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Jegede A, Balogun O, Olorunsogbon OF, Nichols M, Akinyemi J, Jenkins C, Ogunronbi M, Singh A, Obiako R, Wahab K, Bello A, Akpalu A, Sarfo FS, Owolabi LF, Ojebuyi B, Adigun M, Olujobi D, Musbahu R, Titiloye M, Afolami I, Calys-Tagoe B, Uvere E, Laryea R, Fakunle A, Adeleye O, Adesina D, Mensah N, Oguike W, Coleman N, Adeniyi S, Omotoso L, Asibey S, Melikam L, Yusuf J, Gbenga A, Mande A, Uthman M, Kalaria RN, Owolabi M, Ovbiagele B, Arulogun O, Akinyemi RO. Research participants' perception of ethical issues in stroke genomics and neurobiobanking research in Africa. PLoS One 2025; 20:e0292906. [PMID: 40327650 PMCID: PMC12054916 DOI: 10.1371/journal.pone.0292906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 03/16/2025] [Indexed: 05/08/2025] Open
Abstract
BACKGROUND There is a growing interest in stroke genomics and neurobiobanking research in Africa. These raise several ethical issues, such as consent, re-use, data sharing, storage, and incidental result of biological samples. Despite the availability of ethical guidelines developed for research in Africa, there is paucity of information on how the research participants' perspectives could guide the research community on ethical issues in stroke genomics and neurobiobanking research. To explore African research participants' perspectives on these issues, a study was conducted at existing Stroke Investigation Research and Education Network (SIREN) sites in Nigeria and Ghana. METHOD Using an exploratory design, twenty-eight Focus Group Discussions (FGDs) sessions were conducted with stroke survivors (n = 7), caregivers(n = 7), stroke - free controls(n = 7), and Community Advisory Board members(n = 7). Data were collected using an interview guide. Interviews were conducted in English and indigenous languages of the community, audio recorded, and transcribed verbatim. Data were analyzed using NVivo (March, 2020) Software. RESULT Results revealed that stroke genomics and neurobiobanking research in Africa require researchers' direct attention to ethical issues. Concerns were raised about understanding, disclosure and absence of coercion as components of true autonomous decision making in research participation. Participants argued that the risk and benefits attached to participation should be disclosed at the time of recruitment. Fears around data sharing were voiced as adherence to the principle of privacy and confidentiality were of paramount importance to participants. The preference was to receive the results of incidental findings with no stigma attached from society. CONCLUSION Research participants' perspectives are a vital aspect of community engagement in stroke genomics and neurobiobanking research. Findings from this study suggest that research participants are interested in these fields of research in Africa if their concerns about ethical issues are appropriately addressed within the research framework.
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Affiliation(s)
- Ayodele Jegede
- Department of Sociology, Faculty of the Social Sciences, University of Ibadan, Nigeria
| | - Olubukola Balogun
- Department of Sociology, Faculty of the Social Sciences, University of Ibadan, Nigeria
| | - Olorunyomi Felix Olorunsogbon
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Health Promotion and Education, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | - Michelle Nichols
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Joshua Akinyemi
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Carolyn Jenkins
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Mayowa Ogunronbi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Arti Singh
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Reginald Obiako
- Neurology Unit, Department of Medicine, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Nigeria
| | - Kolawole Wahab
- Neurology Unit, Department of Medicine, University of Ilorin Teaching Hospital, University of Ilorin, Ilorin, Nigeria
| | - Abiodun Bello
- Neurology Unit, Department of Medicine, University of Ilorin Teaching Hospital, University of Ilorin, Ilorin, Nigeria
| | - Albert Akpalu
- University of Ghana Medical School, College of Health Sciences, Accra, Ghana
| | - Fred S. Sarfo
- Neurology Unit, Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lukman F. Owolabi
- Neurology Unit, Department of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Babatunde Ojebuyi
- Department of Communication and Language Arts, Faculty of Arts, University of Ibadan, Nigeria
| | - Muyiwa Adigun
- Department of Public Law, Faculty of Law, University of Ibadan, Ibadan, Nigeria
| | - Dorcas Olujobi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Rabiu Musbahu
- Neurology Unit, Department of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Musibau Titiloye
