Meet the CIPHER grantees

Pauline Mary Amuge

Year awarded: 2021
Institution: Baylor College of Medicine Children’s Foundation
Research site: Uganda
Primary mentor: Philippa Musoke, Makerere University-Johns Hopkins University

Pauline Mary Amuge is a paediatrician providing HIV care and conducting clinical and operational research at Baylor College of Medicine Children’s Foundation-Uganda clinic at the Mulago National Referral Hospital in Kampala, Uganda. She is a trial manager and investigator for several clinical trials assessing efficacy and safety of optimal paediatric HIV treatmentreviewing the national TB preventive treatment guidelines for children and adolescents living with HIV in Uganda. Her interests include building capacity of front-line health workers in paediatric TB diagnosis and management and strategies to make TB preventive treatment easily accessible through person-centred models.

More information on Pauline Amuge | Email

“Restrictive COVID-19 control measures interrupted many health facility-based services. This CIPHER project will assess the effect of the pandemic on the initiation and completion of TPT among children and adolescents living with HIV and explore strategies to integrate TPT delivery in existing ART delivery models to improve TPT initiation and completion among these children and adolescents.”

Research project: Differentiated delivery of tuberculosis preventive treatment (TPT) within existing HIV care models to improve TPT uptake and completion among children and adolescents living with HIV in Uganda following the COVID-19 pandemic.

The issue

Children exposed to TB are almost four times more likely to have prevalent TB than unexposed children. The lifetime risk of developing HIV-associated TB is even higher, at 50%. Therefore, TB prevention is critical in the End TB Strategy, particularly among children and adolescents living with HIV. Even after the country-wide TPT scale up, restrictive COVID-19 pandemic control measures may have interrupted access by these children and adolescents to health facility-based TPT. However, there is very limited data on TPT initiation and completion among children and adolescents living with HIV in various HIV care delivery models.

The CIPHER project

The differentiated TPT delivery within existing ART delivery models study is co-led by Prof Philippa Musoke and Prof Anna Maria Mandalakas. It includes 350 children and adolescents living with HIV in Kampala. This project will:

  • Assess the effect of the COVID-19 pandemic on TPT uptake and completion among children and adolescents living with HIV in Kampala district
  • Compare the TPT uptake and completion in community-based and facility-based delivery models among these children and adolescents
  • Identify the barriers and facilitators of uptake and completion of TPT among these children and adolescents.

To assess the effect of the COVID-19 pandemic on TPT services, Dr Amuge will use existing clinic-based data for children and adolescents 0-19 years of age, who were considered eligible for TPT in 2019 and 2020. This CIPHER support will enable her to collect prospective data to compare TPT uptake and completion among those children and adolescents enrolled in community-based delivery with those in facility-based TPT delivery models.

The impact

This study will provide evidence on effective TPT delivery within community-based and facility-based delivery models. This will ultimately guide national standard operation procedures for TPT delivery models for the different age categories to improve TPT uptake, adherence and completion and ultimately reduce the burden of TB among children and adolescents living with HIV. Dr Amuge will engage policy makers during the project and present the results to the national TB control programme.

IPHASA 2021
1st International Paediatric HIV Symposium in Africa - Virtual Symposium 17-18 November 2021

Contact

Resources

Events

Annual international workshop on “Children and Adolescents HIV-Exposed and Uninfected”

CIPHER Grant Programme
Awards up to $150,000 to early-stage investigators to address critical research gaps in paediatric and adolescent HIV in resource-limited settings.

CIPHER Growing the Leaders of Tomorrow Fellowship
Provides support to young investigators in sub-Saharan Africa on priority research topics in paediatric and adolescent HIV clinical science.

CIPHER Global Cohort Collaboration
Brings together the largest collaboration of paediatric and adolescent HIV observational cohort networks to answer key questions of global public health.

Research agendas for paediatric and adolescent HIV