This award will provide Dr. Catherine Todd with protected time and expertise to develop international research in risk reduction of blood-borne viral infections (BBV) and sexually-transmitted infections (STI) during reproductive care in limited-resource settings. Dr. Todd is an obstetrician/gynecologist who completed a family planning fellowship and worked as an international consultant, with the majority of time spent in Afghanistan. She is currently Assistant Professor in the Division of International Health &Cross-Cultural Medicine at the University of California, San Diego. Her career and training goals are to: 1. Gain knowledge in advanced epidemiologic study design, particularly observational and intervention research;2. Acquire survey development and psychometric methodology skills;3. Improve understanding of the intersection of reproductive health and infectious disease research in international settings;4. Learn BBV/STI diagnostic methods suited to resource-poor environments;5. Acquire advanced quantitative data analysis proficiency;6. Conduct a study investigating prevalence and correlates of and barriers to screening for human immunodeficiency virus (HIV), syphilis, and hepatitis B (HBV) in an Afghan antenatal population;and 7. Learn international health programming theory to design and pilot an intervention implementing antenatal screening. The training plan includes coursework and mentoring by experts in infectious disease epidemiology, international maternal health, and psychometric scale methods. A key component is a needs assessment study and a pilot intervention to implement antenatal testing.
The aims of the proposed research are to: 1) Determine prevalence and correlates of HIV, syphilis, and HBV in an antenatal population in Kabul, Afghanistan, 2) Assess patient knowledge and perceptions on screening value for HIV, syphilis, and HBV in obstetric care, 3) Assess knowledge and practice of medical personnel and their influence on HIV, syphilis, and HBV prevention counseling, screening, and iatrogenic infection prevention practice, and 4) Determine feasibility and acceptance of antenatal screening at hospital admission for obstetric patients and providers in Kabul, Afghanistan. Though little is known about BBV prevalence in Afghanistan, multiple factors increase the risk of an epidemic, particularly the antenatal population;implementing testing may circumvent this. Pilot data generated from this study will be used to test the intervention in a larger Afghan population.

Agency
National Institute of Health (NIH)
Institute
Fogarty International Center (FIC)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
3K01TW007408-04S1
Application #
7977128
Study Section
Special Emphasis Panel (ZRG1-ICP-2 (51))
Program Officer
Njage, Yvonne
Project Start
2005-09-29
Project End
2010-09-30
Budget Start
2009-11-04
Budget End
2010-09-30
Support Year
4
Fiscal Year
2010
Total Cost
$103,661
Indirect Cost
Name
Columbia University (N.Y.)
Department
Obstetrics & Gynecology
Type
Schools of Medicine
DUNS #
621889815
City
New York
State
NY
Country
United States
Zip Code
10032
Todd, Catherine S; Mansoor, Ghulam Farooq; Haider, Sadia et al. (2015) A case-control study of correlates of severe acute maternal morbidity in Kabul, Afghanistan. Int J Gynaecol Obstet 130:142-7
Sanders-Buell, Eric; Rutvisuttinunt, Wiriya; Todd, Catherine S et al. (2013) Hepatitis C genotype distribution and homology among geographically disparate injecting drug users in Afghanistan. J Med Virol 85:1170-9
Todd, Catherine S; Macdonald, David; Khoshnood, Kaveh et al. (2012) Opiate use, treatment, and harm reduction in Afghanistan: recent changes and future directions. Int J Drug Policy 23:341-5
Nasir, Abdul; Todd, Catherine S; Stanekzai, M Raza et al. (2011) Prevalence of HIV, hepatitis B and hepatitis C and associated risk behaviours amongst injecting drug users in three Afghan cities. Int J Drug Policy 22:145-52
Nasir, Abdul; Todd, Catherine S; Stanekzai, Mohammad R et al. (2011) Implications of hepatitis C viremia vs. antibody alone on transmission among male injecting drug users in three Afghan cities. Int J Infect Dis 15:e201-5
Todd, Catherine S; Nasir, Abdul; Stanekzai, Mohammad R et al. (2011) HIV awareness and condom use among female sex workers in Afghanistan: implications for intervention. AIDS Care 23:348-56
Sanders-Buell, Eric; Bose, Meera; Nasir, Abdul et al. (2010) Distinct circulating recombinant HIV-1 strains among injecting drug users and sex workers in Afghanistan. AIDS Res Hum Retroviruses 26:605-8
Todd, Catherine S; Nasir, Abdul; Stanekzai, Mohammad R et al. (2010) HIV, hepatitis B, and hepatitis C prevalence and associated risk behaviors among female sex workers in three Afghan cities. AIDS 24 Suppl 2:S69-75
Todd, Catherine S; Nasir, Abdul; Raza Stanekzai, Mohammad et al. (2010) Contraceptive utilization and pregnancy termination among female sex workers in Afghanistan. J Womens Health (Larchmt) 19:2057-62
Todd, Catherine S; Nasir, Abdul; Raza Stanekzai, Mohammad et al. (2010) Prevalence and correlates of syphilis and condom use among male injection drug users in four Afghan cities. Sex Transm Dis 37:719-25

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