It’s about time to tell you about what I’m actually doing and why I’m in Uganda! After Dr. Giordani got me moved into Mulago, I quickly settled in with the Global Health Uganda (GHU) Computerized Cognitive Rehabilitation Therapy (CCRT) team. Michigan State University has a partnership with GHU and Makerere University to conduct this study. The main goals of this study are to determine the effectiveness of CCRT on improving neuropsychological and psychiatric outcomes in Ugandan child survivors of severe malaria and if severity of malaria is predictive of the effectiveness of CCRT.
CCRT is a type of computer intervention that is often used in the states for elderly individuals or children with ADHD to improve their memory and attention skills. In a similar way that this program is used stateside, the hope is that CCRT will improve the cognitive abilities of children following severe episodes of malaria. Testing is done by Mariah, Titus, and Ethel pre-intervention, post-intervention, and one year post-intervention.
Our trainers, Michael, Irene, and Richard take laptops with the program to the participants’ schools 3 times a week for 8 weeks.
When I say severe malaria, it entails cerebral malaria (CM) and severe malaria anemia (SMA). In CM, the parasitic load of malaria becomes so great, they actually settle into the ventricles of the brain and begin affecting brain tissue. SMA occurs because the parasite attacks the red blood cells. When this happens the cells ability to carry oxygen to the brain and other areas is impaired. As you can see, children who are fortunate to survive can, unfortunately, suffer cognitive deficits, either from lack of oxygen or direct tissue destruction, impacting many areas of their lives.
There is clearly a lot going on here and it is a well-established study. But one aspect that is not being directly explored is the relationship between CCRT, neuropsychological testing and academic performance. That’s where I come in! I am currently working to standardize school reports from study participants and record that information in a reliable database. My hope is to identify any differences in academic performance between children in the CM, SMA, and CC (community control) groups at baseline and their one year follow up. We will also be looking at whether the neuropsychological testing is predictive of those differences.
The study has been going on for a few years with a total of 300 participants, so there are lots of school reports, and more continuing to come in. My goal is to have as many children as possible with both baseline and one year school reports to analyze and develop a conclusion.
The time has been flying by so quickly. To think, I am already half way through my time in Uganda! At times that is a comforting thought because it means home is not so far away, but when I’m at work, I often feel I could stay here a few more months to accomplish everything the way I want. It is a lot of work, learning a new research and health care system.
I am enjoying every moment though. Not everything is easy, but that’s what makes it fun. I love the challenge and Kampala definitely keeps it coming!