Nelson K Sewankambo
Datos Biográficos
| ID | 3487940 |
|---|---|
| NOMBRE | Nelson K Sewankambo |
| NOMBRES | Nelson K |
| APELLIDO | Sewankambo |
| FIRMA | SEWANKAMBO N K |
| AFILIACIONES | Makerere University |
| ORCID | 0000-0001-9362-053X |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 54 |
| TOTAL DE CITAS | 37 |
| TOTAL COMO AUTOR | 54 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2000 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 3 |
Trainee Perspectives on the Fogarty African Bioethics Consortium Postdoctoral Fellowship Program
There is a growing demand for postdoctoral bioethics training in Africa, driven by the significant rise in graduate programs offered by universities. This study sought to evaluate the Fogarty African Bioethics Consortium Post-Doctoral Fellowship program and to explore the experiences and perspectives of its trainees as well as the program's impact on their careers in their home countries. This study adopted an exploratory qualitative design invol…
Stronger together
Box Global health research partnerships face persistent inequities, including funding imbalances, unbalanced recognition and inequitable recognition of low-and middle-income country (LMIC) researchers and their overall capacities
Estimated cost-savings from integrated care for HIV, diabetes and hypertension in sub-Saharan Africa
Background In a cluster-randomised trial in Uganda and Tanzania, we showed that integrated management, compared with standard vertical care, could achieve a high standard of care for diabetes and hypertension without adversely affecting outcomes for HIV. However, evidence on the value for money of integrated care is needed to inform policy.Objective Our economic evaluation aimed to establish the value for money of integrated care compared with ve…
Advancing Doctoral and Postdoctoral International Bioethics Training Programs Supported by the D43 National Institutes of Health (NIH) Fogarty Mechanism
Advancing doctoral and postdoctoral international bioethics training in low-and-middle income countries (LMICs) is essential to address the emerging and reemerging healthcare needs of local populations. The COVID-19 pandemic underscored the need for sustenance of global collaboration and rapid adaptability in the future to further prioritize research frameworks to benefit LMICs. Thus, the purpose of the manuscript is to share the successes, chall…
Ensuring Continuity of Health Professions Training Amid a Global Pandemic
Uganda experienced 2 COVID-19 waves that challenged health professional education. All health professions training institutions (HPTIs) in Uganda closed in March 2020. Cognizant of the threat to quality education and the frontline workforce, the National Council for Higher Education (NCHE) and Seed Global Health partnered to examine the risks and benefits of HPTI reopening through the Safe Schools Initiative (SSI). This article described the proc…
Estimation of cause-specific mortality in Rakai, Uganda, using verbal autopsy 1999-2019
BACKGROUND: There are scant data on the causes of adult deaths in sub-Saharan Africa. We estimated the level and trends in adult mortality, overall and by different causes, in rural Rakai, Uganda, by age, sex, and HIV status. OBJECTIVES: To estimate and analyse adult cause-specific mortality trends in Rakai, Uganda. METHODOLOGY: Mortality information by cause, age, sex, and HIV status was recorded in the Rakai Community Cohort study using verbal …
Use of mobile phones to collect data on Covid-19
During the COVID-19 pandemic lockdown, we deployed a rapid, mobile phone-based survey to assess access and participation rates when using mobile phones to collect data on COVID-19 in Rakai, south-central Uganda. We sampled prior Rakai Community Cohort Study (RCCS) participants based on HIV status using mobile phone contacts. We administered a 30-minute phone-based interview to consenting participants to assess their knowledge about different aspe…
Colonization and decolonization of global health
Despite taking on several forms throughout history such as colonial medicine, tropical medicine, and international health, the field of global health continues to uphold colonialist structures. History demonstrates that acts of colonialism inevitably lead to negative health outcomes. Colonial powers promoted medical advancements when diseases affected their own people, and only did so for locals when in the colonies' best interests. Numerous medi…
In the era of universal test and treat in Uganda, recent intimate partner violence is not associated with subsequent ART use or viral suppression
Intimate partner violence (IPV) has been associated with delays throughout the HIV care continuum. This study explored prospective associations between experiences of past-year IPV and two HIV care outcomes in the context of current universal test and treat guidelines using two consecutive rounds of an ongoing HIV surveillance study conducted in the Rakai region of Uganda. Longitudinal logistic regression models examined associations between IPV,…
