Infectious Diseases Institute Uganda

The Infectious Diseases Institute (IDI) was built through Pfizer funding and opened to the public in 2004. The Institute is part of the College of Health Sciences at Makerere University and runs as a semi-autonomous entity with its own grant management, finance and contractual systems. Its main mandate is training, research and clinical care as a tertiary HIV care Centre of Excellence.

It currently provides care and treatment services to over 100,000 people living with HIV in urban and rural settings in Uganda (directly through our large clinic, and in partnership with government and non-government health facilities) which amounts to about 10% of the national effort. IDI is a national referral centre for complicated cases of HIV.

IDI has trained over 19,000 health workers from Uganda and 27 other African countries in HIV/AIDS and TB co-infection, malaria, lab services, pharmacy, systems strengthening and research capacity building. It has a research programme comprising over 40 projects (with over 500 articles in peer-reviewed journals to date), and is also committed to major long-term outreach programmes to build capacity across Uganda. IDI has its own comprehensive clinical data system and employs over 900 staff.

IDI’s Vision is “a healthy Africa free from the burden of infectious diseases”.

AMBITION study participants will also be recruited at Mbarara Regional Hospital, 270km from Kampala.

IDI AMBITION Team

Dr. David Meya: IDI Principal Investigator

I am an Associate Professor in the School of Medicine at the College of Health Sciences, Makerere University, and am adjunct Associate Professor at the University of Minnesota. I have participated in clinical research pertaining to CNS infections and complications, with a focus on HIV Immune Reconstitution Inflammatory syndrome. I have led epidemiological and translational research studies as well as randomized clinical trials in Uganda in collaboration with colleagues from the University of Minnesota. I have been the PI and Co-PI on many clinical research grants funded, amongst others, by NIH, CDC, and the MRC.

I also have a specific interest in public health interventions to prevent meningitis at population level, and have advocated for cryptococcal antigen (CrAg) screening as a strategy to reduce deaths and hospitalizations from cryptococcal meningitis.  I am currently leading efforts to initiate implementation of the national CrAg screening program in collaboration with the Ministry of Health, Clinton Health Access Initiative (CHAI), the Central Public Health Laboratories and U.S. CDC.

Dr. David Boulware: Co-Investigator

I am a Distinguished Associate Professor in Infectious Diseases at the University of Minnesota with formal training in clinical trials, public health, and tropical medicine. My primary research interests revolve around meningitis in resource-limited areas including diagnosis, prevention, treatment, and quality improvement initiatives incorporating cost-effectiveness analyses in order to translate knowledge into improved care. I have worked with colleagues in Uganda since 2005 on cryptococcosis, and work on AMBITION protocol implementation in Uganda.  I have active research collaborations in Uganda, South Africa, and Ethiopia leading a multidisciplinary, international research team. A favourite quotation of mine is “Cryptococcus is too neglected to be considered a neglected disease.”

Dr. Abdu Musubire: Co-Investigator

Prior to joining Makerere University in 2005, I worked as a medical officer at Kibaale District Health Centre IV clinic in western Uganda, where I participated in several HIV related activities, including a baseline qualitative and quantitative survey for HIV services in Kibaale district. I also trained as a national trainer in the integrated management of Adolescent and Adult Illnesses (IMAI) that paved the way to the national rollout of antiretroviral therapy (ART).

I have worked on several cryptococcal research studies at IDI, including the COAT and ASTRO-CM trials. Since 2008, I have served as an attending physician on the neurology ward at Mulago National Referral Hospital.  I am particularly interested in inflammatory and infectious diseases of the nervous system, and am currently conducting research on the causes and clinical outcomes of patients with non-traumatic spinal cord injury.

Dr. Edward Mpoza: Senior Study Doctor

I hold a Bachelors Degree in Medicine and a Masters in Internal Medicine from Makerere University. I also completed a Fogarty Global Health Fellowship with the University of Minnesota. I have previously worked as a study doctor in various clinical trials in cryptococcal meningitis. I am interested in translational HIV research, with a specific interest in cryptococcal meningitis. I look forward to the day when HIV and cryptococcal meningitis will be history.

My role within AMBITION is to provide clinical care for the patients.

Dr. Enock Kagimu: Medical Officer

Prior to joining the team at IDI, I served as a Research Assistant in two prevalence studies based at Mulago National Referral Hospital. Under the mentorship of Dr. David Meya, and through Uganda’s research training collaboration with the University of Minnesota, I was awarded a small grant in 2017 which allowed me to lead a team in an evaluation study of the CrAg screening programme in Uganda as a means of reducing HIV-associated cryptococcal meningitis.

