Nigeria has the second highest HIV burden and one of the highest rates of perinatal HIV transmission globally. HIV adversely affects the brain across the age spectrum (NeuroAIDS), causing a variety of derangements including neurocognitive, neurodevelopmental and neuropsychiatric disorders. These disorders worsen quality of life and drive poor adherence to antiretroviral treatment (ART), thereby increasing the risk of ART failure, morbidity, mortality, and HIV spread. Because relevant research has been neglected, there is no evidence-base to inform clinical practice locally and progress in the field has been limited. We have isolated the omissions in research infrastructure stunting emergence of a versatile NeuroAIDS research team and limiting NeuroAIDS research productivity despite over 20 years of dementia and related research at the University of Ibadan. We propose to capitalize on collaborations between diverse committed scientists and institutions, to address these omissions and develop sustainable NeuroAIDS research capacity at the University of Ibadan. Trainees in the proposed Multidisciplinary NeuroAIDS Research Training to Improve HIV Outcomes in Nigeria will acquire skills to address themes such as: i) impact of neurocognitive, neurodevelopmental and neuropsychiatric disorders on adherence, ART success, survival, and HIV spread across the age spectrum; ii) understanding the roles of aging, malnutrition and prevalent infections that may involve the central nervous system such as malaria and tuberculosis; and iii) discovering sustainable diagnostic, prevention and treatment strategies. Acquired skills will be relevant and broadly applicable to the NeuroAIDS field. Using structured mentoring, we will: 1) train and mentor neurologists/psychiatrists to have neuropsychological and neurodevelopmental expertise for NeuroAIDS research; 2) develop clinical research skills and provide didactic training to multidisciplinary investigators manifestig high potential to conduct NeuroAIDS research; 3) conduct short- and medium-term training practicums plus long-term mentoring to develop critical NeuroAIDS research skills in neuropharmacology, neuropsychological data analyses and grant writing; 4) conduct NeuroAIDS research symposia for researchers and intensive skills workshops for research support staff; and 5) establish a multidisciplinary NeuroAIDS research collaborative as an institutionally committed umbrella for sustainable multidisciplinary NeuroAIDS research. We will prepare a cadre of skilled, multidisciplinary researchers and outstanding research support staff, ensuring emergence of broad and integrative NeuroAIDS research expertise at the University of Ibadan. Trained scientists will contribute to discovery of sustainable solutions to NeuroAIDS, which will stimulate local health authorities to allocate more clinical and research resources to NeuroAIDS. A solid platform will emerge to support the next-level of grant applications such as the NIH Brain Disorders in Developing World: Research Across the Lifespan. Aggregated expertise will feed into University of Ibadan's long-term goal of developing a PhD Program in Neurosciences.

Public Health Relevance

We propose an HIV research training program at the University of Ibadan titled, 'Multidisciplinary NeuroAIDS Research Training to Improve HIV Outcomes in Nigeria.' Up to 50% of adults with AIDS have HIV Associated Neurocognitive Disorders (HAND) while neurodevelopmental disorders are pervasive in infected children and adolescents, worsening quality of life and driving HIV treatment failure, morbidity, mortality, and HIV spread. The proposed program will develop scientists who will lead discovery of sustainable solutions for NeuroAIDS in Nigeria and thereby amplify the benefits of HIV treatment for HIV infected individuals and society.

National Institute of Health (NIH)
Fogarty International Center (FIC)
International Research Training Grants (D43)
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Special Emphasis Panel (ZRG1)
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Mcdermott, Jeanne
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Northwestern University at Chicago
Internal Medicine/Medicine
Schools of Medicine
United States
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