Linkage to care and treatment among men with reactive HIV self-tests after workplace-based testing in Uganda
Introduction: HIV self-testing at workplaces has the potential to reach men at risk of HIV infection with lower access to HIV testing services. While several studies have reported high uptake of HIV self-testing, linkage to HIV care following a positive result remains a challenge. This study, therefore, explored the motivators for and barriers to linkage to HIV care and treatment among men who returned positive results following workplace-based H…
Integrating Care for Diabetes and Hypertension with HIV Care in Sub-Saharan Africa
INTRODUCTION: Although HIV continues to have a high prevalence among adults in sub-Saharan Africa (SSA), the burden of noncommunicable diseases (NCD) such as diabetes and hypertension is increasing rapidly. There is an urgent need to expand the capacity of healthcare systems in SSA to provide NCD services and scale up existing chronic care management pathways. A scoping review mapped extant policy and evidence based literature on the feasibility …
Cango Lyec (Healing the Elephant)
Cango Lyec participants displayed lower than previously reported yet significant levels of probable PTSD and depression. Based on findings from this study, providing trauma-informed care, ensuring food and housing security, eliminating gender-based violence, and reintegrating former abductees remain important tasks to facilitate post-conflict rehabilitation in Northern Uganda
Drivers and barriers to workplace-based HIV self-testing among high-risk men in Uganda
We recommend the involvement of employers in workplace-based HIV self-testing to encourage participation by employees. There is need for HIV self-testing support both during and after the testing process. Both employers and employees recommend the use of non-monetary incentives, and regular training about HIV self-testing to increase the uptake and acceptability of HIV testing services at the workplace
I felt very small and embarrassed by the health care provider when I requested to be tested for syphilis”
HIV programs are likely to be important entry points for syphilis testing among FSW. Multi-level interventions to address testing barriers should consider focusing on these service delivery points. Extending the dual syphilis and HIV testing approach to FSW may improve testing uptake for both infections at public health facilities and decrease population-level incidence
Ethical issues in intervention studies on the prevention and management of diabetes and hypertension in sub-Saharan Africa
Conducting intervention studies in Africa, where medicines supply for chronic conditions is inequitable and patchy, raises major ethical issues. \n \nHere we discuss what should the ethical approach be for a research programme in terms of provision of a steady and sustainable supply of medicines for patients with diabetes and hypertension
SMART Vaccines 2.0 decision-support platform
In resource-constrained environments, priority setting is critical to making sustainable decisions for introducing new and underused vaccines and choosing among vaccine products. Donor organisations and national governments in low-income and middle-income countries (LMICs) recognise the need to support prioritisation of vaccine decisions driven by local health system capacity, epidemiology and financial sustainability. Successful efforts have sup…
Enhancing science preparedness for health emergencies in Africa through research capacity building
Editorial (no available abstract)
Evolution of research ethics in a low resource setting
BACKGROUND: The globalization of clinical research in the last two decades has led to a significant increase in the volume of clinical research in developing countries. As of 2016, Uganda was the third largest destination for clinical trials in Africa. This requires adequate capacity and systems to facilitate ethical practice. METHODS: This was a retrospective study involving review of laws, guidelines, policies and records from 1896 to date. RES…
Hypertension prevalence, awareness, treatment, and control and predicted 10-year CVD risk
In seven communities in east and west Africa, a quarter of participants had hypertension, about 40% were unaware, half of those aware were treated, and half of those treated had controlled blood pressure. The 10-year predicted CVD risk was low across sites. Access to health insurance is needed to improve awareness, treatment, and control of hypertension in sub-Saharan Africa
Communities and Clinical Trials
When clinical trials enter human communities, two complex systems merge-creating challenges for the clinical trial team and the local human community. This is of particular relevance for clinical trials in low-resource settings where the resource scarcity can intensify existing inequities. Here we present a case study of a phase III malaria vaccine clinical trial. Through qualitative interviews with researchers and caregivers of pediatric partici…
