UNIVERSITAS DIPONEGORO

GRADUATE SCHOOL
MASTER OF EPIDEMIOLOGY

Research Methodology and Philosophy of Science

Student’s name: Ntambi Saidi

NIM: 30000221419035

Email: saidi@students.undip.ac.id

Instructor: Dr. M. Sakundarno Adi

Assignment question:

1. Think and decide what is your THESIS RESEARCH TOPICS,

2. Find 5 JOURNAL ARTICLES (in English) that related to your thesis research topics,
3. Read those articles and write the RESEARCH PROBLEM (S) AND THE
RESEARCH OBJECTIVE (S) for each of those articles,

September, 2021
 THESIS RESEARCH TOPIC

PREVALENCE OF MALARIA AMONG PEADIATRIC CANCER PATIENTS AT THE

UGANDA CANCER INSTITUTE, KAMPALA UGANDA.

RELATED JOURNAL ARTICLES:

1. Asua, V., Tukwasibwe, S., Conrad, M., Walakira, A., Nankabirwa, J. I., Mugenyi, L.,
Kamya, M. R., Nsobya, S. L., & Rosenthal, P. J. (2017). Plasmodium Species Infecting
Children Presenting with Malaria in Uganda. The American journal of tropical
medicine and hygiene, 97(3), 753–757. https://doi.org/10.4269/ajtmh.17-0345

2. Mutyaba, I., Wabinga, H. R., Orem, J., Casper, C., & Phipps, W. (2019). Presentation
and Outcomes of Childhood Cancer Patients at Uganda Cancer Institute. Global
pediatric health, 6, 2333794X19849749. https://doi.org/10.1177/2333794X19849749

3. Nordor, A. V., Bellet, D., & Siwo, G. H. (2018). Cancer-malaria: hidden connections.
Open biology, 8(10), 180127. https://doi.org/10.1098/rsob.180127

4. Jatho, A., Tran, B. T., Cambia, J. M., Nanyingi, M., & Mugisha, N. M. (2020). Cancer
Risk Studies and Priority Areas for Cancer Risk Appraisal in Uganda. Annals of
global health, 86(1), 78. https://doi.org/10.5334/aogh.2873

5. Akimana, B., Abbo, C., Balagadde-Kambugu, J., & Nakimuli-Mpungu, E. (2019).

Prevalence and factors associated with major depressive disorder in children and
adolescents at the Uganda Cancer Institute. BMC cancer, 19(1), 466.
https://doi.org/10.1186/s12885-019-5635-z
ARTICLE RESEARCH PROBLEMS AND THE OBJECTIVES

ARTICLE 1:
Plasmodium Species Infecting Children Presenting with Malaria in Uganda (Asua et al.,
2017).
Research problem
There are four common plasmodial species known to cause human malaria in sub-Saharan
Africa, with Plasmodium falciparum being in the lead. Some species are considered uncommon,
presumably due to absence of the duffy erythrocyte receptor in the lion’s share of the African
populations. Other human malaria species considered to be rare in Africa, though seen are;
Plasmodium malariae and Plasmodium ovale. Moreover, there is limited data describing
prevalence of different plasmodial species in Africa, despite its helpfulness in therapeutic and
control strategies. Some studies have shown high prevalence of non-falciparum infections, and
recent evidence suggested that P. vivax can infect Duffy-negative individuals. A previous study
in Uganda, involving molecular analysis of samples from a Kampala cohort did not identify P.
falciparum but rather suggested that plasmodial infections were due to P. malariae, P. ovale, and
P. vivax. Furthermore, a study of children from eastern Uganda noted frequent mixed infections
that were either due to P. falciparum and P. malariae, P. falciparum and P. ovale, or were due to
all three of these species. Data on prevalence of infecting plasmodial species, other than
Plasmodium falciparum to human malaria in Uganda are limited. Thus, to gain further insights
into the species composition in symptomatic malaria, calls for a survey to check the prevalence
of different plasmodial species in samples from children presenting with malaria at multiple sites
in Uganda.

Research objectives
a) General objective
To gain further insight into the plasmodial species composition in children presenting with
symptomatic malaria at multiple sites in Uganda.
b) Specific objectives
i) To determine the prevalence of different plasmodial species in collected blood samples
from children.
 ii) To determine the prevalence of non-falciparum species in collected blood samples from
children.
iii) To compare the prevalence of plasmodium species and non-plasmodium species in
children presenting with malaria.

X
ARTICLE 2:

Presentation and Outcomes of Childhood Cancer Patients at Uganda Cancer Institute

(Mutyaba et al., 2019)

Research problem

There are marked differences in the incidence and survival outcomes of childhood cancers in
sub-Saharan Africa compared with North America and Europe. The reported overall childhood
cancer incidence is lower in Sub-Saharan Africa, ranging between 139 per one million children
(0-19 years) in Kyadondo County, Uganda. In addition, infection-associated cancers like Burkitt
lymphoma and Kaposi sarcoma are predominant in sub-Saharan Africa compared with acute
lymphoblastic leukemia and central nervous system tumors in North America. Furthermore, the
limited data on Burkitt lymphoma, Kaposi sarcoma and lymphoblastic leukemia show poor 1-
year survival rates in sub-Saharan Africa compared with 5-year survival rates for most childhood
cancers in North America or Europe. However, data on presentation, outcomes and factors
associated with survival among children with cancer in sub-Saharan Africa, inclusive of Uganda
are lacking. The present study sought to address these knowledge gap.

