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(非传染性疾病)现在占发病率和质量下降的一半以上。 在资源有限的情况下，生命的价值。尤其重要的是多种疾病的日益流行，或者说 慢性疾病的累积，包括非传染性疾病(如高血压、 糖尿病、慢性阻塞性肺病、创伤事故和癌症)和传染病(例如艾滋病毒、既往肺部疾病 肺炎)对功能、福祉和生活质量的影响。尽管对重叠的认识越来越多 疾病及其对健康结果的累积影响，大多数疾病治疗方案，捐赠者 筹资机制和研究基础设施侧重于传染病，这样的方案仍然存在 很大程度上是孤立的。这种努力的分离导致了研究基础设施的三个关键缺陷 许多低收入环境：1)对互动效果的理解不足和关注有限 2)对多种疾病的特定区域风险因素缺乏重视。 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)；以及3)几乎完全没有交叉所需的实验室基础设施 多学科临床研究，支持对患有多种疾病的人进行全面护理。对…作出回应 为了解决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：在乌干达培养初级教师在多发病方面的专门知识。我们将重点培训一个 对人类健康的整体理解，以及对慢性疾病积累的理解 在这种情况下，条件会影响功能和生活质量。 目标2：培训初级教师以衡量区域社会的决定因素和后果 环境危险因素为多发病。主要关注领域将包括社会行为 以及健康的环境决定因素。 目标3：发展实验室能力，支持多种疾病的临床研究。我们会 利用马萨诸塞州综合医院之间的既定谅解备忘录 (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，以 重点是多发病诊断和区域适当的风险因素检测。 在这个D43研究培训计划中，我们将利用MUST和MGH之间长达15年的合作伙伴关系，以 为12名有前途的博士后和初级教师提供持续的指导和受保护的研究时间 成员必须参加，并建立乌干达多种疾病研究的区域卓越中心。

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.