Population-level adult mortality following the expansion of antiretroviral therapy in Rakai, Uganda
There are limited data on the impact of antiretroviral therapy (ART) on population-level adult mortality in sub-Saharan Africa. We analysed data for 2000-14 from the Rakai Community Cohort Study (RCCS) in Uganda, where free ART was scaled up after 2004. Using non-parametric and parametric (Weibull) survival analysis, we estimated trends in average person-years lived between exact ages 15 and 50, per capita life-years lost to HIV, and the mortalit…
Acceptability of HIV testing for men attending televised football venues in Uganda
This study suggests that HIV testing services at venues where EPL football games are televised is generally acceptable to men. In implementing such services, consideration should be given to preferences for external or unknown health workers and the motivating factors contributing to the use of these services. Given that HIV testing is currently not conducted in these settings, further research should be conducted to evaluate the feasibility of t…
Low HIV viral suppression rates following the intensive adherence counseling (IAC) program for children and adolescents with viral failure in public health facilities in Uganda
Suppression rates were low among ART-treated children with virological failure that completed the recommended three IAC sessions. As we move towards having 90% of ART-treated children and adolescents achieve and maintain viral suppression, there is need to re-evaluate the implementation of IAC among children and adolescents to consider both psychosocial and biological factors such as resistance testing for those with multiple detectable viral loa…
Reaching the First 90 in Uganda
Assessing the influence of knowledge translation platforms on health system policy processes to achieve the health millennium development goals in Cameroon and Uganda
There is a scarcity of empirical data on the influence of initiatives supporting evidence-informed health system policy-making (EIHSP), such as the knowledge translation platforms (KTPs) operating in Africa. To assess whether and how two KTPs housed in government-affiliated institutions in Cameroon and Uganda have influenced: (1) health system policy-making processes and decisions aiming at supporting achievement of the health millennium developm…
Coercive sex in rural Uganda
Does biological relatedness affect child survival
Objective: We studied child survival in Rakai, Uganda where many children are fostered out or orphaned. Methods: Biological relatedness is measured as the average of the Wrightâ s coefficients between each household member and the child. Instrumen
Evaluating a complex research capacity-building intervention
There is increasing policy demand for real-time evaluations of research and capacity-building programmes reflecting a recognition of the management, governance and impact gains that can result. However, the evidence base on how to successfully implement real-time evaluations of complex interventions in international development efforts is scarce. There is therefore a need for reflective work that considers methodologies in context. This article s…
Advancing Doctoral and Postdoctoral International Bioethics Training Programs Supported by the D43 National Institutes of Health (NIH) Fogarty Mechanism
Advancing doctoral and postdoctoral international bioethics training in low-and-middle income countries (LMICs) is essential to address the emerging and reemerging healthcare needs of local populations. The COVID-19 pandemic underscored the need for sustenance of global collaboration and rapid adaptability in the future to further prioritize research frameworks to benefit LMICs. Thus, the purpose of the manuscript is to share the successes, chall…
Communities and Clinical Trials
When clinical trials enter human communities, two complex systems merge-creating challenges for the clinical trial team and the local human community. This is of particular relevance for clinical trials in low-resource settings where the resource scarcity can intensify existing inequities. Here we present a case study of a phase III malaria vaccine clinical trial. Through qualitative interviews with researchers and caregivers of pediatric partici…
Assessing the influence of knowledge translation platforms on health system policy processes to achieve the health millennium development goals in Cameroon and Uganda
There is a scarcity of empirical data on the influence of initiatives supporting evidence-informed health system policy-making (EIHSP), such as the knowledge translation platforms (KTPs) operating in Africa. To assess whether and how two KTPs housed in government-affiliated institutions in Cameroon and Uganda have influenced: (1) health system policy-making processes and decisions aiming at supporting achievement of the health millennium developm…
