Lira

Researchers are conducting a global observational study to better understand acute infections in adults who are hospitalized. This study aims to gather important information on risk factors, clinical signs, disease mechanisms, and management strategies for various infectious diseases, including respiratory infections, infections outside the respiratory tract, established infectious diseases, and emerging infections. The data collected will help guide the selection of treatments and the design of future clinical trials. Participants in this study will not receive any intervention as it is purely observational. The study involves collecting data and biological samples from participants across multiple sites worldwide. It focuses on adults admitted to the hospital, or emergency department with expected admission, due to suspected or confirmed acute infections with symptom onset within the past 30 days. The study is designed to build a comprehensive understanding of acute infectious diseases shortly after their emergence. Participants will be monitored during their hospital stay, with researchers collecting clinical data and biospecimens to characterize the infection. The study measures various outcomes including mortality at day 28, days to recovery, time to sustained recovery, clinical improvement by day 7, organ support-free days, and organ failure scores at day 28. This continuous monitoring will help to establish early knowledge about infectious diseases and inform future trials and management approaches.

Researchers are evaluating a digital-first, multi-component care strategy to improve self-care for patients with Heart Failure (HF) at six Regional Referral Hospital outpatient departments in Uganda. This stepped wedge, cluster-randomized trial will assess both implementation and clinical outcomes, including the effectiveness of an enhanced standard-of-care clinical bundle and a digital health intervention called Medly Uganda. The study focuses on improving HF self-care and reducing mortality and hospitalization rates over time. The study involves training healthcare providers in an enhanced HF clinical care bundle (Core-HF) that includes a treatment protocol, patient and provider self-care training, and medication stock management. After this, the digital health intervention Medly Uganda will be introduced, offering a mobile app for patients to report symptoms and receive self-care guidance, alongside a clinician dashboard for monitoring and nurse-guided management. This phased approach supports standardized care and digital monitoring for better management of HF. Participants will be assessed regularly at baseline and every six months up to 36 months for self-care using the Self-Care of Heart Failure Index and clinical effectiveness including mortality and hospitalizations. The study will also collect qualitative and quantitative data to guide ongoing improvements. Patients must have access to a mobile phone and basic reading skills in specific local languages or English. Continuous monitoring and evaluation throughout the study aim to optimize care delivery and patient outcomes in this setting.

Researchers are studying meningitis in northern Uganda to understand its burden, causes, diagnostic methods, treatments, and ways to prevent it. They aim to identify gaps in care and support the use of routine vaccinations for bacterial meningitis and improved screening for cryptococcal meningitis, which may help save lives in the region. The study involves patients admitted with meningitis symptoms and HIV-positive individuals at risk for cryptococcal infection. The study will enroll 1,100 patients with meningitis symptoms admitted to Lira Regional Referral Hospital for advanced diagnostic testing using rapid tests such as the Pastorex Latex Agglutination Test for bacterial meningitis, Biofire PCR for various meningitis forms, and the Immy CrAg Lateral Flow Assay for cryptococcal meningitis. Additionally, 10,000 HIV-positive patients will undergo cryptococcal antigen (CrAg) screening to determine infection prevalence and compare risk factors and outcomes between CrAg-positive and matched CrAg-negative individuals. Participants will be monitored for outcomes including death during hospitalization (about 2 weeks) and within 24 months after admission. Screening for cryptococcal antigen positivity will be tracked over 2 years. Data collection will involve clinical assessments and diagnostic testing to evaluate meningitis causes and outcomes. The study's results aim to improve meningitis care and prevention strategies in northern Uganda.

Researchers are evaluating the safety and effectiveness of a single infusion of anti-COVID-19 hyperimmune intravenous immunoglobulin (hIVIG) compared to a placebo in adults recently diagnosed with SARS-CoV-2 infection who do not need hospitalization. This Phase 3, double-blind, randomized trial aims to assess participants' clinical status seven days after treatment using a five-category scale ranging from no symptoms to critical illness or death. The study also examines outcomes in two groups: those receiving other approved antiviral treatments and those who are not. Participants receive either a single 3.5-gram infusion of hIVIG or a 35-milliliter infusion of saline placebo, with equal chance of assignment to each group. The randomization is stratified by study site and whether participants are receiving standard antiviral care. The infusion occurs once, and participants are monitored thereafter to compare the effects of hIVIG plus standard care versus placebo plus standard care. During the study, participants provide written consent and agree to follow study procedures through 28 days. Researchers assess clinical status seven days after infusion and track safety and disease progression. The study excludes those with prior immune therapies or certain medical conditions and requires participants to avoid other COVID-19 treatment trials through Day 7 unless hospitalized or experiencing significant disease worsening. Clinical assessments and monitoring continue to ensure participant safety and capture outcomes related to COVID-19 illness severity.

Researchers are conducting a Phase 3, double-blinded, placebo-controlled, multicenter trial to assess whether azithromycin taken as a preventive treatment can reduce death rates in adults with advanced HIV disease. Participants eligible for the study must have confirmed HIV infection with low CD4 counts or specific treatment histories, reflecting advanced immunosuppression. The trial aims to better understand mortality outcomes related to this preventive approach in this population. Participants will be randomly assigned to receive either azithromycin tablets or placebo tablets for 28 days. All participants will be followed for 24 weeks after randomization to measure the main outcome of death from any cause, with total follow-up lasting 48 weeks. The study compares the effects of azithromycin prophylaxis against an inactive placebo to evaluate its impact on survival. During the study, participants will be monitored regularly to track health outcomes, particularly mortality. They must be able to start or adjust antiretroviral therapy within four weeks of joining the trial. Researchers will closely observe for any adverse effects, treatment adherence, and overall health status throughout the follow-up period to assess the safety and effectiveness of the intervention.

This research evaluates a community-based program in Uganda aimed at young fathers aged 16 to 25 years with children under 3 years old. The study examines whether this intervention can improve fathers' knowledge, attitudes, and behaviors related to positive parenting, father-child interaction, reducing harsh physical punishment of children, and intimate partner violence. The trial is designed as a stepped-wedge cluster randomized controlled study covering 72 sub-counties in six Ugandan regions. The intervention, called the Responsible Engaged and Loving (REAL) Fathers Initiative, is a 7-month mentoring program combined with a monthly community poster campaign. Trained mentors, who are respected men from the community, guide young fathers through home and group sessions on non-violent discipline, conflict resolution, family planning, and couple communication. The program focuses on building positive parenting practices and partnerships to reduce violence and improve early childhood development. Participants include young father and spouse couples living together with children under age 3, recruited from selected Ugandan districts. Data will be collected longitudinally at baseline, 8 months, and 16 months using local languages and digital tools. Researchers will assess outcomes such as reductions in intimate partner violence, harsh child punishment, unmet family planning needs, father engagement in immunization, and early child development over the study period. The study uses statistical models to measure the program's impact while accounting for its stepped-wedge design.