This grant proposal Building Enteric Infectious Disease Research Capacity in India describes a training program in public health and infectious diseases, which includes interdisciplinary, translational training in in enteric infectious disease and the response to oral vaccines in developing countries. Enteric infectious diseases are the second major cause of post-neonatal mortality in under-5 children in developing countries, and cause both direct morbidity and sequelae in the form of growth faltering and possibly delayed cognitive development. The poor performance of oral vaccines in low-resource settings makes intervention challenging and a goal of this program is to focus training on inter-disciplinary studies on immunology and the role of gut microbiome in influencing the response to infection and immunization in India. Over the last nine years, a collaborative partnership between investigators at Tufts Medical Center/Tufts University School of Medicine (Tufts) and the Christian Medical College, Vellore (CMC) has established training with an initial focus on epidemiology, risk assessment and surveillance of enteric infections. Building on our knowledge, experience, and collaborative relationships, in this renewal application we will put greater emphasis on interventional clinical research, the enhancement of quantitative skills and in bio-informatics particularly related to the analysis and interpretation of metagenomic studies to develop a more translational approach during the next five years. We will expand the pool of potential trainees to all parts of India and the mentors to include faculty from the Centers for Disease Control and Prevention (CDC), Atlanta and Baylor College of Medicine (BCM), Houston. The goals of extending training in a variety of disciplines necessary to investigate gastrointestinal infections and immune response to oral vaccines with special emphasis on clinical research, vaccinology and bioinformatics, facilitating the transition of trainees to independent research and of working with the Indian government for prioritization of research and training and aid translation of research results into public health practice will be met by a tiered training program with three levels of trainees who will be trained in India and in the US, and who will carry out research projects in India. In each of 5 years, one long term and one intermediate term trainee will be supported with a basic training package, mentored research project development and conduct and continuing professional development. Long-term and intermediate term trainees will be either at the pre-doctoral or the post-doctoral level, with a focus on post-doctoral candidates as far as possible. In each year, one short-term (faculty level) trainee will be selected to attend either targeted training or a short course identified as being relevant to the research training goals of the program. Of a total of 15 trainees, we expect at least 2-3 doctoral degrees and at least 4 competitive research grants to be obtained by the trainees as post-doctoral trainees or faculty. Based on prior results, we expect an average of at least 10 publications annually to which trainees will contribute. Each long term trainee will be expected to have at least 2 first authored publications, and each intermediate term trainee will be expected to have one paper. In addition, the program faculty with work with the Department of Biotechnology's Clinical Service Development Agency to develop a credit based program-the Indian Clinical Researcher Development (InCReD) program which is intended as a new paradigm for providing research skills to 15-20 junior faculty annually at medical schools in India through a combination of distance learning and contact courses. The multi-disciplinary and complementary training, networking and career development support are expected to result in a sustainable research program with significantly increased skills and capacity for infectious disease research in India.
This grant proposal 'Building Enteric Infectious Disease Research Capacity in India' describes a proposed renewal of an interdisciplinary training program in public health and infectious diseases focusing on enteric infectious diseases and the response to oral vaccines in developing countries. Enteric infections have a significant impact on the health of populations in poorer settings, even in the absence of overt diarrhea. Although some infections of major importance can be prevented by vaccination, oral vaccines are insufficiently effective in resource-limited settings--exactly where they are most needed. This collaborative training program originally between Tufts University and Christian Medical College in Vellore, India is being expanded to include the Centers for Disease Control and Prevention, Atlanta for additional training in epidemiology and vaccine impact monitoring and to the Baylor College of Medicine, Houston for training in virology and additional expertise in microbiome studies. In addition to expand the reach of the training program beyond a single Indian institution, the Indian program faculty will partner with the Department of Biotechnology's Clinica Development Service Agency in the development and implementation of the Indian Clinical Researcher Development (InCReD) program which plans to reach 15-20 young faculty at Indian medical schools in the first phase through a combination of credit based distance learning and in-person courses. The expected deliverables are therefore in two main categories, i) three levels of trainees who can contribute to the development of research programs and grow into independent investigators capable of leading research programs in India and ii) a course that supports the development of research skills among young faculty in medical schools across India.
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