Background
Over the past two decades, Uganda has experienced a significant increase in clinical research driven by both academia and industry. This has been combined with a broader spectrum of research proposals, with respect to methodologies and types of intervention that need evaluation by Research Ethics Committees (RECs) with associated increased requirement for expertise. We assessed the competencies of REC members regarding review of research protocols with complex and emerging research study designs. The aim was to guide development of a training curriculum to improve the quality of scientific and ethical review.
Methods
This was a cross-sectional study design, with quantitative data collection methods. Research Ethics Committee members completed a structured pre-coded questionnaire on current competence with complex and emerging study design. REC members were asked to outline a list of additional topics for which they needed training. Data from coded questions were entered into Epidata Version 3.1 and then exported to STATA Version14.1 for analysis. Descriptive analysis was performed and findings are presented using percentages and frequencies.
Results
We enrolled 55 REC members from 6 RECs who have a total of 97 members. The majority of whom were males (56.4%, n = 31/55). The level of competence for review of selected study design was lowest for Controlled Human Infection Model (10.9%, n = 6) and reverse pharmacology design (10.9%, n = 6), and highest for cluster randomized study design (52.7%, n = 29) and implementation science research (52.7%, n = 29).
Conclusion
Competence for review of research protocols with complex and emerging study design was low among participating REC members. We recommend prioritising training of REC members on complex and emerging study designs to enhance quality of research protocol review.
PURPOSE In East Africa, cervical cancer is a leading cause of morbidity and mortality among women diagnosed with cancer. In this study, we describe the burden of risk factors for cervical cancer among women of reproductive age in five East African countries. METHODS For each country, using STATA13 software and sampling weights, we analyzed the latest Demographic and Health Survey data sets conducted between 2014 and 2017 in Burundi, Kenya, Rwanda, Tanzania, and Uganda. We included women age 15-49 years and considered six risk factors (tobacco use, body mass index, age at first sexual intercourse, age at first birth, number of children, and hormonal contraceptive use). RESULTS Of the 93,616 women from the five countries, each country had more than half of the women younger than 30 years and lived in rural areas. Pooled proportion of women with at least one risk factor was 89% (95% CI, 87 to 91). Living in a rural area in Burundi (adjusted incidence rate ration 0.94; 95% CI, 0.9 to 0.99; P = .019) and Rwanda (adjusted incidence rate Ration 0.92; 95% CI, 0.88 to 0.96; P < .001) was associated with a lower number of risk factors compared with living in an urban area. In all the countries, women with complete secondary education were associated with a lower number of risk factors compared with those with no education. CONCLUSION This study reveals a high burden of risk factors for cervical cancer in East Africa, with a high proportion of women exposed to at least one risk factor. There is a need for interventions to reduce the exposure of women to these risk factors.
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