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.
|Bangirana, Paul; Opoka, Robert O; Boivin, Michael J et al. (2014) Severe malarial anemia is associated with long-term neurocognitive impairment. Clin Infect Dis 59:336-44|