I then volunteered as a Medical Officer (MO) on the ASTRO and AMBITION clinical trials in Kampala for 8 months, before I was employed as a full-time clinical trial MO on the meningitis team at IDI. I also participated in the AMBITION-funded Medical Mycology Course at The University of Cape Town in December 2018. I have recently received a certificate in scientific writing as an early career researcher, and am now interested in researching the early detection of HIV-associated central nervous system infections through understanding the pathogenesis, immunology and diagnostics of the disease, so as to improve patient outcomes in low-resource settings.

Dr. Kenneth Ssembambulidde: Study Doctor

I graduated with a Bachelor’s degree in Medicine and Surgery (MBChB) from Makerere University College of Health Sciences. I subsequently worked as a Medical Officer on ASTRO-CM trial, where I developed experience in cryptococcal meningitis clinical care and comprehensive HIV care. I am intrigued by the innate immune responses to Cryptococcus neoformans, in particular complement system and antigen presentation. I hope to further my immunology interests by delving into the world of vaccine development in the near future.

My main responsibilities on the AMBITION trial are screening and enrolling study participants and providing on-going clinical care to the patients with the rest of the clinical team.

I recently completed an MSc in Immunology of Infectious Diseases at LSHTM (September 2018 – September 2019). I have now resumed my role as Study Doctor at IDI Uganda and hope to put my immunology skills to good use in the future by supporting several AMBITION sub-studies.

Dr. Morris Rutakingirwa: Study Doctor

I graduated with a Bachelor’s Degree in Medicine and Surgery (MBChB) from Makerere University here in Kampala. During my Medical Internship in Internal Medicine at Mulago National Referral Hospital, I took a particular interest in clinical care and in the holistic management of patients with HIV/AIDS. As a result, I joined IDI as a Medical Officer on the C-ASSERT clinical trial, where I gained considerable experience in both clinical trial research and in the management of patients with cryptococcal disease.

Under the mentorship of Dr David Meya, I am hoping to further my career in infectious diseases research and clinical care.

Along with other members of the study team, I provide clinical care to all AMBITION participants.

Dr. Samuel Jjunju: Study Doctor

I graduated with an MBChB from Gulu University, Uganda, before becoming a member of the Uganda Medical Association. Prior to joining IDI, I worked as both a Medical Officer and as the Deputy Head of Clinicians at the Namulundu Medical Centre, in the Wakiso District of Uganda.

My current interests lie in the interventional medical research of HIV-associated central nervous system infections, with a specific focus on cryptococcal meningitis.

I am honoured to be working as an AMBITION Study Doctor. My main duties include the screening and enrollment of study participants, inpatient care, and outpatient follow-up.

Darlisha Williams: Project Manager

I have been living and working in Uganda since 2011 as the study coordinator for the University of Minnesota’s cryptococcal meningitis clinical trials. I began my time in Kampala working on COAT (the Trial for the Optimal Timing of HIV Therapy after Cryptococcal Meningitis), followed by the ASTRO study, which investigated the utility of using adjunctive sertraline therapy for the treatment of cryptococcal meningitis.

I received my master’s in public health and epidemiology from the University of Minnesota and have worked previously with the Centers for Disease Control and Prevention, and the World Health Organization on immunization projects in Tanzania.

I oversee the day-to-day AMBITION activities on site and manage the data collection and logistics.

Dr. Laura Nsangi: Project Coordinator

I hold a Bachelor’s Degree in Medicine and Surgery and am currently pursuing a Master’s Degree in Public Health at Makerere University here in Uganda. I have been a Co-Investigator in four clinical trials with the Medical Research Council/Uganda Virus Research Institute and the London School of Hygiene and Tropical Medicine including the START trial, Ebola and HIV Vaccine Trials and the Rift Valley Fever Survivors’ trial. The rigorous training and experience that I received during my four year tenure at MUL further cemented my desire to pursue a research career.

I am particularly interested in infectious disease control in the immunocompromised HIV-affected populations, and especially in neurological conditions such as cryptococcal and TB meningitis.

I am honoured to be able to co-ordinate the meningitis screening and AMBITION study activities at the Mulago study site here at IDI, as well as to offer support to the Mbarara study site.

