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Despite the presence of several funded research projects at academic and research institutions in sub-Saharan Africa, the quality of the pre/post grant award process in these institutions is inadequate. There is a need to strengthen research administration through infrastructural, organizational, and human resource development to match the dynamic research environment and funding requirements. In Uganda, many grant recipient institutions, investigators, and research administrators have limited experience in grantsmanship. The aim of this International Extramural Associates Research Development Award is to develop cadres of research administrators to address current and future National Institutes of Health (NIH) and other funding agencies' policies and procedures, and to strengthen research administrative infrastructure at the Joint Clinical Research Centre, Mbarara University of Science and Technology, Uganda Christian University, Mukono and Ndejje University. This is accomplished through establishing partnerships, strengthening the institutional central research coordination office, and short-term training. The training includes grant writing, submission and award management; public engagement in research; mentorship; research ethics; responsible conduct of research, and applying routine facility data toward quality improvement. This article presents a case study of lessons learned from establishing collaborations for strengthening research administration, such as experiences, challenges, sustainability plans, and recommendations for strengthening research administration. (Contains 1 figure and 2 tables.)

Despite the presence of several funded research projects at academic and research institutions in sub-Saharan Africa, the quality of the pre/post grant award process in these institutions is inadequate. There is a need to strengthen research administration through infrastructural, organizational, and human resource development to match the dynamic research environment and funding requirements. In Uganda, many grant recipient institutions, investigators, and research administrators have limited experience in grantsmanship. The aim of this International Extramural Associates Research Development Award is to develop cadres of research administrators to address current and future National Institutes of Health (NIH) and other funding agencies' policies and procedures, and to strengthen research administrative infrastructure at the Joint Clinical Research Centre, Mbarara University of Science and Technology, Uganda Christian University, Mukono and Ndejje University. This is accomplished through establishing partnerships, strengthening the institutional central research coordination office, and short-term training. The training includes grant writing, submission and award management; public engagement in research; mentorship; research ethics; responsible conduct of research, and applying routine facility data toward quality improvement. This article presents a case study of lessons learned from establishing collaborations for strengthening research administration, such as experiences, challenges, sustainability plans, and recommendations for strengthening research administration. Keywords: Grantsmanship, research administration, research infrastructural development, capacity development, developing countries, Uganda, Introduction Over the last 15 years, there has been an increase in funding for research and training in Africa. Despite a research environment characterized by the presence of several funded [...]

Background: Data on pediatric second-line antiretroviral treatment (ART) outcomes are scarce, but essential to evaluate second-line and design third-line regimens.Methods: Children ≤12 years switching to second-line ART containing a protease inhibitor (PI) in Uganda were followed for 24 months. Viral load (VL) was determined at switch to second-line and every 6 months thereafter; genotypic resistance testing was done if VL ≥ 1000 cps/ml.Results: 60 children were included in the analysis; all had ≥1 drug resistance mutations at switch. Twelve children (20.0%) experienced treatment failure; no PI mutations were detected. Sub-optimal adherence and underweight were associated with treatment failure.Conclusions: No PI mutations occurred in children failing second-line ART, which is reassuring as pediatric third-line is not routinely available in these settings. Poor adherence rather than HIV drug resistance is likely to be the main mechanism for treatment failure and should receive close attention in children on second-line ART. [ABSTRACT FROM AUTHOR]

Objective: Clinical and immunological data about HIV in older adults from low and middle income countries is scarce. We aimed to describe differences between younger and older adults with HIV starting antiretroviral therapy in two low–income African countries. Methods: Setting:: HIV clinics in Uganda and Zimbabwe. Design:: Secondary exploratory cross-sectional analysis of the DART randomized controlled trial. Outcome Measures: Clinical and laboratory characteristics were compared between adults aged 18-49 years (younger) and ≥ 50 years (older), using two exploratory multivariable logistic regression models, one with HIV viral load (measured in a subset pre-ART) and one without. Results: A total of 3316 eligible participants enrolled in DART were available for analysis; 219 (7%) were ≥ 50 years and 1160 (35%) were male. Across the two adjusted regression models, older adults had significantly higher systolic blood pressure, lower creatinine clearance and were consistently less likely to be females compared to younger adults with HIV. Paradoxically, the models separately suggested that older adults had statistically significant (but not clinically important) higher CD4+ cell counts and higher plasma HIV–1 viral copies at initiation. Crude associations between older age and higher baseline hemoglobin, body mass index, diastolic blood pressure and lower WHO clinical stage were not sustained in the adjusted analysis. Conclusions: Our study found clinical and immunological differences between younger and older adults, in a cohort of Africans starting antiretroviral therapy. Further investigations should explore how these differences could be used to ensure equity in service delivery and affect outcomes of antiretroviral therapy.