Research Objective

a) General objective

To describe the presentation, treatment outcomes, and factors associated with survival among
children with cancer managed at Uganda Cancer Institute.

b) Specific objectives
i) To determine the cancer presentations among children with cancer being managed at
Uganda Cancer Institute.
ii) To determine the cancer treatment outcomes among children with cancer being managed
at Uganda Cancer Institute.
iii) To determine the risk factors associated with survival among children with cancer
managed at Uganda Cancer Institute.
ARTICLE 3:

Cancer–malaria: hidden connections (Nordor et al., 2018)

Research problem

Cancer and malaria represent two diseases assigned to separated research spaces in the past.
Cancer, is a top priority in the research agenda of developed countries while malaria, on the other
hand, represents a major health burden for developing countries in the Southern Hemisphere.
Evolutionary history holds an audit that exposure of human populations to malaria has
ceaselessly shaped genetic variation at several loci in the human genome. Consequently,
presence of genes that are used in both diseases could be of impactful importance in their biology
and epidemiology. Previous studies have shown that with respect to possible epidemiological
associations between malaria and cancer, the prevalence of malaria is correlated with that of
endemic Burkitt lymphoma but negatively correlated with all-cause mortality across multiple
cancers. Moreover, malaria is decreasing in most countries where the disease has been endemic
and paradoxically cancer cases are at the rise in many of those regions, Sub-Saharan Africa to be
specific. Hence despite the historical divide between cancer and malaria research, evidence
accumulated over the past decade points to the need for understanding how the two diseases
might influence each other biologically given their evolutionary history and epidemiology.

Research Objective

General objective

To understand how cancer and malaria might influence each other biologically given their
evolutionary history and epidemiology.

Specific objectives

i) To demonstrate the important roles of biological mechanisms in both cancer and malaria.
ii) To highlight the role of these biological mechanisms in distinct developmental stages of
the malaria parasite.
iii) To determine how these biological mechanisms could impact the clinical management of
the two diseases.
ARTICLE 4:
Cancer Risk Studies and Priority Areas for Cancer Risk Appraisal in Uganda (Jatho et al.,
2020)

Research problem
Cancer occupies a front position among the leading causes of death worldwide, with over 18
million new cases and 9.6 million cancer deaths predicted to have happened in 2018 alone. By
2030, it is assumed that about 26 million new cases and 17 million deaths will occur due to
cancer per year. Globally, almost 50% of all new cancer cases and 70% of all deaths due to
cancer occur in low- and middle-income countries. Uganda alone reported 32,000 new cases and
21,000 deaths due to cancer in 2018 and 56,238 cancer individuals. Late presentation and limited
access to diagnosis and treatment services contribute to the high cancer death rate in Uganda.
thus, based on the current cancer incidence, a majority of the top seven cancers in Uganda, can
be minimized by modifying their risk factors.

Keeping the prevalence of cancer risk factors under check in a specific population guides cancer
prevention, early detection efforts and national cancer control programming. There is unmet need
for comprehensive cancer risk and prevention studies in Uganda. This study therefore was to
provide the scope of cancer risk studies conducted in Uganda, since their findings would help
guide researchers and policymakers on current priority cancer risk evaluation.

Research objective
a) General objective
To determine the scope of cancer risk studies conducted in Uganda and guide researchers and
policymakers on the locally generated evidence and perspectives on current priority cancer risk
appraisal.

b) Specific objectives
i) To determine the scope of cancer risk studies conducted in Uganda.
ii) To determine the findings of cancer risk studies conducted in Uganda.
ARTICLE 5:

Prevalence and factors associated with major depressive disorder in children and
adolescents at the Uganda Cancer Institute (Akimana et al., 2019)

Research problem

Annually, close to two hundred thousand children and adolescents suffer from different types of
cancer worldwide. Majority of these live in low and middle-income countries, which translates to
a high mortality rate in these countries. Like other chronic diseases, cancer individuals are faced
with a multitude of psychological and social challenges, which are more pronounced in children
and adolescent, having to cope with a number of issues as they move from one stage of
development to another. Factors that contribute to depression include; patient-related factors
such as family history of depression, disease- and treatment-related variables such as pain and
other physical symptoms, awareness of cancer diagnosis, and contributions of the patient’s
surroundings such as social support.

Most studies have been done in the adult population and thus the data is limited among children
and adolescents; especially in low resource settings like Uganda. The present study assessed the
prevalence and factors associated with children and adolescents attending the Uganda cancer
institute out-patient clinic.

Research objective

a) General objective

To determine the prevalence and factors associated with major depressive disorder in children
and adolescents attending the Uganda cancer institute out-patient clinic.

b) Specific objectives
i) To determine the prevalence of major depressive disorder in children and adolescents
attending the Uganda cancer institute out-patient clinic.
ii) To determine the factors associated with major depressive disorder in children and
adolescents attending the Uganda cancer institute out-patient clinic.