In Mali and many parts of Africa, the incidence of mycobacterial infection is very high and driven in large part by the overlapping HIV epidemic. Mycobacterium tuberculosis (MTB) and Mycobacterium africanum (MAF), both closely related members of the M.tuberculosis complex (MTBC), as well as non-tuberculous mycobacterium (NTM) cause human mycobacterial infections and disease in West Africa. MTBC has been widely studied; however, little is known about differences in pathogenesis, genetics, epidemiology, diagnosis, and management between MTB, MAF, and NTM among HIV-infected individuals. The University of Sciences, Techniques, and Technologies of Bamako, Mali (USTTB; University of Bamako) in collaboration with the Point- G and Gabriel Tour Teaching Hospitals in Bamako, are well equipped to build a translational research-training program in HIV-associated mycobacterial infection. The research team at USTTB has received substantial and continuous support from the NIH starting with its intramural malaria research program in the late 1980s. In 2005, this program was expanded to include HIV and tuberculosis research, which included development of a BSL-3 high containment laboratory capable of testing for mycobacterial drug resistance and testing for Ebola virus. NIAID has continuously supported the HIV and tuberculosis programs since its formation. In 2014, NIAID committed an additional 4 years of development support for the University Clinical Research Center (UCRC) in order to enhance clinical research opportunities. In our proposed program, we will continue developing HIV and mycobacterial research capacity at USTTB with established collaborators at Northwestern University, Johns Hopkins University and NIAID by leveraging ongoing research training efforts at these institutions to address each of the following aims: 1) produce and enhance the careers of Malian researchers capable of performing advanced research on the molecular biology, genetics, immunology, clinical investigation and microbiology of HIV-associated mycobacterial infection; 2) enhance and strengthen the graduate training programs at USTTB which focus on HIV infection and its mycobacterial co-morbidities through faculty enrichment and support of clinical and laboratory scientists; and 3) develop new intensive USTTB Diploma programs in retrovirology, HIV co-morbidities and mycobacteriology which will serve as core training programs for existing faculty and staff locally and from other low- and middle-income institutions throughout the region. Through this program, we will achieve the overall goal of training the next generation of investigators focused on HIV-associated mycobacterial infection who will be able to conduct HIV-related research on the evolving epidemic in Mali. We aspire to take USSTB investigators to the next level of research capacity and to make USSTB a center of excellence in the research and care of HIV and associated mycobacterial infections in West Africa.
The HIV and Mycobacterial Disease Research Training Program in Mali will provide doctorate and post- doctorate clinical, laboratory, and translational research training opportunities to Malian physicians and scientists studying HIV-associated mycobacterial infections. The program will foster timely and clinically relevant research as well as expand established collaborations between researchers at the University of Sciences, Techniques and Technologies of Bamako, Northwestern University, and Johns Hopkins University.