 |
Joseph Konde-Lule | |
|---|---|
| Nationality | Ugandan |
| Occupation(s) | Social Epidemiologist, Associate Professor |
| Years active | 1977-2014 |
| Employer | Makerere University |
| Known for | HIV Behavioral Intervention Research in Rakai, Uganda |
| Awards | Takemi Fellow (1990-1991), UCSF ITAPS Fellow (1990) |
Joseph Konde-Lule is a retired Ugandan medical sociologist and epidemiologist who conducted extensive work regarding HIV risk behaviors in rural Uganda. [1]
Joseph Konde-Lule holds degrees as a Bachelor of Medicine and Bachelor of Surgery as well as a Master of Public Health. He was an associate professor in the Department of Epidemiology & Biostatistics, now under the School of Public Health, at Makerere University in Uganda from 1977 until 2014. He additionally served as the first head of the department. [2] [3]
Throughout his career, Konde-Lule has amassed over seventy-two publications to his name, many of them focusing on understanding social determinants of HIV and its spread within Uganda. [4] His career in public health research began with his thesis which focused on syphilis prevalence and how understanding of the virus, or lack thereof, was allowing it to continue to spread within communities. He later applied this research background to understanding HIV/AIDS prevalence when he began work in Kasangati, Uganda in 1987. [1]
It is generally accepted by epidemiologists that the decline of HIV prevalence in Uganda was largely due to efforts focused on changing behavior; HIV is a virus currently without a cure. Therefore, for prevalence to decline, populations of infected individuals must decline as well. Uganda created "one of the most extensive AIDS education programs in Africa" in part due to the targeted mitigation strategies crafted from the work conducted in Rakai starting in 1989. [5]
The Rakai Project was a research initiative funded by both Columbia University and the Uganda Ministry of Health so as to better understand the disease and its spread. Based on the work conducted by this research initiative, it was discovered that three communities are predominantly at risk of contracting HIV in Uganda: those near trading centers, small villages by secondary roads, and rural agrarian villages. [6] The effectiveness of Uganda's containment strategy involves the fact that HIV research was focused on ways to prevent further spread of HIV. Thus, with time and targeted research initiatives, fewer people contracted HIV and prevalence began to decline. [7]
The peak of Dr. Joseph Konde-Lule's work occurred in his work on the Rakai Project. Many of Dr. Joseph Konde-Lule's Rakai studies sought to determine populations of heightened risk of contracting HIV in Uganda. This was largely driven by the finding that many individuals in the Rakai district indicated substantial understanding of AIDS and prevention techniques, like the use of condoms, yet were still experiencing high rates of infection. [1] [5] In particular, studies found that those individuals in charge of the household were at high risk of contracting HIV, indicating the ways the disease could impact economics and social organization in a household. Additional risk factors included employment that required mobility and migration and involvement in the cash economy. [8]
In addition to identifying these high risk groups, Konde-Lule's work in Rakai sought to understand the sexual networks of transmission. Of particular interest for future policy included the finding that girls had a significantly higher HIV infection rate than boys of the same age group seemingly due to the fact that girls were more likely to engage in sexual relationships with older men, a group with already heightened HIV rates compared to younger boys in the community. Additionally, married individuals were expressing higher prevalence of HIV than unmarried individuals, a finding that ran counter to previous speculation. [6]
In 1990, Konde-Lule was recognized as a Takemi Fellow of the Harvard School of Public Health, an acknowledgement of the significant work he contributed to the improvement of public health in Uganda. [9] In 1990, he also received a competitive ITAPS fellowship from University of California at San Francisco for his project "Assessment of the rate of progression of HIV infection in a Ugandan cohort during 5 years of follow-up." [10]
HIV superinfection is a condition in which a person with an established human immunodeficiency virus infection acquires a second strain of HIV, often of a different subtype. These can form a recombinant strain that co-exists with the strain from the initial infection, as well from reinfection with a new virus strain, and may cause more rapid disease progression or carry multiple resistances to certain HIV medications.
The very high rate of HIV infection experienced in Uganda during the 1980s and early 1990s created an urgent need for people to know their HIV status. The only option available to them was offered by the National Blood Transfusion Service, which carries out routine HIV tests on all the blood that is donated for transfusion purposes. The great need for testing and counseling resulted in a group of local non-governmental organizations such as The AIDS Support Organisation (TASO), Uganda Red Cross, Nsambya Home Care, the National Blood Bank, the Uganda Virus Research Institute together with the Ministry of Health establishing the AIDS Information Centre in 1990. This organization worked to provide HIV testing and counseling services with the knowledge and consent of the client involved.
