical Trial Monitoring Unit and A chairperson Procurement Committee for Mbale Clinical Research Institute.

About

Ebitu Caleb Daniel serves as an I.T Support Officer at the Mbale Clinical Research Institute. He is recognized as an accomplished network and systems administrator, who takes pleasure in applying his skills to support and contribute to the technological advancement of research within the institution.
 
Ebitu graduated from Uganda Christian University Mukono with a Bachelor’s degree in Computer Science. Over the years, he has also acquired various certifications including CCNA, Information Security, Google Cloud Developer, PMP (Telecom), and Federated Identity Management.

About

Laban has accumulated over four years of experience in managing research financial processes since joining the Mbale Clinical Research Institute on July 1, 2019, as an Accounts Assistant. This experience complements his extensive background of over ten years in the banking sector, where he has previously worked for two banks in roles involving people management, cash management, internal controls, and accountability.

He holds a Bachelor’s degree in Business Studies, specializing in Accounting, from the Islamic University of Uganda. He is currently pursuing a Certificate of Public Accountants (CPA) from the Institute of Certified Public Accountants of Uganda (ICPAU), with only two papers remaining to complete the course.

Driven by an ambition to advance his career in accounting and expand his experience in research-related accounting managed by well-established systems and processes, he believes that MCRI is the ideal place for his professional growth.