(3 LINES) In tropical countries more than 60% of human infections shared with wild and domestic animals. Leveraging PEPFAR investments, the Infectious Diseases Institute will define the epidemiology of zoonoses in acutely febrile patients and test new, rapid diagnostics to change the treatment paradigms. PHS 398/2590 (Rev. 06/09) Page Continuation Format Page
ETIOLOGY AND OUTCOMES OF ACUTE FEBRILE ILLNESS IN CHILDREN AND ADULTS IN UGANDA PROJECT SUMMARY With the SARS outbreak in 2002 and more recently with Ebola in West Africa, the global community has focused attention on the threat of emerging and re-emerging infections, particularly those with pandemic potential. Uganda is located in a hot spot for these infections, many of which may be zoonotic. We propose to leverage the research and capacity building experience of the Infectious Diseases Institute (IDI) and its collaborative and productive relationship with the government of Uganda to study the infectious causes of acute febrile illness in both adults and children. We will use existing tools to increase the proportion of acute febrile hospitalized patients for whom we have a specific diagnosis, to implement sero-surveillance to understand exposure to various infectious diseases including vaccine preventable illness, priority pathogens, and vector-borne infections, and to study inflammatory biomarkers in children and their association with neurodevelopmental outcomes. The IDI is a research, clinical and training center of excellence. Established in 2002, the IDI has established a strong track record in performing locally relevant research that leads to improved models of care and changes in policy and practice in the area of HIV and related infections. In addition, the outreach programs largely funded by the CDC and PEPFAR as the key implementing partner took a strong health systems institutional strengthening approach to provide prevention care and treatment to more than 100,000 patients. The proposal addresses the critical barriers to achieving global health security in Uganda by collating and analyzing existing data from cohorts and diagnostic testing, and enhancing surveillance through lab capacity strengthening and technical transfer of innovative new laboratory techniques to maximize our ability to make a diagnosis. It is innovative because it leverages previous US government/PEPFAR investments in the IDI from HIV programs and uses the IDI?s expertise in research, training, clinical care, implementation, and scale-up for global health security. In addition, it leverages the close working relationship between the current and former Senior Management Team members at the IDI to recruit acutely febrile cohorts to test and implement rapid diagnostic innovation. Establishing diagnostic certainty in a larger proportion of febrile patients will allow for targeted antimicrobial treatment (reducing risk for antimicrobial resistance). It will also increase the signal sensitivity to detect new pathogens with epidemic potential. The research productivity, programmatic track record, and existing collaborative partnerships of the IDI increase the likelihood of success. PHS 398/2590 (Rev. 06/09) Page Continuation Format Page
