Project: The African Severe Asthma Project.
Countries: Uganda, Kenya, Ethiopia & The Netherlands.
Aims: To identify and characterise severe asthma in Eastern Africa and to determine the frequency of genes related to treatment-resistant severe asthma in 1676 asthma patients aged ≥12 years.
Potential impact: The findings of the study may improve the understanding of the natural history, asthma-related burden, and unmet needs in patients with severe and difficult-to treat asthma in this understudied population. It will also identify important subgroups and possible asthma phenotypes unique to the study population including clinical features and response to therapy, which may help improve asthma management and outcome in the population and among African patients in general.
Project: Defining the molecular profile of breast cancer in Uganda and its clinical implications.
Countries: Uganda & United States of America.
Aims: To characterise the molecular profile and determine the prevalence of breast cancer subtypes in 100 women ≥18 years presenting with an initial diagnosis of breast cancer and evaluate the robustness of reverse transcription polymerase chain reaction (RT-PCR), widely available in Africa primarily used to monitor HIV management, to diagnose the receptor status of patients with breast cancer.
Potential impact: Optimal breast cancer management depends on knowledge of hormone-receptor status.
This project will potentially improve the understanding of tumour biology, prevention targets and prognosis of breast cancer in Uganda. Knowledge of the distribution of tumour receptor subtypes and specific molecular aberrations that may be unique to black African patients may inform the development of new targeted drugs or better deployment of existing therapies in the longer term.
Project: The identification of modifiable viral and inflammatory risk factors for cerebrovascular and cardiovascular disease (CBD/CVD) in HIV-infected Malawian adults.
Countries: Malawi & United Kingdom.
Aims: To determine if chronic immune activation driven by HIV and viral antigenaemia increases the risk of cerebrovascular/cardiovascular disease (CBD/CVD) in HIV infected adults on anti-retroviral therapy (ART) in sub-Saharan Africa.
Potential impact: Findings from the study may improve the understanding of the contribution of HIV viremia, inflammation, chronic immune activation, other latent viral infections, traditional CVD risk factors, and ART on the development of atherosclerosis and CBD/CVD. These findings will potentially inform prevention strategies in sub-Saharan Africa among HIV patients and also inform the development of clinical guidelines for the effective management of HIV patients identified to be at high risk of developing CBD/CVD.
Project: Comparison of three combination therapies in lowering blood pressure in black Africans (CREOLE).
Countries: Nigeria, South Africa, Cameroon, Kenya, Mozambique, Uganda & United Kingdom.
Aims: To compare the efficacy of three different combinations of two antihypertensive drugs (amlodipine/hydrochlorthiazide amlodipine/perindopril or perindopril /hydrochlorthiazide) on 24 hour ambulatory blood pressure (BP) levels and other BP and cardiovascular risk parameters (including clinic measured systolic and diastolic BP, BP control, albuminuria, blood lipids and blood glucose) in black African patients.
Potential impact: The best antihypertensive drug combinations for treatment of hypertension in Africa is currently unknown and the findings of the proposed study may potentially provide the required evidence to inform clinical guidelines and protocols for the effective management of essential hypertension in black populations in Africa and globally.
Project: The identification and characterisation of chronic kidney disease (CKD) in Uganda and Malawi.
Countries: Uganda, Malawi & Unite Kingdom.
Aims: To identify the most accurate way of estimating renal function in adults in Uganda and Malawi and to determine the prevalence of CKD in these populations and the risk factors associated with CKD.
Potential impact: Equations for estimating glomerular filtration rate (GFR) have not been validated in sub-Saharan African populations, and data on GFR in Africa are few. The proposed study will examine the accuracy of different equations for calculating eGFR by comparing results to directly measured GFR using iohexol.