- Department of Health Promotion and Education, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | - Ibukun Afolami
- Department of Human Nutrition and Dietetics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Ezinne Uvere
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ruth Laryea
- University of Ghana Medical School, College of Health Sciences, Accra, Ghana
| | - Adekunle Fakunle
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Osi Adeleye
- Neurology Unit, Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria
| | - Deborah Adesina
- Neurology Unit, Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria
| | - Nathaniel Mensah
- Neurology Unit, Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Wisdom Oguike
- Neurology Unit, Department of Medicine, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Nigeria
| | - Nathaniel Coleman
- University of Ghana Medical School, College of Health Sciences, Accra, Ghana
| | - Sunday Adeniyi
- Neurology Unit, Department of Medicine, University of Ilorin Teaching Hospital, University of Ilorin, Ilorin, Nigeria
| | - Lanre Omotoso
- Neurology Unit, Department of Medicine, University of Ilorin Teaching Hospital, University of Ilorin, Ilorin, Nigeria
| | - Shadrack Asibey
- Neurology Unit, Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lois Melikam
- Neurology Unit, Department of Medicine, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Nigeria
| | - Jibril Yusuf
- Neurology Unit, Department of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Abdullateef Gbenga
- Neurology Unit, Department of Medicine, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Nigeria
| | - Aliyu Mande
- Neurology Unit, Department of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Muhammed Uthman
- Neurology Unit, Department of Medicine, University of Ilorin Teaching Hospital, University of Ilorin, Ilorin, Nigeria
| | - Rajesh N. Kalaria
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Neurovascular Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Mayowa Owolabi
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Centre for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Nigeria
| | - Bruce Ovbiagele
- School of Medicine, University of California, San Francisco, California, United States of America
| | - Oyedunni Arulogun
- Department of Health Promotion and Education, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | - Rufus O. Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Centre for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Nigeria
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Nabukenya S, Waitt C, Twimukye A, Mushabe B, Castelnuovo B, Zawedde-Muyanja S, Muhindo R, Kyaddondo D, Mwaka ES. Decision-making and role preferences for receiving individual pharmacogenomic research results among participants at a Ugandan HIV research institute. BMC Med Ethics 2025; 26:23. [PMID: 39923018 PMCID: PMC11806758 DOI: 10.1186/s12910-025-01181-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 01/29/2025] [Indexed: 02/10/2025] Open
Abstract
Little is known about how people living with HIV should be engaged in the decision-making process for returning individual pharmacogenomic research results. This study explored the role people living with HIV want to play in making decisions about whether and how individual results of pharmacogenomic research should be presented to them. A convergent parallel mixed methods study was conducted, comprising a survey of 221 research participants and five deliberative focus group discussions with 30 purposively selected research participants. Most participants (122, 55.2%) preferred the collaborative role, 67 (30.3%) preferred the active role and 32 (14.5%) preferred the passive role. Factors that significantly influenced preference for an active role compared with a collaborative role were marital status (OR: 0.282, p = 0.013), research experience (OR: 4.37, p = 0.028), and religion (OR: 2.346, p = 0.041). The reasons proffered for the active role included prior experience with antiretroviral treatment and increased exposure to research activities. The reasons given for preferring the passive role included limited level of awareness about the interaction between patients' genes and drugs, trust in researchers to make the right decision, and fear of making decisions with harmful implications. Overall, findings from our study show that participants want to be engaged in the decision-making process. Research teams ought to provide adequate and simple information about the pharmacogenomic research and implications of the results to support participants' informed decisions.
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Affiliation(s)
- Sylvia Nabukenya
- Makerere University College of Health Sciences, Kampala, Uganda.
- Infectious Diseases Institute, Kampala, Uganda.
