Increasing availability of antiretroviral therapy (ART) in sub-Saharan Africa (SSA) has led to decreases in mortality rates. The WHO estimates that 940,000 million deaths were attributable to HIV in 2017, with the majority caused by co-infecting pathogens. Uganda still has a prevalence rate of 6.5% among adults aged 15-49 (UNAIDS). Many patients still present late and often co-infected with opportunistic infections such as tuberculosis (TB) and cryptococcal meningitis. Viral hepatitis (B & C) co-infection occurs in 2-10% and poses challenges in terms of best anti-viral treatment, diagnosis, and prevention. Challenges present also for HIV-infected individuals stable on ART, because they are at higher risk of ?non AIDS? non-communicable diseases, particularly hypertension, diabetes mellitus, renal disease, pulmonary disease, cardiovascular disease, cancer, bone abnormalities and liver failure. HIV infection itself also seems to be associated to an accelerated aging process. The Infectious Diseases Institute (IDI) in Uganda is a Research and Care Center of Excellence and has already established research programs in HIV and co-infections under the previous Heads of Research (Y. Manabe, and A Kambugu, previous Program Director and Uganda Program Director respectively). The current Head of Research (B Castelnuovo- proposed Program Director in this Cycle), has worked closely with Dr Manabe and Dr Kambugu for the last 10 years, when she was the Head of the Research Capacity Building Unit and Deputy Head of Research. We plan to train 9 master students, 2 PhD students and 5 post-doctoral students at Makerere University, Uganda. Our previous 5-year cycle has solidified a core group of productive, independent scientists through post-doctoral training who can now act as local mentors. We will shift the leadership of the training program from the US to the Uganda Institution in order to ensure sustainable research capacity building. We will also encourage a peer-to-peer mentorship model among scientists with the same level of experience to expand the impact of training. International mentors will still play a key role in overall mentorship of the local experts particularly to expand research networks and to provide grant-writing support. At the end of this 5-year training program, our overarching objective is to solidify a core group of expert, productive, independent scientists who can promote sustainable capacity building by garnering outside funding, continuing to mentor others including peers, and be recognized as international, regional leaders and mentors in the area of HIV co-infections.

Public Health Relevance

The proposed continuation of the partnership training program for the Johns Hopkins University Bloomberg School of Public Health in Baltimore and the Infectious Diseases Institute (IDI) in Uganda will train Post-Doctoral Fellows, PhD, and Masters Students, who will be mentored by a pool of dedicated local mentors, guided by an international faculty who have previously engaged in funded, regionally relevant, published research in HIV and co-infections (tuberculosis, cryptococcal meningitis, viral hepatitis, and long term complication). At the end of this 5-year training program, our overarching objective is to solidify a core group of productive local mentors, who in turn can train scholars in garnering outside funding, mentoring others, and being recognized as regional, international, leaders who are able to influence policy and practice in the area of HIV and co-infections

Agency
National Institute of Health (NIH)
Institute
Fogarty International Center (FIC)
Type
International Research Training Grants (D43)
Project #
2D43TW009771-06
Application #
9768677
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Bansal, Geetha Parthasarathy
Project Start
2014-06-01
Project End
2024-03-31
Budget Start
2019-09-01
Budget End
2020-03-31
Support Year
6
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Infectious Diseases Institute
Department
Type
DUNS #
954577867
City
Kampala
State
Country
Uganda
Zip Code
22418
Worodria, William; Ssempijja, Victor; Hanrahan, Coleen et al. (2018) Opportunistic diseases diminish the clinical benefit of immediate antiretroviral therapy in HIV-tuberculosis co-infected adults with low CD4+ cell counts. AIDS 32:2141-2149
Nabaggala, Maria Sarah; Parkes-Ratanshi, Rosalind; Kasirye, Ronnie et al. (2018) Re-engagement in HIV care following a missed visit in rural Uganda. BMC Res Notes 11:762
Zawedde-Muyanja, S; Manabe, Y C; Sewankambo, N K et al. (2018) Xpert® MTB/RIF associated with improved treatment initiation among patients with smear-negative tuberculosis. Int J Tuberc Lung Dis 22:1475-1480
Nakiyingi, Lydia; Nakanwagi, Prossy; Briggs, Jessica et al. (2018) Performance of loop-mediated isothermal amplification assay in the diagnosis of pulmonary tuberculosis in a high prevalence TB/HIV rural setting in Uganda. BMC Infect Dis 18:87
Katwesigye, Elizabeth; Seremba, Emmanuel; Semitala, Fred et al. (2017) Low sero-prevalence of hepatitis delta antibodies in HIV/ hepatitis B co-infected patients attending an urban HIV clinic in Uganda. Afr Health Sci 17:974-978
Ssempijja, Victor; Nakigozi, Gertrude; Chang, Larry et al. (2017) Rates of switching to second-line antiretroviral therapy and impact of delayed switching on immunologic, virologic, and mortality outcomes among HIV-infected adults with virologic failure in Rakai, Uganda. BMC Infect Dis 17:582
Hermans, Sabine M; Babirye, Juliet A; Mbabazi, Olive et al. (2017) Treatment decisions and mortality in HIV-positive presumptive smear-negative TB in the Xpertâ„¢ MTB/RIF era: a cohort study. BMC Infect Dis 17:433
Sekaggya-Wiltshire, C; von Braun, A; Scherrer, A U et al. (2017) Anti-TB drug concentrations and drug-associated toxicities among TB/HIV-coinfected patients. J Antimicrob Chemother 72:1172-1177
Ramachandran, Anu; Manabe, Yukari; Rajasingham, Radha et al. (2017) Cost-effectiveness of CRAG-LFA screening for cryptococcal meningitis among people living with HIV in Uganda. BMC Infect Dis 17:225
Manabe, Yukari C; Worodria, William; van Leth, Frank et al. (2016) Prevention of Early Mortality by Presumptive Tuberculosis Therapy Study: An Open Label, Randomized Controlled Trial. Am J Trop Med Hyg 95:1265-1271

Showing the most recent 10 out of 25 publications