Multi-morbidity in Uganda Research Capacity Initiative (MURCI) at Mbarara University of Science and Technology

1.0摘要 慢性非传染性疾病现在占发病率和质量下降的一半以上 在资源有限的环境中。特别重要的是，多重发病率日益流行， 慢性疾病的积累，包括非传染性疾病（例如高血压， 糖尿病、COPD、创伤性事故和癌症）和传染病（例如HIV、既往肺病 肺炎）对功能、健康和生活质量的影响。尽管越来越多的人认识到 条件及其对健康结果的累积影响，大多数疾病治疗计划，捐助者 资助机制和研究基础设施专注于传染病，这些计划仍然存在。 大部分是孤立的这种工作的分离导致了研究基础设施的三个关键短板， 许多低收入环境：1）对互动效应的理解和关注有限 之间，和管理，共病条件; 2）缺乏对区域特定的风险因素的关注， 可能与高资源环境不同的发病率（例如健康的社会决定因素、职业 暴露，空气污染）;和3）几乎完全缺乏必要的实验室基础设施， 多学科临床研究，以支持对患有多种疾病的人的整体护理。应对 为了弥补乌干达研究基础设施方面的这些差距，我们将实现以下具体目标： 目标1：在乌干达发展初级教员关于多种发病率的专门知识。我们将把训练重点放在 全面了解人类健康，并了解慢性疾病的积累 在这种情况下，条件影响功能和生活质量。 目标2：培训初级教员，以衡量区域社会发展的决定因素和后果。 和环境危险因素的多重发病率。重点领域将包括社会行为 和健康的环境决定因素。 目标3：发展实验室能力，以支持对多种疾病的临床研究。我们将 充分利用马萨诸塞州总医院与 (MGH)和姆巴拉拉科技大学（MUST）临床研究实验室， 支持能力建设、质量保证和跨学科临床实验室计划， 侧重于多种发病率诊断和适合区域的风险因素检测。 在这个D43研究培训计划中，我们将利用MUST和MGH之间长达15年的合作关系， 为12名有前途的博士后和初级教师提供持续的指导和保护研究时间 在MUST的成员，并建立了一个乌干达地区的卓越中心，在多种发病率的研究。

1.0 Abstract Chronic, non-communicable diseases (NCDs) now account for over half of morbidity and reductions in quality of life, in resource-limited settings. Of particular importance is the growing epidemic of multi-morbidity, or the accumulation of chronic conditions, including combinations of both non-communicable (e.g. hypertension, diabetes, COPD, traumatic accidents, and cancer) and communicable diseases (e.g. HIV, prior lung disease from pneumonia) on functioning, well-being and quality of life. Despite the growing appreciation of overlapping conditions and their cumulative effect on health outcomes, the majority of disease treatment programs, donor funding mechanisms, and research infrastructures focus on infectious diseases, and such programs remain largely siloed. This separation of efforts results in three critical short-comings to the research infrastructure in many low-income settings: 1) a poor understanding and limited attention paid to the interactive effects between, and management of, comorbid conditions; 2) lack of attention to region-specific risk factors for multi- morbidity that are likely to differ from high-resource settings (e.g. social determinants of health, occupational exposures, air pollution); and 3) a near total absence of the requisite laboratory infrastructure for cross-cutting multidisciplinary clinical research to support holistic care for those with multi-morbid conditions. To respond to these gaps in research infrastructure in Uganda, we will conduct the following specific aims: Aim 1: Develop junior faculty expertise in Uganda on multi-morbidity. We will focus training on a holistic understanding of human health, and an understanding of how accumulation of chronic conditions impacts functioning and quality of life in this setting. Aim 2: Train junior faculty to measure determinants and consequences of the regional social and environmental risk factors for multi-morbidity. Key focus areas will include social-behavioral and environmental determinants of health. Aim 3: Develop laboratory capacity to support clinical research on multi-morbidity. We will leverage an established Memorandum of Understanding between the Massachusetts General Hospital (MGH) and the Mbarara University of Science and Technology (MUST) Clinical Research Laboratory to support capacity building, quality assurance, and a trans-disciplinary clinical laboratory program to focus on multi-morbidity diagnostics and regionally appropriate risk factor testing. In this D43 research training program, we will leverage a 15-year partnership between MUST and MGH, to provide sustained mentorship and protected research time to 12 promising post-doctoral and junior faculty members at MUST and establish a Ugandan regional center of excellence in multi-morbidity research.