| | - Catriona Waitt
- Infectious Diseases Institute, Kampala, Uganda
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | | | - Brian Mushabe
- Makerere University College of Health Sciences, Kampala, Uganda
| | | | | | | | - David Kyaddondo
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Erisa S Mwaka
- Makerere University College of Health Sciences, Kampala, Uganda
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Ochieng J, Kwagala B, Barugahare J, Möller M, Moodley K. Awareness, experiences and perceptions regarding genetic testing and the return of genetic and genomics results in a hypothetical research context among patients in Uganda: a qualitative study. JOURNAL OF MEDICAL ETHICS 2024; 50:829-834. [PMID: 38290855 PMCID: PMC11286839 DOI: 10.1136/jme-2022-108885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 01/18/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Genetic testing presents unique ethical challenges for research and clinical practice, particularly in low-resource settings. To address such challenges, context-specific understanding of ethical, legal and social issues is essential. Return of genetics and genomics research (GGR) results remains an unresolved yet topical issue particularly in African settings that lack appropriate regulation and guidelines. Despite the need to understand what is contextually acceptable, there is a paucity of empirical research and literature on what constitutes appropriate practice with respect to GGR.The study assessed patients' awareness, experiences and perceptions regarding genetic testing and the return of GGR results in a hypothetical context. METHODS This cross-sectional study employed a qualitative exploratory approach. Respondents were patients attending the medical outpatient unit of Mulago National Hospital. Three deliberative focus group discussions involving 18 respondents were conducted. Data were analysed through thematic analysis. RESULTS Three main themes and several subthemes were identified. Most respondents were aware of genetic testing, supportive of GGR and receiving results. However, only a few had undergone genetic testing due to cost constraints. They articulated the need for adequate information and genetic counselling to inform decision-making. Privacy of results was important to respondents while others were willing to share results. CONCLUSION There was general awareness and support for GGR and the return of results. Stigmatisation emerged as a barrier to disclosure of results for some. Global health inequity impacts access and affordability of genetic testing and counselling in Africa and should be addressed as a matter of social justice.
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Affiliation(s)
- Joseph Ochieng
- Anatomy, Makerere University College of Health Sciences, Kampala, Uganda
- Division of Medical Ethics and Law, University of Stellenbosch, Division of Medical Ethics and Law, Cape Town, South Africa
| | - Betty Kwagala
- Population Studies, Makerere University College of Business and Management Sciences, Kampala, Uganda
| | - John Barugahare
- Philosophy, Makerere University College of Humanities and Social Sciences, Kampala, Uganda
| | - Marlo Möller
- DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Keymanthri Moodley
- Centre for Medical Ethics and Law, University of Stellenbosch, Stellenbosch, Western Cape, South Africa
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Nankya H, Alibu VP, Wamala E, Matovu E, Barugahare J. Understanding of Key Considerations for Effective Community Engagement in Genetics and Genomics Research: A Qualitative Study of the Perspectives of Research Ethics Committee Members and National Research Regulators in a low Resource Setting. J Empir Res Hum Res Ethics 2024; 19:197-207. [PMID: 39431418 DOI: 10.1177/15562646241289015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2024]
Abstract
To attain effective community engagement (CE) for genetics and genomics research (GGR) is a challenge. This study aimed to analyzed participants' perspectives on how to attain effective CE for GGR in Uganda. A cross-sectional qualitative study involving in-depth interviews with twenty research ethics committee members and three national research regulators was conducted. GGR is faced with; low genetic literacy among stakeholders, social implications, cultural attitudes towards GGR, and lack of specific guidelines for CE in GGR. Attaining effective CE in GGR should involve; development of guidelines for GGR streamlining CE; boosting stakeholders' Knowledge in GGR and CE; engagement beyond sensitization; and consensus decision-making. Overall, attaining effective CE in GGR requires addressing the key aspects unique to GGR.
