Infectious diseases account for the majority of ill health in children in resource-limited countries. A substantial proportion of children and adults who survive infectious diseases suffer significant long-term neurodevelopmental morbidity. Infection-related neurocognitive morbidity is of great importance as impairments affect every aspect of an individual's life, including long-term employability and social interactions. However, the epidemiology and pathogenesis of infection-related neurocognitive impairment in sub-Saharan Africa remain poorly understood. We propose an innovative approach to infectious disease training in Uganda that will focus on this critically important but understudied area. Innovative aspects of this proposal include: emphasis on infection-related long-term morbidity, a diverse mix of trainees from multiple disciplines and at all levels, integrated core training that is required of all degree students, and development of mentorship capacity for Ugandan faculty as part of the training program. Studies by the Program Director and his collaborators involve careful assessment of immunologic, epidemiologic and genetic risk factors for the development of neurocognitive impairment in children with cerebral malaria and in HIV-infected adults with cryptococcal meningitis. These studies provide an ideal basis for training in the pathogenesis of infection-related neurocognitive impairment. The goal of this application is to establish a core of Ugandan researchers who significantly advance the understanding, prevention and treatment of long-term neurocognitive disability associated with infectious diseases. We propose to accomplish this goal through long and short-term training, and through development of capacity for faculty mentorship. Long-term training will include training of a post-doctoral fellow in neuropsychology, doctoral students in neuropsychology (two), and microbiology, immunology, epidemiology and biostatistics, and training of two medical residents in their Masters of Medicine research. Short-term training will involve providing workshop and short-course training for project and university medical, laboratory and data personnel. Mentorship capacity will be developed through identification and implementation of best practices for faculty mentorship at Makerere University. The novel training proposed will create a new generation of interdisciplinary researchers who can work together to understand, treat and prevent infection-related neurocognitive morbidity in Uganda.
In low and middle-income countries, many children and adults who survive infectious diseases suffer significant long-term injury to their brain that affects many processes like intelligence, language, speech and movement. Training doctors and scientists to discover why this is happening and to prevent it from happening could improve the lives of the millions of children and adults in low and middle-income countries who have infections that affect the brain.
|Villaverde, Chandler; Namazzi, Ruth; Shabani, Estela et al. (2017) Clinical Comparison of Retinopathy-Positive and Retinopathy-Negative Cerebral Malaria. Am J Trop Med Hyg 96:1176-1184|
|Shabani, E; Ouma, B J; Idro, R et al. (2017) Elevated cerebrospinal fluid tumour necrosis factor is associated with acute and long-term neurocognitive impairment in cerebral malaria. Parasite Immunol 39:|
|Holmberg, Dag; Franzén-Röhl, Elisabeth; Idro, Richard et al. (2017) Cerebrospinal fluid kynurenine and kynurenic acid concentrations are associated with coma duration and long-term neurocognitive impairment in Ugandan children with cerebral malaria. Malar J 16:303|
|Ssemata, Andrew S; Gladding, Sophia; John, Chandy C et al. (2017) Developing mentorship in a resource-limited context: a qualitative research study of the experiences and perceptions of the makerere university student and faculty mentorship programme. BMC Med Educ 17:123|
|Shabani, Estela; Hanisch, Benjamin; Opoka, Robert O et al. (2017) Plasmodium falciparum EPCR-binding PfEMP1 expression increases with malaria disease severity and is elevated in retinopathy negative cerebral malaria. BMC Med 15:183|
|Brand, Nathan R; Opoka, Robert O; Hamre, Karen E S et al. (2016) Differing Causes of Lactic Acidosis and Deep Breathing in Cerebral Malaria and Severe Malarial Anemia May Explain Differences in Acidosis-Related Mortality. PLoS One 11:e0163728|
|Cusick, Sarah E; Opoka, Robert O; Ssemata, Andrew S et al. (2016) Comparison of iron status 28 d after provision of antimalarial treatment with iron therapy compared with antimalarial treatment alone in Ugandan children with severe malaria. Am J Clin Nutr 103:919-25|
|Ssenkusu, John Mbaziira; Hodges, James Steven; Opoka, Robert Opika et al. (2016) Long-term Behavioral Problems in Children With Severe Malaria. Pediatrics 138:|
|Idro, Richard; Kakooza-Mwesige, Angelina; Asea, Benjamin et al. (2016) Cerebral malaria is associated with long-term mental health disorders: a cross sectional survey of a long-term cohort. Malar J 15:184|
|Shabani, Estela; Opoka, Robert O; Bangirana, Paul et al. (2016) The endothelial protein C receptor rs867186-GG genotype is associated with increased soluble EPCR and could mediate protection against severe malaria. Sci Rep 6:27084|
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