Viral Load and Heterosexual Transmission of Human Immunodeficiency Virus Type 1
BACKGROUND AND METHODS: We examined the influence of viral load in relation to other risk factors for the heterosexual transmission of human immunodeficiency virus type 1 (HIV-1). In a community-based study of 15,127 persons in a rural district of Uganda, we identified 415 couples in which one partner was HIV-1-positive and one was initially HIV-1-negative and followed them prospectively for up to 30 months. The incidence of HIV-1 infection per 1…
Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda
Age Differences in Sexual Partners and Risk of HIV-1 Infection in Rural Uganda
OBJECTIVES: To assess whether differences in age between sexual partners affect the risk of HIV infection in female adolescents and young adults. METHODS: A total of 6177 ever sexually active women aged 15 to 29 years completed a sociodemographic and sexual behavior questionnaire and provided a blood sample for HIV-1 serology. The age difference between partners was categorized as men 0 to 4 years older (referent group), 5 to 9 years older and 10…
Does biological relatedness affect child survival
Objective: We studied child survival in Rakai, Uganda where many children are fostered out or orphaned. Methods: Biological relatedness is measured as the average of the Wrightâ s coefficients between each household member and the child. Instrumen
Human resources for health
Measuring quality of life among HIV-infected women using a culturally adapted questionnaire in Rakai district, Uganda
To examine self-reported quality of life and health status of HIV-infected women and a comparison sample of HIV-uninfected women in rural Uganda, we culturally adapted a Lugandan version of the Medical Outcomes Survey-HIV (MOS-HIV). We administered a cross-sectional survey among 803 women (239 HIV-positive and 564 HIV-negative) enrolled in a community study to evaluate maternal and child health in Rakai District, Uganda. The interview took 20 min…
Burden of infection among heads and non-head of rural households in Rakai, Uganda
The objective was to determine HIV prevalence, symptomatology and mortality among adult heads and non-heads of households, in order to assess the burden of HIV on households. It was a community study of 11,536 adults aged 15-59, residing in 4,962 households in 56 villages, Rakai district, Uganda. First, 4,962 heads and 6,574 non-heads of households were identified from censuses. Interviews were then used to determine socio-demographic/behavioural…
Coercive sex in rural Uganda
Rates of HIV‐1 Transmission per Coital Act, by Stage of HIV‐1 Infection, in Rakai, Uganda
BACKGROUND: We estimated rates of human immunodeficiency virus (HIV)-1 transmission per coital act in HIV-discordant couples by stage of infection in the index partner. METHODS: We retrospectively identified 235 monogamous, HIV-discordant couples in a Ugandan population-based cohort. HIV transmission within pairs was confirmed by sequence analysis. Rates of transmission per coital act were estimated by the index partner's stage of infection (rece…
Immunisation coverage among children born to HIV-infected women in Rakai district, Uganda
To evaluate the impact of maternal HIV-infection on routine childhood Immunisation coverage, we compared the Immunisation status of children born to HIV-infected and HIV-uninfected women in rural Uganda. The study population was 214 HIV(+) and 578 HIV(-) women with children aged 6 to 35 months previously enrolled in a community study to evaluate maternal and child health in Rakai District, Uganda. Sampling of subjects for interview was stratified…
Vaccine preparedness
To explore how to better educate rural Africans about preventive HIV/AIDS vaccine trials, 15 semi-structured, open-ended interviews were conducted with villagers in Lyantonde, Rakai District, Uganda. This study reports on the findings by focusing on the attitudes, knowledge and questions the rural villagers had about HIV/AIDS-preventive vaccine testing. While several interviewees confused preventive vaccines with therapeutic vaccines, most were c…
Repeat Voluntary HIV Counseling and Testing (VCT), Sexual Risk Behavior and HIV Incidence in Rakai, Uganda
Male circumcision for HIV prevention in men in Rakai, Uganda
Alcohol Use, Intimate Partner Violence, Sexual Coercion and HIV among Women Aged 15–24 in Rakai, Uganda
Towards a common definition of global health
Science-based health innovation in Uganda
BACKGROUND: Uganda has a long history of health research, but still faces critical health problems. It has made a number of recent moves towards building science and technology capacity which could have an impact on local health, if innovation can be fostered and harnessed. METHODS: Qualitative case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-…