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Affiliation(s)
- Harriet Nankya
- Department of Philosophy, College of Humanities and Social Sciences, Makerere University, Kampala, Uganda
| | - Vincent Pius Alibu
- Department of Biochemistry and Sports Science, College of Natural Sciences, Makerere University, Kampala, Uganda
| | - Edward Wamala
- Department of Philosophy, College of Humanities and Social Sciences, Makerere University, Kampala, Uganda
| | - Enock Matovu
- Department of Biochemistry and Sports Science, College of Natural Sciences, Makerere University, Kampala, Uganda
| | - John Barugahare
- Department of Philosophy, College of Humanities and Social Sciences, Makerere University, Kampala, Uganda
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Adžemović T, Kabbale KD, Katagirya E, Mukisa J, Wayengera M. "A Call To Action": The need for genetic counseling in Uganda. GENETICS IN MEDICINE OPEN 2024; 2:101879. [PMID: 39712973 PMCID: PMC11658546 DOI: 10.1016/j.gimo.2024.101879] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 07/22/2024] [Accepted: 07/24/2024] [Indexed: 12/24/2024]
Affiliation(s)
- Tessa Adžemović
- Department of Medicine, Brigham and Women's Hospital, Boston, MA
- Department of Pediatrics, Boston Children's Hospital, Boston, MA
- Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Kisakye Diana Kabbale
- Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Eric Katagirya
- Dept of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda
| | - John Mukisa
- Dept of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Misaki Wayengera
- Dept of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda
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Oladayo AM, Prochaska S, Busch T, Adeyemo WL, Gowans LJ, Eshete M, Awotoye W, Sule V, Alade A, Adeyemo AA, Mossey PA, Prince A, Murray JC, Butali A. Parents and Provider Perspectives on the Return of Genomic Findings for Cleft Families in Africa. AJOB Empir Bioeth 2024; 15:133-146. [PMID: 38236653 PMCID: PMC11153024 DOI: 10.1080/23294515.2024.2302993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
BACKGROUND Inadequate knowledge among health care providers (HCPs) and parents of affected children limits the understanding and utility of secondary genetic findings (SFs) in under-represented populations in genomics research. SFs arise from deep DNA sequencing done for research or diagnostic purposes and may burden patients and their families despite their potential health importance. This study aims to evaluate the perspective of both groups regarding SFs and their choices in the return of results from genetic testing in the context of orofacial clefts. METHODS Using an online survey, we evaluated the experiences of 252 HCPs and 197 parents across participating cleft clinics in Ghana and Nigeria toward the return of SFs across several domains. RESULTS Only 1.6% of the HCPs felt they had an expert understanding of when and how to incorporate genomic medicine into practice, while 50.0% agreed that all SFs should be returned to patients. About 95.4% of parents were willing to receive all the information from genetic testing (including SFs), while the majority cited physicians as their primary information source (64%). CONCLUSIONS Overall, parents and providers were aware that genetic testing could help in the clinical management of diseases. However, they cited a lack of knowledge about genomic medicine, uncertain clinical utility, and lack of available learning resources as barriers. The knowledge gained from this study will assist with developing guidelines and policies to guide providers on the return of SFs in sub-Saharan Africa and across the continent.
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Affiliation(s)
- Abimbola M Oladayo
- Department Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Sydney Prochaska
- Department of Global Health, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Tamara Busch
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Wasiu L. Adeyemo
- Department of Oral and Maxillofacial Surgery, University of Lagos
| | - Lord J.J. Gowans
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mekonen Eshete
- Addis Ababa University, School of Medicine, Department of Surgery, Addis Ababa, Ethiopia
| | - Waheed Awotoye
- Department Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Veronica Sule
- Department of Operative Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Azeez Alade
- Department Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | | | - Peter A. Mossey
- Department of Orthodontics, University of Dundee, Dundee, UK
| | | | | | - Azeez Butali
- Department Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
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Ibrahim ME, Adarmouch L, Elgamri A, Abd ElHafeez S, Mohammed Z, Abdelgawad F, Elsebaie EH, Abdelhafiz AS, Gamel E, El Rhazi K, Abdelnaby A, Ahram M, Silverman H. Researchers' Perspectives Regarding Ethical Issues of Biobank Research in the Arab Region. Biopreserv Biobank 2024; 22:98-109. [PMID: 36951637 PMCID: PMC11044858 DOI: 10.1089/bio.2022.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
Background: The recent expansion of genomic biobank research in the Arab region in the Middle East North Africa has raised complex ethical and regulatory issues. However, there is a lack of studies regarding the views of Arab researchers involved in such research. We aimed to assess the perceptions and attitudes of Arab researchers regarding these issues in biobank research. Methods: We developed a questionnaire to assess the perceptions and attitudes regarding genetic research of researchers from Egypt, Sudan, Morocco, and Jordan. The questionnaire requested demographic data, perceptions, and attitudes regarding the collection, storage, and use of biospecimens and data, the use of broad consent, data security, data sharing, and community engagement. We used multiple linear regressions to identify predictors of perceptions and attitudes. Results: We recruited 383 researchers. Researchers favored equally the use of broad and tiered consent (44.1% and 39.1%, respectively). Most respondents agreed with the importance of confidentiality protections to ensure data security (91.8%). However, lower percentages were seen regarding the importance of community engagement (64.5%), data sharing with national colleagues and international partners (60.9% and 41.1%, respectively), and biospecimen sharing with national colleagues and international partners (59.9% and 36.2%, respectively). Investigators were evenly split on whether the return of individual research results should depend on the availability or not of a medical intervention that can be offered to address the genetic anomaly (47.5% and 46.4%, respectively). Predictors of attitudes toward biospecimen research included serving on Research Ethics Committees, prior research ethics training, and affiliation with nonacademic institutions. Conclusions: We recommend further exploratory research with researchers regarding the importance of community engagement and to address their concerns about data sharing, with researchers within and outside their countries.