Jane Frances Ndyetukira: Study Nurse

I have 19 years of experience in Nursing and Midwifery, and have been working as a senior nurse in Cryptococcal Meningitis clinical studies since 2010, including the COAT and ASTRO-cm trials. I have particular interests in Counselling and Health Education, and I am currently pursuing a Bachelor’s Degree in Public Health to further these interests.

My main responsibilities in the AMBITION Study are consenting participants, providing general nursing care (including clinical monitoring and administering medications), completion of CRFs and follow-up of participants to ensure minimal loss to follow up. I also provide general oversight to ensure that all study procedures are completed accurately at each visit.

Cynthia Ahimbisibwe: Study Nurse

I have 10 years of experience in Nursing and Midwifery, and have been working as a senior nurse in Cryptococcal Meningitis clinical studies since 2010, including the COAT and ASTRO-cm trials. I have special Interests in Counselling and Health Education, and hold a Bachelor’s Degree in Community Psychology.

My main responsibilities in the AMBITION Study are consenting participants, providing general nursing care (including clinical monitoring and administering medications), completion of CRFs and follow-up of participants to ensure minimal loss to follow up. I also provide general oversight to ensure that all study procedures are completed accurately at each visit.

Carol Namuju: Study Nurse

I am a Nurse/Counsellor and a Social Scientist. I hold a Certificate in Nursing, with a Diploma in Guidance and Counselling (2004). I attained a degree in Social Sciences from Makerere University in 2010. I then undertook a course in Applied Clinical Research Evidence Medicine (ACREM) in 2012/2013, under the Department of Clinical Trials – School of Medicine, Makerere University. I have worked as a Research Nurse for four years investigating the pathogenesis of TB IRIS in TB/HIV Co-infected adults in the EDCTP-funded INTERACT and TB/HIV OUTCOME studies at IDI – Mulago. I joined the Meningitis team as a full time Research Nurse in 2016. I am also a Co-ordinator of the sub-study Autopsy Study which seeks to assess the pathogen and anti-infective distribution and responses in HIV-positive patients (adults). I have a strong interest in career development, and I hope to pursue a Master’s in Public Health in the near future.

My role within the AMBITION study involves screening and recruiting participants, providing informed consent, clinical assessment, medical history, sample collection, data collection, data management, AE/SAE reviewing and reporting, drug administration, follow-up of participants and training delivery.

Alisat Sadiq: Study Counsellor

I have formal training in HIV AIDS related counselling, and began my career as a study counsellor for the COAT) Study that was enrolling Anti Retro- viral Therapy (ART) naïve patients only. I later worked as a counsellor in the ASTRO-CM study, and over the years, I have developed an interest in understanding and exploring the unique counselling needs of AIDS patients either failing on ART or presenting late with Stage IV disease including Cryptococcal Meningitis.

My colleagues know me as the person who “never fails to consent a patient!” My major roles in the AMBITION study are therefore administering consent to study participants and ensuring minimal loss to follow up. I will also look out for the overall social welfare of study participants that may interfere with compliance to study procedures.

Andrew Akampurira: Medical Laboratory Technologist: Microbiology

I have been working with IDI and Makere College of Health Sciences for ten years, and have participated in the  IRIS, COAT, NOAT, ORCAS, ASTRO studies. I am interested in prevention, improved care and patient management. For the AMBITION study I perform all microbiology laboratory assays and other laboratory disciplines as per the study protocol.

Richard Kwizera: Medical Mycologist / Lab Scientist

I am a Medical Mycologist here at IDI. I hold a Bachelors Degree in Biomedical Laboratory Technology (Makerere University) and a Masters Degree in Biomedical Laboratory Sciences and Management (University of Manchester). I am currently a PhD Fellow in the Department of Microbiology. I have eight years of laboratory experience with a special research interest in Diagnostics, Epidemiology and Management of pulmonary and opportunistic fungal infections.

I am highly experienced in mycology laboratory techniques and have experience in HIV, TB and fungal disease diagnosis and management. I am also attached to the Makerere fungal group investigating the ouccomes of HIV patients with cryptococcal meningitis in collaboration with the University of Minnesota. I have previously been involved in translational research studying point-of-care testing for cryptococcal infections in HIV, and rapid detection of CSF sterility in HIV/cryptococcal co-infection.

My main role within AMBITION is to perform laboratory specimen processing, laboratory QA/QC and to coordinate all laboratory-related activities on the study.

Catherine Nanteza: Study Administrator

I hold a Bachelors Degree in Environmental Management from Makerere University, in addition to training in finance management for non-finance managers. I joined IDI in 2011 as an administrative assistant on the COAT study. I have since provided project administrative services to several meningitis studies within IDI.

