The goal of this Core is to recruit and characterize patient cohorts in Haiti, and to collect, process and ship clinical samples for studies of tuberculosis (TB) latency and persistence in Projects 1-4. The Core activities will be performed by the Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) in Port au Prince, Haiti. GHESKIO is dedicated to research, service, and training in HIV and tuberculosis and is the largest TB treatment center in the Caribbean. In 2012, GHESKIO diagnosed and treated 1,666 patients with TB including 81 multi-drug resistant (MDR) cases. GHESKIO also provides primary care services and performs TB contact tracing in an urban slum. City of God, with 100,000 people adjacent to GHESKIO's facilities. The incidence of TB in City of God is 768/100,000 per year with 52 family clusters identified in 2011-2012. The GHESKIO BSL3 TB laboratory performs solid and BACTEC liquid culture, first- and second-line drug sensitivity testing, molecular identification and drug sensitivity testing, and spoligotyping. GHESKIO has been affiliated with Weill Cornell Medical College since its creation in 1982 and has received continuous NIH research support since 1983. GHESKIO conducts NIAID sponsored clinical research including trials of new MDR-TB anti-tuberculous drugs The specific aims of the core are: 1) Recruit and characterize patient cohorts for study in projects 1 - 4 of the TBRU, including 1,500 TB cases and controls, 90 families with multiple members with active TB, 125 patients with drug sensitive TB to develop new diagnostic assays for early bactericidal activity (EBA) drug trials, and a cohort of 60 MDR TB patients to study early correlates of persistent MTB. Clinical data will be collected with the RedCap data management system and entered via the internet with data stored at the Weill Cornell Clinical and Translational Science Center in New York. 2) Collect, process, and ship clinical samples for the conduct of studies outlined in Projects 1 - 4 including: whole blood and peripheral blood monocytes for genetic and immunologic assays, sputum for culture and VBNC assays, stool for microbiome, and sputum and whole blood for transcriptome studies.
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