University of North Carolina's School of Public Health (UNC), Johns Hopkins University's School of Medicine (JHU) and the African Studies Center, Department of Social and Cultural Anthropology, Catholic University (CU), Leuven, Belgium propose to strengthen the psychiatric disorders (PD) research capacity of the Center for Teaching and Research in Social Science for sub-Saharan Africa (CERDAS)/Kinshasa School of Public Health (KSPH), University of Kinshasa in Kinshasa, Congo. This multi-step research and capacity building process will occur through expansion/reinforcement of the existing CERDAS/KSPH partnership with UNC, JHU and CU. Our initial efforts will focus on: 1) The interplay between PD and incident and prevalent cases of HIV infection observed in large cohorts of pregnant women and their nuclear families we currently follow in Kinshasa's (population approximately 9 million) largest maternity, Kingasani Maternity (KM) (annual number of deliveries approximately 10,000) located in Ndjili (population approximately 2 million). Ndjili will also be the site for our community-based (CB) PD research. 2) The incidence and consequences of postnatal depression (PND) in this same KM population. Our studies will be CB. PD is often stigmatizing. CEDRAS/CU has conducted field research in Ndjili for 15+ years with traditional healers caring for patients with PD who sock treatment at """"""""hidden"""""""" local healing sites operating out of contact with Western-orientated facilities. Our group has solid credible/effective contact with these local healers. Basing our studies at KM/Ndjili will further facilitate our efforts to reach into the target community to """"""""unearth"""""""" patients with PD who would otherwise remain unenumerated (important in epi studies), undiagnosed and untreated. We intend to use the existing infrastructure at our highly effective prevention of mother to child HIV transmission intervention program at KM to study PD and PND in our population. In the R24 grant we will first identify essential areas for short-term research and assign KSPH MPH scholar physicians to conduct carefully mentored research. Carefully selected Brain Disorder Fellows (BDF) will receive 12 months mentored training in Leuven Baltimore/Chapel Hill. Returning to Kinshasa, BDF will receive re-entry grants for additional research projects to inform our R01 grant preparation. Periodic meetings in Kinshasa among all collaborators will enable us to collectively prepare a competitive R01 grant.
