EXCEED THE SPACE PROVIDED. Tuberculosis is an reemerging disease, which after years of decline in the United States underwent an increase in incidence from 1985-1992. Lack of public health infrastructure, funding, and a general complacency that tuberculosis was a disease of the past contributed to this resurgence in the United States and the continuing increasing incidence worldwide. Among the many problems facing tuberculosis controllers is a lack of well- trained individuals.There is a significant need for clinicians who understand in many variations of tuberculosis infection and disease, and for biologists trained in handling this unique pathogen under appropriate conditions of biological safety. Johns Hopkins University has had a long-standing interest in tuberculosis research and control, beginning with the personal interest of professor William Osier who began studying this disease in Baltimore in 1898. Currently a cadre of about twenty faculty members have significant research interest in tuberculosis. These faculty members are spread throughout the University in both the faculty of the School of Medicine and the faculty of the School of Public Health. This proposal request support for two clinical fellows and two post- doctoral research fellows for training in tuberculosis. The resources of our university permit intensive clinical experience with U.S. patients treated for tuberculosis as well as clinical and research in human tuberculosis overseas in sites in Haiti, Brazil, Peru, and South Africa. In addition there is a significant research endeavor in the molecular pathogenesis, the pathology, the mechanisms of drug resistance, and the immunology of tuberculosis. This proposal will provide multidisciplinary training in both clinical aspects and basic science investigation in tuberculosis. Well-trained young investigators are essential for future tuberculosis control efforts =ERFORMANCE SITE{S) (organization, city, state) Johns Hopkins University School of Medicine Baltimore City Health Department -Tuberculosis Clinic KEY PERSONNEL ========================================Section End===========================================