Disclosure of HIV results among discordant couples in Rakai, Uganda
Disclosure of HIV sero-positive results among HIV-discordant couples in sub-Saharan Africa is generally low. We describe a facilitated couple counselling approach to enhance disclosure among HIV-discordant couples. Using unique identifiers, 293 HIV-discordant couples were identified through retrospective linkage of married or cohabiting consenting adults individually enrolled into a cohort study and into two randomised trials of male circumcision…
Evolving values in ethics and global health research
Over the past 25 years, the ethics of international health research have shifted from addressing narrow issues such as cultural differences in informed consent practices towards a greater emphasis on development and social justice. We anticipate that the next 'era' in international research ethics will involve an intensification of this focus on the role of research in achieving global justice. Three values, in particular, will shape how ethics c…
Okukkera Ng'omuzungu (lost in translation)
As major global governance entities begin to re-assess the structure and goals of health research in resource-poor settings, social science can make a vital contribution by expanding the traditional field of research ethics to include new concepts such as the social value of global health research. This essay recasts the definition of social value in health research by shifting away from the official spaces where research occurs and towards the m…
Combatendo as DCNT
A “Aliança DCNT” (“NCD Alliance”)1 visa colocar as doenças crônicas não transmissíveis (DCNT) na agenda global de saúde, a fim de enfrentar a chamada “crise das DCNT”. Melhorar os indicadores de morbidade e mortalidade em 2015 dependerá, em grande medida, da prevenção e controle das DCNT, especialmente nos países em desenvolvimento2. *Reprinted with permission from Elsevier (The Lancet, 2011, 6 September 2011, online first) - Reprodução autorizad…
A grander challenge
BACKGROUND: "Grand challenges" in global health have focused on discovery and development of technologies to save lives. The "grander challenge" involves building institutions, systems, capacity and demand to effectively deliver strategies to improve health. In 2008, Makerere University began a radical institutional change to bring together four schools under one College of Health Sciences. This paper's objective is to demonstrate how its leaders…
Perception and valuations of community-based education and service by alumni at Makerere University College of Health Sciences
BACKGROUND: Training of health professionals can be deliberately structured to enhance rural recruitment by exposing the trainees to the realities of rural life and practice through Community-Based Education and Service (COBE) programs. Few studies have surveyed the alumni of these programs to establish their post-university views and whether the positive impact of COBE programs endures into the post-university life. This study surveyed the alumn…
In the face of war
BACKGROUND: Adolescent girls are an overlooked group within conflict-affected populations and their sexual health needs are often neglected. Girls are disproportionately at risk of HIV and other STIs in times of conflict, however the lack of recognition of their unique sexual health needs has resulted in a dearth of distinctive HIV protection and prevention responses. Departing from the recognition of a paucity of literature on the distinct vulne…
Comparison of HIV-related vulnerabilities between former child soldiers and children never abducted by the LRA in northern Uganda
This study persuasively demonstrates that all young people in northern Ugandan have been similarly affected by HIV infection during war and displacement. Post-conflict programme planners must therefore abandon rudimentary targeting practices based on abductees as a high-profile category. Instead, they must develop evidence-based HIV interventions that are commensurate with young people's specific needs. As such programmes will be less stigmatizin…
War and HIV
Despite growing knowledge of the dynamics of HIV infection during conflict, far less is known about the period that follows cessation of hostilities and its implications for population health. This study sought to fill a lacuna in epidemiological evidence by examining HIV infection and related vulnerabilities of young people living in resource-scarce, post-emergency transit camps that are now home to thousands of displaced people following two de…
Medicine (48 obras) · HIV/AIDS Research and Interventions (23 obras) · Political science (21 obras) · Demography (18 obras) · Environmental health (17 obras) · Nursing (17 obras) · Public health (16 obras) · Family medicine (15 obras) · Sociology (15 obras) · Adolescent Sexual and Reproductive Health (13 obras)