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Affiliation(s)
- Maha E. Ibrahim
- Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Latifa Adarmouch
- Department of Community Medicine, Public Health and Epidemiology, Faculty of Medicine, Cadi Ayyad University, Marrakesh, Morocco
| | - Alya Elgamri
- Department of Orthodontics, Pediatric Dentistry and Preventive Dentistry, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - Samar Abd ElHafeez
- Epidemiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Zeinab Mohammed
- Department of Public Health and Community Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Fatma Abdelgawad
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Eman H. Elsebaie
- Department of Public Health, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Samir Abdelhafiz
- Department of Clinical Pathology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Ehsan Gamel
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - Karima El Rhazi
- Department of Epidemiology and Public Health, Faculty of Medicine, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Asmaa Abdelnaby
- Department of Public Health, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mamoun Ahram
- Department of Physiology and Biochemistry, School of Medicine, The University of Jordan, Amman, Jordan
| | - Henry Silverman
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Nankya H, Wamala E, Alibu VP, Barugahare J. Community engagement in genetics and genomics research: a qualitative study of the perspectives of genetics and genomics researchers in Uganda. BMC Med Ethics 2024; 25:1. [PMID: 38166828 PMCID: PMC10763360 DOI: 10.1186/s12910-023-00995-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Generally, there is unanimity about the value of community engagement in health-related research. There is also a growing tendency to view genetics and genomics research (GGR) as a special category of research, the conduct of which including community engagement (CE) as needing additional caution. One of the motivations of this study was to establish how differently if at all, we should think about CE in GGR. AIM To assess the perspectives of genetics and genomics researchers in Uganda on CE in GGR. METHOD A cross-sectional qualitative study was conducted at Makerere University and Uganda Virus Research Institute. Twenty-five individuals participated, the majority being male (sixteen). Participants included nineteen genetics and genomics researchers (researchers and research coordinators), two CE officers, three nurses and one nursing counsellor. Data were collected using in-depth interviews and analyzed in a thematic manner using NVivo version 12 Plus. STUDY FINDINGS Thirteen of the respondents had conducted CE in their GGR in either a geographical and disease-specific community. Some respondents said CE principles are the same and there is no need for special consideration for CE in GGR. Others gave ethical issues in GGR that require special consideration for CE in such research and these were categorized into six themes: GGR is new to communities, Difficulty in communicating GGR by the researchers, Genes are shared in communities, Cultural sensitivities against GGR, Community attitude toward GGR, Some GGR studies take long to end, and Negotiation of research benefits. Special considerations for CE when conducting GGR were suggested and categorized into seven themes: creating awareness of GGR in communities, obtaining both community acceptance and individual consent, CE team composition, involve communities in solving GGR challenges, prolong CE in some GGR, develop guidelines for CE in GGR, and legal considerations on GGR. CONCLUSION GGR was characterized by special issues that require special CE considerations for such research.
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Affiliation(s)
- Harriet Nankya
- Department of Philosophy, College of Humanities and Social Sciences, Makerere University, P. O Box 7062, Kampala, Uganda.
