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Uganda Virus Research Institute

REPUBLIC OF UGANDA

Epidemiology

Department of Epidemiology and Data management

PI: Tom Lutalo

1.     Improving the measurement of adolescent and adult mortality in low income-countries

Objective

  • Testing a Mobile Measurement Tool for Adolescent and Adult Mortality in Low and Middle-Income Countries.
  • With child mortality rapidly declining, an increasing proportion of all deaths in low and middle-income countries (LMICs) will occur at adolescent and adult ages in the next decades. The Sustainable Development Goals (SDGs) set out by the United Nations reflect this shift: over the next 15 years (2015-2030), several SDG targets will focus on reducing deaths from causes that affect primarily those age groups (e.g., HIV/AIDS, maternal mortality, road traffic accidents, suicides). Investments in adolescent and adult health from US federal institutions, international organizations and governments of LMICs are thus expected to increase significantly.
  • The mortality impact of such investments may however remain unknown because few LMICs have vital registration systems that allow measuring mortality precisely. Despite current efforts to improve such systems, household-based surveys (e.g., the Demographic and Health Surveys, DHS) will remain the primary data source on adolescent an adult mortality in LMICs. These surveys entail asking a random sample of respondents to report their siblings' survival history (SSH), i.e., whether each of their siblings

   1) is alive

   2) how old s/he is, and

   3) if deceased, how old s/he was at the time of death and the time since death. SSH permit directly estimating mortality rates at ages 15 and older, and also include basic assessments of the causes of    siblings' deaths. They are however still affected by pervasive reporting errors. For example, respondents may omit some deaths, whereas other deaths may be added, or displaced in time. The net effects of these reporting errors on mortality indicators are large and hard to predict, but existing analytical corrections are based on very limited validation studies and do not capture this complexity.

  • They risk accentuating bias and/or misrepresenting uncertainty in mortality estimates. In this project, we propose to improve the accuracy of survey-based estimates of adolescent and adult mortality through a) innovative data collection techniques (e.g., event history calendars, recall cues) and b) integrated Bayesian methods that account for sampling and non-sampling errors. Results from this study will help develop and target adolescent and adult health interventions in low and middle income countries, and evaluate the effectiveness of global health initiatives.

2. Enhancing Good Epidemiological Practice at Uganda Virus Research Institute (UVRI)

Objective

  • Develop standards of good epidemiological practice at UVRI on which departments, staff, current and future collaborating partners are to be obliged.
  • The UVRI and its partners conduct scientific investigations on viral and other communicable diseases in the country. This involves investigations of both endemic and epidemic diseases, partnering with the Ministry of Health, international and local stakeholders. However, the epidemiological investigations and reporting models used are primarily anchored in the objectives of the main funders and lead investigators outside of the UVRI core fraternity. There is a need for UVRI to develop guidelines and recommendations for good epidemiological practice as a starting point to enhance good scientific research at the Institute, through a consensus building process. The guidelines would be addressed to everyone at UVRI involved in the planning, preparation, execution, analysis and evaluation of research that should involve an epidemiological aspect. The guidelines Are to be based on current widely accepted standards of epidemiological research already in use internationally. Of note is that these guidelines will not be inflexible to threaten freedom of Epidemiological research at UVRI. They will instead define a framework within which epidemiological research will be used to maximize benefits relating to all its areas of application. These guidelines will be important with regard to both the execution of upcoming approved studies and the planning of future ones. It is planned for the guidelines to cover;- Ethics in research, planning of epidemiological investigations, writing of protocols, biospecimens, quality assurance, Data Management and Documentation, Analysis and Interpretation, Data protection, Contractual obligations and Communication and Public Health.
  • The funders for this work include the Vote to Epidemiology and Data Department from UVRI and NIH