BackgroundSome areas of Africa are witnessing a malaria transition, in part due to escalated international donor support and intervention coverage. Areas where declining malaria rates have been observed are largely characterized by relatively low baseline transmission intensity and rapid scaling of interventions. Less well described are changing patterns of malaria burden in areas of high parasite transmission and slower increases in control and treatment access.MethodsUganda is a country predominantly characterized by intense, perennial malaria transmission. Monthly pediatric admission data from five Ugandan hospitals and their catchments have been assembled retrospectively across 11 years from January 1999 to December 2009. Malaria admission rates adjusted for changes in population density within defined catchment areas were computed across three time periods that correspond to periods where intervention coverage data exist and different treatment and prevention policies were operational. Time series models were developed adjusting for variations in rainfall and hospital use to examine changes in malaria hospitalization over 132 months. The temporal changes in factors that might explain changes in disease incidence were qualitatively examined sequentially for each hospital setting and compared between hospital settingsResultsIn four out of five sites there was a significant increase in malaria admission rates. Results from time series models indicate a significant month-to-month increase in the mean malaria admission rates at four hospitals (trend P < 0.001). At all hospitals malaria admissions had increased from 1999 by 47% to 350%. Observed changes in intervention coverage within the catchments of each hospital showed a change in insecticide-treated net coverage from <1% in 2000 to 33% by 2009 but accompanied by increases in access to nationally recommended drugs at only two of the five hospital areas studied.ConclusionsThe declining malaria disease burden in some parts of Africa is not a universal phenomena across the continent. Despite moderate increases in the coverage of measures to reduce infection and disease without significant coincidental increasing access to effective medicines to treat disease may not lead to severe disease burden reductions in high transmission areas of Africa. More data is needed from a wider range of malaria settings to provide an honest tracking progress of the impact of scaled intervention coverage in Africa.
Background A large proportion of postgraduate students the world over complete a research thesis in partial fulfilment of their degree requirements. This study identified and evaluated support mechanisms for research generation and utilization for masters’ students in health institutions of higher learning in Uganda. Methods This was a self-administered cross-sectional survey using a modified self-assessment tool for research institutes (m-SATORI). Postgraduate students were randomly selected from four medical or public health Ugandan universities at Makerere, Mbarara, Nkozi and Mukono and asked to circle the most appropriate response on a Likert scale from 1, where the “situation was unfavourable and/or there was a need for an intervention”, to 5, where the “situation was good or needed no intervention”. These questions were asked under four domains: the research question; knowledge production, knowledge transfer and promoting use of evidence. Mean scores of individual questions and aggregate means under the four domains were computed and then compared to identify areas of strengths and gaps that required action. Results Most of the respondents returned their questionnaires, 185 of 258 (71.7%), and only 79 of these (42.7%) had their theses submitted for examination. The majority of the respondents were male (57.3%), married or cohabiting (58.4%), and were medical doctors (71.9%) from Makerere University (50.3%). The domain proposal development for postgraduate research project had the highest mean score of 3.53 out of the maximum 5. Three of the four domains scored below the mid-level domain score of 3, that is, the situation is neither favourable nor unfavourable. Areas requiring substantial improvements included priority-setting during research question identification, which had the lowest mean score of 2.12. This was followed by promoting use of postgraduate research products, tying at mean scores of 2.28 each. The domain knowledge transfer of postgraduate research products had an above-average mean score of 2.75. Conclusions This study reports that existing research support mechanisms for postgraduate students in Uganda encourage access to supervisors and mentors during proposal development. Postgraduate students’ engagement with research users was limited in priority-setting and knowledge transfer. Since supervisors and mentors views were not captured, future follow-on research could tackle this aspect.
BackgroundPost–graduate students world over complete a research thesis in partial fulfillment of their degree requirements. This study identified and evaluated support mechanisms for research generation and utilization for masters’ students in health institutions of higher learning in Uganda. MethodsA self administered cross–sectional survey using a modified Self Assessment Tool for Research Institutions (SATORI). Post–graduate students were requested to encircle the most appropriate response in a Likert scale from 1 where the ‘situation was unfavorable and/or there was a need for an intervention’; to 5 where the ‘situation was good or needed no intervention’. These questions were asked under four domains: the ‘research question’; ‘knowledge production’; ‘knowledge transfer’ and ‘promoting use of evidence’. Mean scores of individual questions and aggregate means under the four domains were computed; and then compared to identify areas of strengths and gaps that required action.ResultsMost of the respondents returned their questionnaires, 185 of 258 (71.7%) and only 79 (42.7%) had their theses submitted for examination. Three of the four domains scored below the mid–level domain score of 3, that is “the situation is neither favorable nor unfavorable”, table 2. Specifically, the domain of “Proposal development for post-graduate research project” had the highest mean score of 3.53 out of the maximum 5. Areas requiring substantial improvements were, priority setting during “Research question identification”, which had the least mean score of 2.12. This was followed by “promoting use of post–graduate research products”, tying at 2.28 mean scores each. The domain, “Knowledge transfer of post-graduate research products”, had an above average mean score that is 2.75.ConclusionsThis study reports that existing research support mechanisms for post–graduate students in Uganda encourage access to supervisors and mentors. Secondly, post–graduate students engagement with research users was limited, as was awareness of intellectual property rights. Views of supervisors and mentors were not captured, a subject for future research.
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