| | - Edward Wamala
- Department of Philosophy, College of Humanities and Social Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - Vincent Pius Alibu
- Department of Biochemistry and Sports Science, College of Natural Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
| | - John Barugahare
- Department of Philosophy, College of Humanities and Social Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
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Ochieng J, Kwagala B, Barugahare J, Möller M, Moodley K. Feedback of individual genetic and genomics research results: A qualitative study involving grassroots communities in Uganda. PLoS One 2022; 17:e0267375. [PMID: 36399445 PMCID: PMC9674126 DOI: 10.1371/journal.pone.0267375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 10/10/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Genetics and genomics research (GGR) is associated with several challenges including, but not limited to, methods and implications of sharing research findings with participants and their family members, issues of confidentiality, and ownership of data obtained from samples. Additionally, GGR holds significant potential risk for social and psychological harms. Considerable research has been conducted globally, and has advanced the debate on return of genetic and genomics testing results. However, such investigations are limited in the African setting, including Uganda where research ethics guidance on return of results is deficient or suboptimal at best. The objective of this study was to assess perceptions of grassroots communities on if and how feedback of individual genetics and genomics testing results should occur in Uganda with a view to improving ethics guidance. METHODS This was a cross-sectional study that employed a qualitative exploratory approach. Five deliberative focus group discussions (FGDs) were conducted with 42 participants from grassroots communities representing three major ethnic groupings. These were rural settings and the majority of participants were subsistence farmers with limited or no exposure to GGR. Data were analysed through thematic analysis, with both deductive and inductive approaches applied to interrogate predetermined themes and to identify any emerging themes. NVivo software (QSR international 2020) was used to support data analysis and illustrative quotes were extracted. RESULTS All the respondents were willing to participate in GGR and receive feedback of results conditional upon a health benefit. The main motivation was diagnostic and therapeutic benefits as well as facilitating future health planning. Thematic analysis identified four themes and several sub-themes including 1) the need-to-know health status 2) paternity information as a benefit and risk; 3) ethical considerations for feedback of findings and 4) extending feedback of genetics findings to family and community. CONCLUSION Participation in hypothetical GGR as well as feedback of results is acceptable to individuals in grassroots communities. However, the strong therapeutic and/or diagnostic misconception linked to GGR is concerning given that hopes for therapeutic and/or diagnostic benefit are unfounded. Viewing GGR as an opportunity to confirm or dispute paternity was another interesting perception. These findings carry profound implications for consent processes, genetic counselling and research ethics guidance. Privacy and confidentiality, benefits, risks as well as implications for sharing need to be considered for such feedback of results to be conducted appropriately.
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Affiliation(s)
- Joseph Ochieng
- Makerere University School of Biomedical Sciences, Kampala, Uganda
- Centre for Medical Ethics and Law, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Betty Kwagala
- Makerere University School of Statistics and Planning, Kampala, Uganda
| | | | - Marlo Möller
- Division of Molecular Biology and Human Genetics, DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Keymanthri Moodley
- Centre for Medical Ethics and Law, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Ochieng J, Kwagala B, Barugahare J, Mwaka E, Ekusai-Sebatta D, Ali J, Sewankambo NK. Perspectives and experiences of researchers regarding feedback of incidental genomic research findings: A qualitative study. PLoS One 2022; 17:e0273657. [PMID: 36037169 PMCID: PMC9423610 DOI: 10.1371/journal.pone.0273657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 08/13/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There is a plethora of unanswered ethical questions about sharing incidental findings in genetics and genomics research. Yet understanding and addressing such issues is necessary for communicating incidental findings with participants. We explored researchers' perspectives and experiences regarding feedback of incidental genomics findings to participants. METHODS This was a qualitative study using semi-structured interview schedules for In-depth interviews. Thirty respondents were purposively selected based on role as genetics and genomics researchers in Uganda. Data were analysed through content analysis to identify emerging themes using a comprehensive thematic matrix. QSR International NVivo software was used to support data analysis. RESULTS a). On perceptions, sharing of incidental findings was acceptable and four themes emerged including role of professional judgement; role of ethics committees and ethical guidelines; optimal disclosure practices; limits to professional duty and uncertainty and; b). on practices, sharing had been carried out by some researchers and a theme on experience and practices emerged. CONCLUSION Feedback of incidental genomics research findings to participants is generally acceptable to researchers. Some researchers. Challenges include lack of ethical guidelines and uncertainty about the findings.
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Affiliation(s)
- Joseph Ochieng
- Makerere University School of Biomedical Sciences, Kampala, Uganda
| | - Betty Kwagala
- Makerere University School of Business and Management Studies, Kampala, Uganda
| | - John Barugahare
- Makerere University School of Liberal and Performing Arts, Kampala, Uganda
| | - Erisa Mwaka
- Makerere University School of Biomedical Sciences, Kampala, Uganda
| | | | - Joseph Ali
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- Johns Hopkins Berman Institute of Bioethics, Baltimore, MD, United States of America
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