I am the AMBITION Project Administrator for the meningitis team at IDI. My role involves providing administrative support to the team.

Rhona Muyise: Pharmacist

I hold a Bachelors degree in Pharmacy from Mbarara University of Science and Technology. I am an active member of the Pharmaceutical Society of Uganda and have 3 years’ experience in clinical research as a clinical trial Pharmacist. I have over 6 years’ experience in HIV/AIDS care, and more specifically pharmaceutical care. I am currently working as a lead clinical Pharmacist at IDI in both the PCT clinic and the research pharmacy. My primary role in PCT is to ensure patient-tailored pharmaceutical care, with a particular emphasis on dose adjustment for patients with non-communicable diseases such as chronic and acute renal diseases. I am also responsible for overseeing stock management and for pharmacovigilance.

I also work as the Lead Trial Pharmacist in five separate clinical trials here in Kampala, including AMBITION. My key areas of expertise include receipt storage, dispensing, the accountability of IMPs, protocol-specific summary reports, dispensation retention, inventory and destruction tasks, the development and preparation of SOPs, and the generation of both standard and customised forms for drug accountability. In AMBITION, my responsibilities include overseeing the randomisation process, checking for completeness of prescriptions, monitoring for appropriate dosing, assessing patients’ understanding regarding their medication, as well as providing them with any additional education/counselling and ensuring appropriate medication monitoring.

Mbarara AMBITION Team

Dr. Conrad Muzoora: Site PI

I am a HIV physician-scientist with formal training in clinical research. I completed my Masters in Internal Medicine at Mbarara University in 2008, following which I started a five-year fellowship in clinical research with the University of California San Francisco.

I have been involved in HIV care and research for the last ten years, and have special interests in Tuberculosis (TB) and Cryptococcal Meningitis (CM). My main research goals focus upon improving the diagnosis and treatment of TB and CM, particularly in persons living with HIV. I have conducted five clinical trials involving CM, and several other projects involving HIV and TB.

Dr. Edwin Niwagyira: Study Doctor

I hold a Bachelors Degree in Medicine and a Bachelors in Surgery (MBCh.B), and am also a final year candidate of Master of Medicine in Internal Medicine at Mbarara University of Science and Technology. I worked as a research medical officer for the ASTRO trial, on Phase II in Mulago Hospital and Phase III in Mbarara Hospital. My main interests lie in infectious diseases research, and from my mentors (Conrad and Kabanda) I hope to do much more in HIV and opportunistic diseases research.

As a study doctor, my main duties involve patient enrolment, sample collection, inpatient care, and outpatient follow up.

Joan Rukundo: Study Nurse

I am a qualified Nurse with over four years of experience. During this time, I have been directly involved in a number of research studies, ranging from heart failure to stroke.

My interests predominantly lie in counselling and health education, and I am currently completing my Diploma in Nursing with a view to further my studies in the future.

My main responsibilities on the AMBITION study include consenting participants, administering drugs, assisting in the LP process, completing CRFs, and being a key point of contact in the follow-up of study participants.

Mike Ssemusu: Study Nurse

I graduated with a diploma in Nursing from Bishop Stuart University in Uganda. I began my career working as a Volunteer Nurse on a number of studies including ADEPT, RifT and CCM. During this time, I gained considerable experience in both clinical trial research and in the management of patients with HIV, TB and cryptococcal meningitis.

My primary interests lie in exploring the psychological effects associated with the counselling and management of patients with infectious diseases.

My main responsibilities on AMBITION are to screen and consent participants, provide general nursing care (including clinical monitoring), administer study medications and undertake sample and data collection. I also oversee outpatient follow-up of study participants.

With the mentorship of Dr. Edwin Niwagyira and Dr. Conrad Muzoora, I hope to gain further experience in this field and develop my career in infectious disease research and clinical trials.

Irene Rwomushana: Study Coordinator

Following the completion of my Undergraduate Degree, I studied for an MSc in Clinical Trials at the University of Edinburgh in the UK.

As a Study Coordinator, I have gained invaluable skills in clinical trial monitoring and management through working in various therapeutic areas of clinical research. In addition to my role as AMBITION Study Coordinator at the Mbarara recruiting site, I am also the Co-auditor for an investigational site systems audit, and a Regulatory Affairs Officer.

My interests lie primarily in clinical trial monitoring, management and auditing.

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