My career goal is to become an independent investigator in the field of neuroinflammatory disorders in Uganda. A variety of neuroinflammatory disorders are common in Uganda, but these disorders are poorly understood. There are only a handful of trained neurologists in Uganda and very few researchers focusing on understanding neurological disorders. Thus, there is a major gap in expertise in this area, and I wish to develop my career to fill this gap through this K43 program by gaining expertise that I can apply to investigating the epidemiology and pathogenesis of neuroinflammatory conditions in Uganda. This K43Award will provide me the support necessary to complete the following goals: 1. Design and execution of Epidemiological studies and clinical trials of neurological conditions in Sub- Saharan Africa. To understand the epidemiology of neurological conditions and design interventions for improving care among neurology patients, I will need additional training and experience related to epidemiology and biostatistics and in design and execution of clinical trials. 2. Neuroinflammation and infections of the central nervous system. To understand the etiology and pathogenesis of neuroinflammation, I will need additional training and experience related to neurological clinical assessments, infections of the central nervous system and neuroinflammation. 3. Translational and implementation research In my future career, I aim to bridge basic science research to clinical application and back. This training and experience will help me to translate findings from bench to bedside and back as I develop new projects as my career develops. I would also be interested in learning how to translate evidence based interventions to practice and policy. I have assembled a team of mentors comprising of the following: primary research mentors-Drs.Boulware (epidemiology and biostatics, infectious diseases) and Dr. Meya (immunology, infectious diseases), and Dr. Bohjanen (microbiology and immunology, infectious diseases) ,Dr. Meyer (neurology, epidemiology of neurological conditions) Prof. Katabira (neurology in HIV infection) and Dr Andrew Kambugu (infectious diseases, clinical research). For this k43 award, I will investigate epidemiology, etiology and pathogenesis of non-traumatic spinal cord injury. I will seek to: (1).To define the etiologies of non-traumatic spinal cord injury (SCI) in Uganda, (2) To determine if the CSF immune signature of idiopathic transverse myelitis can be grouped according to the known infectious etiologies of acute transverse myelitis. (3) To determine the demographic, clinical, and immunologic predictors of poor outcome among individuals with non-traumatic spinal cord injury (SCI). This project will serve as a basis for an R01 application before the end of the K award.
The number of people with of non-traumatic SCI is unknown because of non-uniform diagnostic categorization. The causes are many and vary by the different regions of the world, however the condition is thought to be more common in Africa. Many people either die with the condition or are left disabled due to the high costs and lack of neurologic expertise required to manage the condition in resource-limited settings.
