Research Programme
MITU’s research activities focus on the development and evaluation of health interventions, often through the conduct of randomised controlled trials (RCTs). This strategic focus distinguishes the Unit from other research institutions in the region and contributes to its status as a centre of excellence in the design and use of intervention trials. The Unit also conducts observational studies, to provide an epidemiological evidence base for intervention trials. Special efforts are made to promote the integration of research findings and evidence into healthcare policy and practice.
The geographical location of MITU allows research to be conducted in six regions around Lake Victoria in northwestern Tanzania. This offers a unique opportunity for research to take place in a range of urban, peri-urban and rural study locations, all within easy travelling distance of the Unit, so that urban/rural gradients in disease prevalence and risk factors can be readily observed and analysed.
Research is organised around the following main themes:
Since its inception, the collaboration between LSHTM, MITU and NIMR has focused mainly on the development and evaluation of interventions against HIV and other sexual health problems. HIV infection remains a major public health problem in sub-Saharan Africa where the majority of people living with HIV globally reside. MITU continues to contribute to the development and testing of new and novel methods aimed at preventing new infections, whilst also strengthening health systems’ response to the epidemic in reducing the burden of HIV/AIDS and related diseases, improving care and treatment, and mitigating the impact of the epidemic. Recently completed and ongoing research activities in this area include the following projects:
- Health Research Programme Consortium - Tackling the Structural Drivers of the HIV Epidemic (STRIVE RPC).
- The burden of sexually transmitted infections and non-communicable diseases among adults in the fishing communities in northwestern Tanzania.
- EMPOWER: An evaluation of a combination HIV prevention intervention that includes oral PrEP for adolescent girls and young women in South Africa and Tanzania.
- Impact of alcohol-focused interventions on treatment outcomes amongst HIV patients in Tanzania and South Africa: A feasibility study.
- Mobility patterns and feasibility of tracking women at high risk of HIV in fishing communities of Lake Victoria in Tanzania.
- Reducing Post-Hospital Mortality in HIV-infected Adults in Tanzania.
Cervical cancer is the commonest cancer in women from low and middle-income countries. It is also the leading cause of years of life lost from cancer in many parts of the developing world. Renewed hope for cervical cancer control has recently come from vaccines against human papillomavirus (HPV) which is the primary cause of cervical cancer and associated cervical lesions. MITU’s recently completed and ongoing research activities in this area include the following projects:
- A phase IIIb, double-blind, randomized, controlled, multicentre study to assess the immunogenicity and safety of GlaxoSmithKline Biologicals HPV-16/18 L1 AS04 vaccine administered intramuscularly according to a three-dose schedule (0, 1, 6 months) in healthy female subjects aged 10-25 years.
- Delivery, uptake and acceptability of HPV vaccination in Tanzanian girls.
- Epidemiology and natural history of HPV in a cohort of adolescent girls after sexual debut.
- Lessons learnt from HPV vaccine demonstration projects and national programmes in low and middle income countries.
- A dose reduction immunobridging and safety study of two HPV vaccines in Tanzanian girls (DoRIS trial).
Populations in sub-Saharan Africa (SSA) are experiencing a demographic and epidemiological transition marked by a rapidly emerging epidemic of chronic conditions that include non-communicable diseases (NCDs) such as cardio-vascular, metabolic, renal and pulmonary diseases. Research projects implemented by MITU aim to determine the burden and risk factors for NCDs in northwestern Tanzania, assess the ability of health systems to deliver effective care and treatment, and evaluate affordable prevention and treatment strategies. Recently completed and ongoing research activities in this area include the following projects:
- Improving health systems response to chronic diseases in Africa.
- A multi-centre study of the prevalence and environmental and genetic determinants of type 2 diabetes in sub-Saharan Africa (The H3A Diabetes Study).
- Hypertension in HIV-infected adults in Tanzania.
- Distribution of blood pressure and risk factors associated with hypertension among adolescents and young people in northwestern Tanzania and Southern Uganda.
- The burden of sexually transmitted infections and NCDs among adults in the fishing communities in northwestern Tanzania.
- Incidence of pre-hypertension and associated factors among secondary school students in Mwanza (Tanzania): A prospective cohort study.
Alcohol use is one of the major risk factors for the global burden of disease, and is associated with a range of medical conditions and injuries. These include increased risk of acquiring HIV and poor adherence to antiretroviral therapy (ART) which may lead to more rapid disease progression among people living with HIV. MITU has been involved in observational and intervention studies in a range of populations, and has made significant contributions in increasing the understanding of the role of alcohol as an individual and structural risk factor for HIV infection. Recently completed and ongoing research projects include:
- Epidemiology of alcohol use and its association with HIV among women at high risk of HIV in
northwestern Tanzania. - Epidemiology of alcohol use and associated risk factors among young people in northwestern
Tanzania. - Understanding the role of alcohol availability, promotion and affordability on young people’s sexual
health and safety in Mwanza and Kilimanjaro regions. - Impact of alcohol-focused interventions on treatment outcomes amongst HIV patients in
Tanzania and South Africa: A feasibility study.
Strengthening reproductive health services, including improving the quality of antenatal and delivery care, may help in reducing maternal (and infant) mortality which remain unacceptably high in sub-Saharan Africa. Within this area, MITU recently conducted the following projects:
- Safer Deliveries: an intervention to improve uptake and quality of delivery care services in rural Tanzania.
- A behavioral economic analysis of reproductive health in Tanzania.
Many of the major infectious diseases and emerging chronic non-communicable diseases (NCDs) in sub- Saharan Africa have their roots in exposures that develop during adolescence or early adulthood, the group which accounts for more than a third of the population of most low-income countries. As part of MITU’s research programme, ground-breaking studies have looked at the epidemiology and control of major health problems of adolescents and young adults, including research around HIV, human papillomavirus (HPV) and related infections, as well as the evolution of selected NCDs and related risk factors. Recently completed and ongoing research activities in this area include the following projects:
- Feasibility and acceptability of delivering adolescent health interventions alongside HPV vaccination in Tanzania (HAIIS – HPV vaccine Adolescent Intervention Integration Study).
- Epidemiology of alcohol use and associated risk factors among young people in northwestern Tanzania.
- Distribution of blood pressure and risk factors associated with hypertension among adolescents and young people in northwestern Tanzania.
- Evaluation of the impact of the ‘Adolescent 360’ – intervention programme aiming to increase contraceptive use among sexually-active adolescent girls in Tanzania.
- A cluster-randomised trial of a hand hygiene intervention to optimise helminthic infections control among school children in Kagera region, NW Tanzania (‘Mikono Safi’ – ‘Clan Hands’).
- Prevalence of high blood pressure among secondary school and college students in Mwanza, Tanzania and Entebbe, Uganda.
- Incidence of pre-hypertension and associated factors among secondary school students in Mwanza (Tanzania). A prospective cohort study.
MITU is also conducting research activities in other new areas, including:
- A cluster randomised trial to assess the impact of a combined Microfinance and participatory gender training intervention for women, and a participatory gender training programme for women and their male partners in reducing intimate partner violence.
- A Phase 1 study to evaluate the safety, tolerability and immunogenicity of heterologous prime-boost regimens using MVA-BN®-Filo and Ad26.ZEBOV administered in different sequences and schedules in healthy adults.
- A study to investigate the predictors of intimate partner violence: A mixed method longitudinal
study in Tanzania. - A study to determine the incidence of drowning and related risk factors among fishing
populations, conducted in 8 fishing communities of Lake Victoria.
