The department of Medical Microbiology strongly believes that microbiological research will play a leading role in solving Uganda’s medical ailments. In order to address the need for continued research and training in infectious diseases, the department has rapidly transformed into a vibrant research and training center within the College of Health Sciences. Research in our department is integrated, spanning from basic research to applied research and operation/clinical research. We believe in this integration since basic research provides a firm foundation for applied and operational research. Undergraduate and graduate (masters and PhD) students from a wide range of the university’s programs are actively involved in our research programs. Upon finishing, the graduates pursue careers in research or health care or the academia.

Research in the department can be an individual grant support to a departmental faculty, or a collaborative study between the faculty and any other scientist or study group.

The department’s research focus is mainly in the following areas, mirrored by the laboratories where various research activities are localized:

  • Molecular biology of infectious diseases: based at the Molecular Biology and diagnostics laboratories
    • Strategic basic research on the biology of pathogens aiming at drug/vaccine discovery and development of diagnostic tests and molecular epidemiological tools for screening of infectious diseases
    • Molecular epidemiology of infectious diseases
    • Molecular mechanisms of drug resistance
    • Routine Molecular diagnostics
  • Immunological research: based at the Immunology laboratory
    • Immunology of infectious diseases
    • Pregnancy immunology
  • Mycobacteriology: based at the BSL3 Mycobacteriology laboratory

TB Vaccine study clinical trials

  • Clinical/Operational research: based at the clinical Microbiology and mycology laboratories

1) Current Research projects in the Molecular Biology Laboratory

Cell to Cell signaling in Mycobacteria- this project is funded by NIH grant #1R01A175637-01. This project has is supporting three graduate students, one doing a PhD in Molecular Microbiology and the other two are doing Masters degree in Molecular Biology. All the the students are in their advanced years of study. PI: Dr Moses L. Joloba

Molecular Biology of Mycobacterium tuberculosis: Molecular Characterization of MTB complex in Kampala- this project is funded by Sida-Sarec. The project supported a PhD student through Makerere University-Karolinska Institute collaboration, and a Masters student who studied the Molecular Epidemiology of Mycobacterium bovis in Kampala. These students accomplished their studies successfully and their work was published in referral journals. PI: Dr Moses L. Joloba

Molecular Biology of Mycobacterium tuberculosis: Evaluation of Rapid Methods for Diagnosis of Multi-Drug Resistant TB in Kampala”This is another Sida-Sarec supported project. The project is funding one PhD student and one Msc student, now in their final years of study. A manuscript from this work was published by BMC Infectious diseases, and it is one of the most highly accessed papers this year. PI: Dr Moses L. Joloba

Molecular Biology of Mycobacterium tuberculosis: Phenotypic and Microevolution of MTC of Uganda Genotype: this study belongs to the Mycobacteria tuberculosis Strain working groupof the Tuberculosis Research Union (TBRU).This project is aiming at investigating the role of different genotypes of MTC in transmission, treatment response, clinical and radiological presentation of MTC. A PhD student and an international student are supported by this project. PI: Prof. Henry Boom; CO-PI: Dr Moses L. Joloba

Molecular Biology of Streptococcus pneumoniae: Transformation Efficiencies of Drug susceptible and Drug Resistant Pneumococci- This study was completed last year and the data revealed that there were no differences in transformation efficiencies among drug resistant and drug susceptible serotypes of Streptococcus pneumoniae. The study funded a Tanzanian Masters student. A manuscript is ready for submission for publication.
PI: Dr Moses L. Joloba

Prevalence of infection with multiple strains of Mycobacterium tuberculosis among patients with pulmonary tuberculosis in Kampala, Uganda: This study was done with Howard Hughes funding, aiming at evaluating the presence of multiple strain infections in a high TB burden country using the Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR) molecular typing technique in our laboratory.
This study was pioneered by an international Medical student from the University of Pittsburg, USA, with initial support from AITRIP and the Forgarty scholarship program. The study also supports a local Msc student. PI: Kate Dickmanns, CO-PI: Dr Moses L. Joloba

Tuberculosis Drug resistance survey in Kampala:This study is funded by the European Union, and it has supported two Master’s students: one in Public Health and another in Molecular biology. PI: Dr Moses L. Joloba

Characterization of Extended spectrum B-lactamases elaborated in Uganda: this is a doctoral study funded by Makerere University School of Graduate studies and belongs to Dr. F.C. Najjuka, a lecturer in the department. The study has so far supported up to seven undergraduate students. PI: Dr F.C. Najjuka

A multi-centre comparative trial of efficacy and safety of sodium stibogluconate (SSG) versus paromomycin (PM) versus combination of SSG and PM as the first line treatment for visceral leishmaniasis in Ethiopia, Kenya, Sudan and Uganda. PI: Dr. E. Ssentongo & Prof J.Olobo

