Research activities
Reduction of Early Mortality among HIV-Infected subjects starting Antiretroviral Therapy (REMSTART) Trial PDF Print E-mail

This is a new multi-country randomised trial to be implemented both in Tanzania and Zambia in collaboration with London School of Hygiene and Tropical Medicine (LSHTM). It is financed by the European and Developing Countries Clinical trial Partnership (EDCTP). The study is expected to commence early 2012.

The trial will be conducted in urban centres in Tanzania (at the Care and Treatment Centre, in Mwanayamala, Dar-es-Salaam) and Zambia (University Teaching Hospital, Lusaka) in collaboration with partners from the Kenya Medical Research Institute, in Nairobi, the London School of Hygiene and Tropical Medicine, University College London, St Georges 35 Medical School London, Foundation for innovative new Diagnostics In Switzerland, Karolinska University Hospital, Sweden and the World Health Organisation. 

The project will address two research questions namely:

  • Can a complex intervention involving i) accelerated initiation of ART, ii) increased involvement of lay-workers in adherence iii) increased frequency of diagnostic testing for major co-infections lead to a reduction in early mortality among patients initiating ART compared to current standard of care.
  • Are home-based Voluntary Counseling and  Testing (VCT) for HIV and screening for tuberculosis among family members of subjects on ART feasible and cost-effective?


The specific objectives are:

  1. To determine the effects of the intervention, accelerated initiation of ART and enhanced monitoring, support and diagnostics just before and during the first 4-6 weeks of therapy, as compared with standard care. The primary endpoint will be all-cause mortality up to 12 months after enrolment into the study.
  2. To determine the costs incurred by the health service with this intervention strategy (in relation to standard care) and to relate these to the survival. To determine also the costs associated with accessing care for patients in the two arms of the trial.
  3. To determine the effects of the intervention on patient retention, hospital admissions,outpatient attendance as compared to standard care.

 

Last Updated on Thursday, 14 March 2013 14:18
 
East Africa Public Health Laboratory Networking Project PDF Print E-mail

The World Bank, as a part of its global goal of strengthening health systems, has supporting five year project known as East Africa Public Health Laboratory Networking Project (EAPHLNP) that involves Tanzania, Kenya, Uganda and Rwanda as part of strengthening laboratory capacity in control of infectious diseases.

In this regard, The Government of Tanzania has received Credit of US$15 million from the International Development Association (IDA) for the Project.  The project will: (i) strengthen capacity to rapidly diagnose communicable diseases of public health importance and share information to mount an effective regional response; (ii) support joint training and capacity building to expand the pool of qualified laboratory technicians; and (iii) fund joint operational research and promote knowledge sharing to enhance the evidence base for these investments and support regional coordination and program management. 

An essential component of the project will be close collaboration with key partners who are already at work in East Africa, such as the East Central and South African Health Desk (ECSA) and the East African Community (EAC) Health Desk

In Tanzania, the project will involve the construction of a National Public Health Laboratory and renovation and provision of supplies to six satellite laboratories, namely Ndanda Hospital, Sumbawanga Regional Hospital, Maweni (Kigoma) Regional Hospital, Musoma Regional Hospital, Mnazi mmoja Hospital and Kibong’oto Hospital. In addition, the project will provide regional and local training to laboratory staff.

Last Updated on Thursday, 14 March 2013 14:20
 
TB/HAART Project PDF Print E-mail

This is a multi-country study involving four countries – Tanzania, Uganda, Zambia and South Africa which started in 2006 with financial  and technical support from WHO/TDR. The purpose is to evaluate the impact of early initiation of HAART on TB treatment outcomes for TB patients co-infected with HIV. By the end of 2010, there were only 4 sites participating in the study in Dar es Salaam, Iringa, Morogoro and Tanga. However, the Morogoro and Tanga sites were stopped by the Steering Committee to  recruit new subjects because of failure to abide to good laboratory and clinical practice (GLP/GCP) standards. To mitigate the loss, the number of recruiting sites were increased from 10 to 14 (10 satellite plus 4 main sites) and the project strengthened supervision and training of staff in Dar es Salaam. The recruitment of subjects increased on average from 9 per month to 19 against a target of 25 per month. Overall, 108 new subjects were recruited and 112 were followed up in 2010.

During this period, the programme also conducted refresher training to  the entire research team to ensure that they are conversant with the guidelines and regulations governing the implementation of the study including ethical issues. In addition, 60 TB-HAART study personnel from all study sites were provided with on-job training on GLP/GCP and 20 laboratory staff from the participating sites was trained on LED FM microscopy. At the same time the project recruited three new Clinical Trial Assistants to improve follow-up of subjects recruited into the study.
Muhimbili National Hospital and the municipal hospitals in Dar es Salaam together with the regional in Iringa continued to provide satisfactory laboratory results due to improved supply of chemicals and reagents from the project and frequent supportive supervision by study coordinators. 

It is important also to report that the project lost its only car due to road accident in December, 2010 during one of its supervision missions in Morogoro. Five of the 6 people in the car received body injuries of varying degrees and two of them were admitted at Muhimbili Orthopaedic Institute for more than 2 weeks. All of them have since resumed their work.

Last Updated on Sunday, 05 August 2012 14:07
 
First National Tuberculosis Prevalence Survey PDF Print E-mail

This is a national wide population based survey designed to determine the best estimates of prevalence of pulmonary tuberculosis disease in the country. During thisyear, the programme participated in an international workshop  organised by WHO in Ethiopia to review the sampling framework and sample size in line with the current WHO guidelines. The programme also received clearance from GFATM through country CCM to use part of Round 6 reprogrammed funds to finance the survey.  The recruitment and training of key survey team’s members, development of SOPs and field manual, logistical arrangements and collection of field data are scheduled for the next year.

Last Updated on Sunday, 05 August 2012 14:08