TB control is increasingly compromised by the global rise in M/XDR-TB. Effective M/XDR-TB epidemiologic surveys and case management, as well as the development of new diagnostics and anti-TB drugs, require strong laboratory capabilities, for example, to define drug resistance profiles in patients undergoing TB therapy. Such extensive laboratory support has not been a routine component of TB control programs but, rather, the domain of research labs. While some research labs in South Africa have high levels of sophistication in their technical capabilities and scientific expertise, the numbers of trained personnel are limited, making significant expansion of diagnostic and research capacities difficult. In addition, state-of-the-art BSL3 facilities are available at only a few research sites, and knowledge of infection control for M/XDR-TB is in need of development. Thus, there is currently an unmet need for training and scale-up of the skilled laboratory and research activities required to address the expanding M/XDR-TB epidemic in South Africa. Our application for the Global Infectious Disease Training Program is designed to address this need. The training offered will be at multiple levels: (1) training in establishment and management of functional BSL-3 facilities to safely carry out the supporting microbiology for M/XDR-TB research, (2) training in specific molecular techniques, such as molecular epidemiology and new diagnostic methods, and (3) training in advanced research approaches to support specific projects on M/XDR-TB, including immunology and pathogenesis. Training will predominantly comprise short term periods, rather than degree programs or full post-doctoral fellowships. The program will be carried out in the facilities of the Public Health Research Institute at UMDNJ in Newark, NJ. To achieve our goals, we will recruit individuals at different levels of expertise, including pre- and post-doctoral candidates that are involved in TB research programs in South Africa. The training modules are intended to strengthen the research capacity of pre-existing and new research groups that are either expanding or initiating new projects on M/XDR-TB. When necessary, trainees will make repeat visits to the US for additional training to support their ongoing research projects. We anticipate that some of these traineeships will be part of ongoing collaborations and others will evolve into new collaborations between South African investigators and US investigators addressing the emerging M/XDR-TB epidemic. PUBLICE HEATLH
This GID Training Program will help to build sustainable M/XDR-TB research capacity in South Africa by enhancing the scientific expertise of investigators and health professionals and fostering collaborative links. Since pathogens such as MTB can be easily transmitted internationally via modern transportation modes, the project is also highly relevant to the public health of the United States and its citizens.
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