Malaria Vaccine Studies in Uganda: Site Preparation, Infrastructure Development, And Capacity Building For Clinical Trials. PI: Prof. J. Olobo

The efficacy of artemether- lumefantrine therapy and assessment of possible molecular markers of resistance in Uganda. PI: Dr. Hakim Sendagire

Comparison of the development of thymidine analogue mutations with CD4 monitoring alone versus CD4 monitoring plus viral load monitoring in naïve HIV-1 individuals on first-line antiretroviral therapy in Africa. PI: Dr. Hakim Sendagire

The phylogeography of Kaposi’s sarcoma-associated herpesvirus 8 in Uganda. CO-PI: Dr Henry Kajumbula

Services in the new Molecular Diagnostic Laboratory

Increased emphasis on diagnosis of human diseases by molecular genetic analysis has occurred in the recent years. Clinicians have become increasingly aware of the tremendous power of molecular-based tests for the diagnosis of human diseases. Molecular diagnostic tests, originally developed in a research setting, have been commercially packaged into a myriad of formats that are sufficiently quick and simple for effective use in clinical diagnosis of human diseases. The use of these diagnostic assays is becoming increasingly common in many clinical settings in Uganda, and is likely to extend to major referral hospitals in the near future. Thus, as the molecular basis of more diseases is elucidated, these technologies will continue to be methods utilized in clinical settings in the near future. This surge of new molecular-based tests has created the need for individuals trained in the theory and practice of performing or developing these tests. Funded by Sida-Sarec, this laboratory is constructed to meet this need. Upon completion, this laboratory will be fully equipped with facilities to detect all human pathogens and genetic diseases.

In 2006, the molecular biology laboratory introduced PCR for identification of MTC infections as a routine for the first time in Uganda. Since then, approx 5000 samples (culture and sputum) from the Joint Clinical Research Center have been speedily and accurately worked on. In addition, A number research programmes also bring samples to the laboratory for identification of MTC. Occasionally, clinicians and health workers bring suspect specimen to rule out MTC infection from their patients. So we deal with a diverse source of specimen and samples.  Rigorous steps and utmost care are taken to ensure quality of results disseminated.

Ugandan clinicians, health workers and researchers: We look forward to processing your samples using robust and reliable molecular techniques

Download PCR protocol for identification of M. tuberculosis

Download IS6110-RFLP Protocol for fingerprinting of M. tuberculosis

Completed projects in the Molecular Biology laboratory

Evaluation of various methods for rapid detection of multi-drug resistant tuberculosis:This was a WHO/TDR grant support to Moses Joloba.In this study four new methods (one molecular and other 3 culture based) were compared with the conventional indirect Bactec method for rapid detection of rifampicin resistance. The methods werecompared for turnaround time, cost and technical ease. Year of completion: 2007. Manuscript published in the open access journal, BMC Infectoius diseases where it is highly accessed. PI: Dr. Moses Joloba
Role of Cell-Cell signaling homologues in Mycobacteria Signaling: This was an RO3 NIH grant support to Moses Joloba. A genetic approach was used to identify and characterize mycobacteria genes that are required for production or sensing extracelluar signals. In addition, biochemical methods were used to purify signals. The grant was upgraded to RO1 (see cell to cell signaling in mycobacteria). PI: Dr. Moses Joloba

2) Current Research Projects in the Immunology Laboratory

This is the first and only fully fledged teaching immunology teaching laboratory in the department and Makerere University. The laboratory collaborates with the Makerere University Walter Reed, Medical Research Council, Uganda Virus Research Institute and the Joint Clinical Research Centre Laboratories. The laboratory is fully equipped performs and teaches all T-cell and immunoglobulin based immunological techniques. The department started a doctoral program in immunology with 5 fully sponsored PhD immunology students, based in this laboratory. The doctoral program also serves as an avenue for the training of masters graduates. Although it is new, the doctoral program has been favorably reviewed by Welcome Trust, Karolinska institute and Case Western Reserve Universities that are well recognized immunology teaching institutions.

Collaborative Research studies

The University of Washington PIP (Partners in prevention study) Study:  This completed study was about Randomized Placebo Controlled Trial of HSV-2 Suppression to prevent HIV transmission among HIV discordant couples. The serology and immunological screening on patient samples were done in the immunology laboratory.

The University of Washington COS (Couples Observational Study): This is a study among HIV discordant couples. This study explores the role of HSV-2 suppression in prevention of HIV transmission in discordant couples. Unlike previous studies, this study includes all participants irrespective of their level of immune suppression or being on ARVs

University of Washington PrEP Study:This study is about Parallel comparison of Tenofovir and Emtricitabine/Tenofovir  Pre- Exposure Prophylaxis to prevent HIV-1 Acquisition with in HIV-1 Discordant couples.

