Browsing by Author "Salata, Robert A."

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    First Trial Of The HIV­1 Vaccine In Africa: Ugandan Experience
    (Bmj, 2002) Mugerwa, Roy D.; Kaleebu, Pontiano; Mugyenyi, Peter; ­Mbidde, Edward Katongole; Hom, David L.; Byaruhanga, Rose; Salata, Robert A.; Ellner, Jerrold J.; HIV­1 Vaccine Trial Group
    Trials of the HIV­1 vaccine have been conducted in Europe, North America, Brazil, China, and Thailand.1 The first trial of a candidate vaccine in Africa was recently completed in Uganda. It involved a ran­domised, placebo controlled trial of a vaccine in healthy volunteers at low risk of HIV infection.2 3 The vaccine, called “ALVAC­HIV,” uses a live recombinant canarypox vector to express envelope and core genes of HIV­1. Many commentators predicted that it would be dif­ficult to conduct trials of HIV vaccines in developing countries because of scientific, sociobehavioural, ethical, and logistical barriers.4–8 Before we started the trial in Uganda, we gathered data to help us overcome these potential barriers. We collected epidemiological9 and sociobehavioural10 data about people who had participated in studies that looked at preparing for trials of the HIV vaccine. These data showed the preva­lence and incidence of HIV, behaviours placing people at risk of becoming infected with HIV, and the social acceptability of a vaccine against HIV.9–11 The people received detailed education and counselling about infection with HIV and about HIV vaccines, and we recruited some for our trial.11We organised three open workshops at the HIV candidate vaccine trial workshop in Kampala in 1996 to gain consensus from scientists, policy makers, community representatives, and the media about how to undertake research into HIV vaccines. Despite these initiatives to solve problems before the trial began, we still encountered many barriers. In this article, we discuss these barriers and the strategiesthat we developed to overcome them.
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    Global Medical Education Partnerships to Expand Specialty Expertise: A Case Report on Building Neurology Clinical and Research Capacity
    (Human resources for health, 2014) Kaddumukasa, Mark; Katabira, Elly; Salata, Robert A.; Costa, Marco A.; Ddumba, Edward; Furlan, Anthony; Mwesige, Angelina Kakooza; Kamya, Moses R.; Kayima, James; Longenecker, Chris T.; Kizza, Harriet Mayanja; Mondo, Charles; Moore, Shirley; Pundik, Svetlana; Sewankambo, Nelson; Simon, Daniel I.; Smyth, Kathleen A.; Sajatovic, Martha
    Neurological disorders are a common cause of morbidity and mortality in sub-Saharan African, but resources for their management are scarce. Collaborations between training institutions in developed and resource-limited countries can be a successful model for supporting specialty medical education and increasing clinical and research capacity.This report describes a US National Institutes of Health (NIH) funded Medical Education Partnership Initiative (MEPI) to enhance expertise in neurology, developed between Makerere University College of Health Sciences in Kampala, Uganda, and Case Western Reserve University School of Medicine in Cleveland, OH, USA.This collaborative model is based on a successful medical education and research model that has been developed over the past two decades. The Ugandan and US teams have accumulated knowledge and 'lessons learned' that facilitate specialty expertise in neurological conditions, which are widespread and associated with substantial disability in resource-limited countries. Strengths of the model include a focus on community health care settings and a strong research component. Key elements include strong local leadership; use of remote technology, templates to standardize performance; shared exchanges; mechanisms to optimize sustainability and of dissemination activities that expand impact of the original initiative. Efficient collaborations are further enhanced by external and institutional support, and can be sequentially refined.Models such as the Makerere University College of Health Sciences - Case Western Reserve University partnership may help other groups initiate collaborative education programmes and establish successful partnerships that may provide the opportunity to expand to other chronic diseases. A benefit of collaboration is that learning is two-directional, and interaction with other international medical education collaborators is likely to be of benefit to the larger global health community.
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    Prevalence of latent rheumatic heart disease among HIV-infected children in Kampala, Uganda
    (Journal of acquired immune deficiency syndromes, 2016) Gleason, Brigette; Mirembe, Grace; Namuyonga, Judith; Okello, Emmy; Lwabi, Peter; Lubega, Irene; Lubega, Sulaiman; Musiime, Victor; Kityo, Cissy; Salata, Robert A.; Longenecker, Chris T.
    Rheumatic heart disease (RHD) remains highly prevalent in resource-constrained settings around the world, including countries with high rates of HIV/AIDS. Although both are immune-mediated diseases, it is unknown whether HIV modifies the risk or progression of RHD. We performed screening echocardiography to determine the prevalence of latent rheumatic heart disease in 488 HIV-infected children aged 5-18 in Kampala, Uganda. The overall prevalence of borderline/definite RHD was 0.82% (95% CI 0.26% to 2.23%) which is lower than the published prevalence rates of 1.5-4% among Ugandan children. There may be protective factors that decrease the risk of RHD in HIV-infected children.