Established in 1989 in Kyamulibwa sub-county, Kalungu district, the GPC aims to study the epidemiology of infectious and non-communicable diseases (NCDs), as well as to study the social aspects of science among the general population.
The platform comprises a population of around 22,000 people within 25 adjacent study villages and has the capacity to facilitate varied field activities, including census (house-to-house demographic surveillance) and medical surveys. The GPC also offers free basic care to study participants through a clinic at the MRC/UVRI/LSHTM Uganda Research Unit field station in Kyamulibwa.
The GPC was established in 1989 in Kyamulibwa sub-county, Kalungu district. Originally, its main aim was to study the epidemiology of HIV/AIDS in the general population. Over time, the GPC has expanded to address scientific questions on other infectious diseases and non-communicable diseases (NCDs), and for social science research.
It comprises a population of around 22,000 people within 25 adjacent study villages. The GPC has capacity to conduct field activities, which include a census (house-to-house demographic surveillance) and medical survey, and runs a clinic at Kyamulibwa field station offering free basic care to study participants.
The GPC comprises a team of over 20 epidemiologists providing critical services related to public health surveillance, field investigation, analytic studies, evaluation and linkages to medical practice. The team is led by:
- Joseph Mugisha Okello (Head- GPC)
- Eugene Ruzagira - Head- HIV Epidemiology and Intervention Programme)
- Beatrice Kimono (GPC Survey coordinator)
- Ronald Makanga (GPC Data manager)
Scientific research at the GPC utilises a multi-level community engagement structure that incorporates general patient care for study cohorts at the field station and identification, follow up and management of participants within areas of focus.
Census and Survey component in the field
This component describes the procedures for gathering samples as a preliminary step for scientific research, such as public health surveillance and field investigations. Activities here include:
- Community Engagement and Mobilisation
- Annual GPC map updates using Geographic Information System (GIS) mapping
- Annual collection of census data such as pregnancies, births and deaths registrations as well as other demographic structures of the GPC.
- Annual collection of cause-specific mortality data
- NCD surveys to monitor prevalence of NCD risk factors since 2011.
- Conduct HIV sero-survey every two years to monitor HIV prevalence and incidence. This has been done since the baseline survey of 1989/1990.
GPC Clinic at Kyamulibwa field station
This offers general daily outpatient activities for treating patients that come from the GPC study villages ranging from 60-80 patients on regular days, and 120-160 patients on busy days. Other activities at the clinic include:
- Dispensing of drugs and general nursing care
- Clinical data entry of prescription forms for future research use.
- Special clinics including the diabetes clinic, the hypertension clinic, the epilepsy clinic and sickle cell clinic
ART clinic
This specialised service is run separately from the GPC general clinic, providing antiretroviral drugs to all people residing within the GPC study villages. All drugs accessed through the ART clinic are supplied by Joint Medical Stores, a licensed national supplier of medicines and related health supplies in Uganda.
1) Longitudinal population and clinic data since 1989. These data include annual census data, HIV related data, hepatitis B and C data, and NCD data. We also have verbal autopsy data, birth and death records and since 2020, SARS CoV-2 and COVID-19 related data.
2) Genetic data, including genome-wide data from 6,400 individuals and whole-genome sequences from 1,978 a key resource for both Unit and continent-wide collaborative studies (e.g., Choudhury et al, “High-depth African genomes inform human migration and health,” Nature 2020).
3) Longitudinal blood samples for every survey round since 1989. The samples (serum, plasma, whole blood and cell pellets) are stored within the Unit’s biorepository in Entebbe and logged on Freezerworks. Since 2020, the Platform has SARS-CoV-2 samples (blood and nasopharyngeal swabs). The samples are available for answering research questions for both Unit and external scientists – indeed more than 40 papers have been published in the quinquennium, based on analyses of historical serum samples. These stored samples also make the GPC particularly attractive for future field research because they provide the ability to compare data historically.
4) A well organised infrastructure including office space, study clinic and a clinical laboratory. The clinical laboratory is well equipped to process samples for storage and to perform simple, immediate laboratory tests - haematology, CD4 cell counts, microscopy and cell separation. The laboratory has -80C freezers, and liquid nitrogen tanks that are used to store samples before they are transported to the main CDLS laboratory and biorepository in Entebbe. The Platform administration is based at the field station next to Kyamulibwa Sub-County headquarters. The Platform is supported with a small fleet of vehicles and motorcycles for field work.
5) Well-trained staff, experienced in survey data collection, data management and data analysis.
6) Well organised community engagement structure and activities, with strong support from the Community Advisory Board (CAB) and the office of the District Health Officer (DHO).
7) Provision of antiretroviral therapy (ART) to people living with HIV. The ART clinic is supported by the Uganda Government. Between 2018-2022, we conducted the 26th survey round and 28th census round. We monitored current HIV prevalence, incidence and viral suppression and assessed progress on the 90-90-90 fast-track targets. These data show that 81.6% of the men know their HIV status, 98.9% of those who are HIV positive are on ART and 91% of these are virally supressed. These data are a good reflection of the national picture.
For HIV surveillance, we have analysed data collected within the last three decades including this QQ and shared the report with the Ministry of Health, for use in the National HIV report. These provide important information on changes in HIV incidence in the context of a changing national HIV response, and identify some gaps. For example, we observed markedly higher HIV incidence in women compared to men which has also been observed in other populations in Uganda. This underscores the need for targeted interventions.
For inquiries about GPC resources email: GPC@mrcuganda.org.
GPC resources are used by both Unit and external researchers to advance research. They have also provided a comprehensive research training platform to PhD medical students specialising in the epidemiology of infectious and non-communicable diseases.
Capacity building at the GPC is an immersive experience that gives both PhD students and research fellows the opportunity to participate in ongoing research studies. These experiences further enable PhD students to gain in-depth understanding of clinical issues and delve deeper into their previous study findings.