The immunological tests done in the laboratory:

  • HIV-ELISA
  • HSV-2 ELISA
  • Hepatitis B  ELISA
  • RPR  + TPHA
  • Agglutination tests
  • Western blotting/Immunoblotting

3) Current Research Projects in the BSL3 Mycobacteriology Laboratory

The AERAS Mycobacteriology BSL2 laboratory
Aeras TB vaccine study supported construction of the BSL2 Laboratory in Makerere University. This laboratory is the first of its kind in the University and it is used for liquid and solid culture of mycobacteria, Molecular tests as well as Drug susceptibility testing.

Epidemiological Studies towards Phase III TB Vaccine Trials in Uganda
Many TB cases and deaths occur in resource-limited settings in Africa where access to health services is often limited. Efforts are currently underway for developing and testing of more effective TB vaccines. Testing of these vaccines in areas where they are most needed has advantages in spite of the limited capacity to conduct such trials in these settings. Capacity building activities in these settings including TB epidemiological studies are therefore necessary. In Uganda, TB vaccine activities to build capacity for future phase III TB vaccine trials are being trained. Two prospective cohorts of 2500 BCG-vaccinated infants and 7000 adolescents aged 12-18 years will be under TB surveillance for two years. The studies are conducted in the Iganga/Mayuge Demographic Surveillance Site (DSS) located in a rural/peri-urban setting in Eastern Uganda.

The Biosafety level III Mycobacterialogy Laboratory
The Department of Medical Microbiology College of Health Sciences Makerere University provided space and other technical support, and AERAS global TB Vaccine foundation funded the construction and staffing of Bio-safety Level 3 laboratory for the TB vaccine study. The laboratory has a Director, a Manager, a supervisor, a field Manager, two technologists, one data Clark, two support staffs and two drivers.

4) Research and services in the Clinical Microbiology laboratory

This is the clinical diagnostic branch of the department of Medical Microbiology. The clinical laboratory offers affordable and quality diagnostic services to a plethora of specimens from patients suspected to have infectious diseases.  We offer bacterial, parasitic, fungal, and viral diagnosis detection in the specimens. The laboratory is strategically located centrally in Kampala, surrounded by a number of hospitals and clinics within the city. The clinical laboratory has increasingly become the nations referral centre for the public and private hospitals/clinics within the Kampala area, and countrywide.

The Clinical Laboratory receives specimens from a number of sources. These include Mulago Hospital, Infectious Diseases Institute, Paediatric Infectious Diseases Institute, Makerere University-Johns Hopkins University Clinic, Private Clinics and Private not-for-profit health facilities in Kampala City and upcountry, as well as from walk in individual patients.

Specimens of any type are processed here. Modern techniques raging from biochemical, serological, culture to molecular biology techniques are employed to identify disease causing Microorganisms. This work is executed by dedicated personnelcomposed of Specialist Clinical Microbiologists, technologists and support staff.
During 2008, the laboratory processed about 7000 specimens.

The major clients for the clinical microbiology laboratory include:

  • The Infectious Disease Clinic of The Infectious Disease Institute (IDI)- idi.mak.ac.ug
  • The Baylor Uganda, Paediatric HIV Clinic
  • The Makerere University- Johns Hopkins Collaboration
  • A number of Graduate students (Masters and PhD) doing Research Projects for their dissertations

Collaborative Research
A joint grant application ‘The Environmental Transmission of the AIDS associated Pathogen Cryptococcus neoformans in Africa’ has been submitted in collaboration with a group from the University of Minnesota for funding.
Through this grant, a number of equipment will be bought for the lab.

Accreditation:
The Clinical Microbiology laboratory has embarked on the process of accreditation.

Specimens Tests Performed

  • Biopsy Tissues e.g. Pleura, Bone marrow etc
  • Blood
  • Corneal scrapping
  • CSF (Cerebrospinal fluid)
  • Fluid aspirates (Pleural, Peritoneal, Joint, Pericardial, Cysts, Hydrocele)
  • Genital Specimens e.g urethral swab, High vaginal swab
  • Hair, Skin, & Nails for Fungal diagnosis  
  • Nasopharyngeal and oro-pharyngeal swabs
  • Pus
  • Semen
  • Skin snips for Microfilaria
  • Sputum, Induced sputum, Bronchoalveolar Lavage, Tracheal aspirates
  • Stool for bacterial pathogens
  • Stool for parasites
  • Swabs
  • Urine

5) The Mycology laboratory

The Department of Medical Microbiology has the only clinical mycology laboratory in the country. It is instrumental in detecting existing and new fungal infections in the era of HIV/AIDS. The lab is a powerful resource to disseminate knowledge on diagnosis of fungal diseases in Uganda.