The University of North Carolina’s Division of Global Women’s Health (UNC) works closely with the University of Zambia’s Department of Obstetrics and Gynecology to conduct clinical research, support sub-specialty training and ongoing medical education, and provide specialist surgical services, particularly in the field of gynaecologic oncology. UNC Kamwala Clinic is one of the research sites under the University of North Carolina Global Projects: Zambia (UNC GPZ). Not only does the UNC-GPZ support clinical and research training in Zambia, with a focus on women’s health, its aim is to improve the health of mothers and their families today and to train tomorrow’s generation of caregivers and public health leaders.
The UNC Kamwala Clinic site began enrolling participants in the ECHO Study in August 2016. Modesta Chileshe, the Community Liaison Officer, tells us about the site and the UNC Kamwala team’s experience so far.
Where is the UNC Kamwala site, and what area does it serve?
The UNC Kamwala ECHO site is housed within the plot of the Lusaka Urban District Health Management Team (LUDHMT) Kamwala Clinic in Kamwala Township, Lusaka. The name Kamwala means a small stone, and this is the name of the township that serves as the major recruitment area for ECHO in Zambia. The Kamwala Clinic initially consisted of an outpatient department, an observation room and a small pharmacy. In 1998, the clinic was expanded to include a laboratory, admission wards and an administration block. Within the Kamwala Clinic, the team mainly recruits potential participants from the maternal and child health and family planning departments.
How many participants have you enrolled so far in ECHO?
The Kamwala ECHO site started screening participants on the 5th of August 2016, and as of 20 April, 376 women had been enrolled.
What lessons have you learnt so far?
The biggest lesson learnt is that participants have social support systems which need to be respected at all times in order to retain them on the study. Participants may not be in a position to make final decisions about their participation in the study, but other people around them can influence their participation. We therefore ask the potential participants to come to the clinic with those who influence them and we go through the informed consent forms and study procedures with them and answer any questions they may have.
What are the main questions the community is asking about ECHO?
The only questions they ask are mainly about why the study is being done when the products are already being used and what happens if a participant seroconverts.
We answer the first question by telling community members that even though these contraceptive options have been around for many years, their link to HIV acquisition is uncertain. Some studies show that that there is a link while others show that there is no link and the ECHO study is trying to confirm whether or not using any of these methods increases a woman’s risk of getting infected with HIV.
To the second question we respond by telling community members that if a woman seroconverts during the study, we will provide her with counselling and refer her to the Kamwala Clinic so that she can receive HIV care and treatment. The woman will stay in the study for 18 months as planned and will continue to have study visits every 3 months.
We would like to thank Modesta Chileshe (Community Liaison Officer) and the entire UNC-Kamwala team for their dedication to this important study and their contributions to this article.