Economic epidemiology is a field at the intersection of epidemiology and economics. Its premise is to incorporate incentives for healthy behavior and their attendant behavioral responses into an epidemiological context to better understand how diseases are transmitted. This framework should help improve policy responses to epidemic diseases by giving policymakers and health-care providers clear tools for thinking about how certain actions can influence the spread of disease transmission.
The Makerere University School of Medicine (MUSM), also known as the Makerere University Medical School, is the school of medicine of Makerere University, Uganda's oldest and largest public university. The medical school has been part of Makerere University since 1924. The school provides medical education at diploma, undergraduate, and postgraduate levels.
Frederick Wabwire-Mangen is a Ugandan physician, public health specialist and medical researcher. Currently he is Professor of Epidemiology and Head of Department of Epidemiology & Biostatistics at Makerere University School of Public Health. Wabwire-Mangen also serves as the Chairman of Council of Kampala International University and a founding member of Accordia Global Health Foundation’s Academic Alliance
Nelson Kawulukusi Sewankambo, MBChB, MMed, MSc, FRCP, LLD (Hon), sometimes spelled as Nelson Ssewankambo, is a Ugandan physician, academician, medical researcher, and medical administrator. He is a professor of medicine and former principal of the Makerere University College of Health Sciences, a semi-autonomous constituent college of Makerere University.
David M. Serwadda is a Ugandan physician, medical researcher, academic, public health specialist and medical administrator. Currently he is a Professor of Public Health at Makerere University School of Public Health, one of the schools of Makerere University College of Health Sciences, a semi-autonomous constituent college of Makerere University, the oldest university in Uganda. Serwadda is also a founding member of Accordia Global Health Foundation's Academic Alliance.
The affected community is composed of people who are living with HIV and AIDS, plus individuals whose lives are directly influenced by HIV infection. This originally was defined as young to middle aged adults who associate with being gay or bisexual men, and or injection drug users. HIV-affected community is a community that is affected directly or indirectly affected by HIV. These communities are usually influenced by HIV and undertake risky behaviours that lead to a higher chance of HIV infection. To date HIV infection is still one of the leading cause of deaths around the world with an estimate of 36.8 million people diagnosed with HIV by the end of 2017, but there can particular communities that are more vulnerable to HIV infection, these communities include certain races, gender, minorities, and disadvantaged communities. One of the most common communities at risk is the gay community as it is commonly transmitted through unsafe sex. The main factor that contributes to HIV infection within the gay/bisexual community is that gay men do not use protection when performing anal sex or other sexual activities which can lead to a higher risk of HIV infections. Another community will be people diagnosed with mental health issues, such as depression is one of the most common related mental illnesses associated with HIV infection. HIV testing is an essential role in reducing HIV infection within communities as it can lead to prevention and treatment of HIV infections but also helps with early diagnosis of HIV. Educating young people in a community with the knowledge of HIV prevention will be able to help decrease the prevalence within the community. As education is an important source for development in many areas. Research has shown that people more at risk for HIV are part of disenfranchised and inner city populations as drug use and sexually transmitted diseases(STDs) are more prevalent. People with mental illnesses that inhibit making decisions or overlook sexual tendencies are especially at risk for contracting HIV.
Makerere University Walter Reed Project (MUWRP) was established in 2002 for the primary purpose of HIV vaccine development and building of vaccine testing capability in Uganda. It is one of the 5 international research sites established by the Department of Defense (DoD) United States HIV Research Program (MHRP), a program centered at the Walter Reed Army Institute of Research (WRAIR) in Silver Spring, Maryland. MUWRP's main facility is centrally located in Kampala, near the Makerere University College of Health Sciences where the MUWRP laboratory is located. The main facility includes the clinic, administrative, and data offices.
The Infectious Diseases Institute (IDI), established within Makerere University, is a Ugandan not-for-profit organization which aims to strengthen health systems in Africa, with a strong emphasis on infectious diseases; through research and capacity development. In pursuit of its mission both in Uganda and Sub-Saharan Africa, IDI provides care to People Living with HIV (PLHIV) and other infectious diseases, builds capacity among healthcare workers through training and ongoing support, maintains a focus on prevention, and carries out relevant research.
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Harriet Mayanja-Kizza, MBChB, MMed, MSc, FACP, is a Ugandan physician, researcher, and academic administrator. She is the former Dean of Makerere University School of Medicine, the oldest medical school in East Africa, established in 1924.
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