Established in 1998 the UMIHV AIDS International Training and Research Program (AITRP) has supported masters level and doctoral degree training of 14 trainees, long-term postdoctoral training for eight, short term training in Baltimore for 25 including “sandwich training” for senior faculty leaders, and 84 courses, workshops and scientific meetings impacting 1250 scientists at partner institutions in Jamaica, Trinidad, Tobago, Brazil, Mali, and Nigeria. As detailed in CareerTrac, former trainees are scientifically productive and have assumed significant leadership positions in their host countries. For the future, the "Mentor the Mentor" training paradigm first engages host country academic leaders with U.S. faculty in short term research training to build sustainable institutional research capacity. Following this mentor training, U.S. and host country faculty members work together supporting the educational and research agenda of the South to South trainee.
Since his matriculation with a Ph.D in Epidemiology from the University of Maryland in 2008, Dr. Périssé has assumed a research position at Fundacao Oswaldo Cruz in Rio de Janeiro. His innovative thesis project spawned three publications (see page 6) and pioneered the application of network theory in the area of risk assessment for clinical trials research. His project identified that the application of egocentric network data provides additional information beyond that routinely identified through standard risk assessment approaches. The study was conducted among 1,231 from a major HIV testing site in Rio de Janeiro. The cross sectional questionnaire not only identified self reported risk but also collected information on risk factors for up to 10 sex partners in the network of sexual contacts of participants. Employing sophisticated receiver operator statistical methods the study found that partner-related variables better described the HIV serostatus of the volunteer than did self report among men who have sex with men
(MSM). Among women while the trend was in a similar direction, the number of network partners was lower and the association did not achieve statistical significance. The thesis research also developed new insights concerning the use of cues to augment identification of additional sexual contacts. A derivative analysis also confirmed pervious observations of the protective effect of male circumcision among the largely MSM cohort enrolled in the study. In his new position, André is preparing a GRIP submission to investigate the application of ego-networktheory in clinical research .
While the impact of HIV infection on human Mycobacterium tuberculosis has been extensively studied and reported, little is known about the impact of HIV on human tuberculosis caused by M. bovis. Sporadic reports of pulmonary tuberculosis from M. bovis have been reported with more frequency in Nigeria especially in the north where nomadic cattle herdsmen are a major source of unpasteurized milk and milk products. Aliyu’s PhD dissertation proposal hypothesizes that a significant percentage of patients with TB and HIV in Nigeria are caused by M. bovis through exposure to unpasteurized milk products. A weakened immune system from HIV infection likely promotes susceptibility to M. Bovis and may be detected in the pattern of clinical presentation. His primary data collection will benefit from a new BL-3 laboratory implemented by IHV Nigeria at the National TB and Leprosy Training Center in Zaria that includes molecular diagnostic capacity for distinguishing TB subtypes.
Chuka Anude, MD MPH is a current UM-IHV AITRP Fellow under the mentorship of Professor William Blattner. Dr Anude is a Johns Hopkins trained global public health physician with a decade of experience in building innovative, and sustainable public health research and disease control programs that respond to the needs of countries and local communities. He is currently enrolled at the Johns Hopkins Bloomberg School. Dr Anude’s
PhD dissertation research “HIV AIDS Care and Antiretroviral Therapy (HACART) Study” is an observational clinic-based cohort study designed to
answer questions of associations between clinical and non-clinical predictors of default from care, treatment outcomes and mortality, and immunovirologic failure. Significant predictors will then be used in the development of a prediction model using baseline clinical and non-clinical predictors. The study will also determine the association of baseline hemoglobin levels, socio-economic status, regimen type and residential distance from treatment site with different treatment outcomes. The study captures data from a cohort of adult HIV infected patients receiving antiretroviral therapy at three Institute of Human Virology, Nigeria PEPFAR treatment sites at University of Abuja Teaching Hospital, University of Benin teaching Hospital and Asokoro District Hospital. Currently, the study is actively recruiting participants and enrollment is projected to end by March 2010 with data analysis commencing in the coming months.
Dr. Collins, a post doctoral trainee from the University of West Indies, Jamaica, working with molecular virologist Dr. Jean Carr, is investigating HIV viral envelopes from heterosexually transmitted viruses from Trinidad and Tobago compared to those of sub-type B from Argentina, acquired through sex between men. Her Jamaican faculty mentor is Dr. Marcia Roye who has also received advanced training in Dr. Carr’s laboratory. Following up on reports that variable loop length and glycosolation pattern determine efficiency of transmission by different routes, Dr. Collins employs Single Genome Amplification and sequencing of the quasi-species from each individual to study these relationships. Preliminary results support the hypothesis that variable loop length is associated with different modes of transmission. Based on this training Dr. Collins has become a very accomplished molecular virologist and along with her Jamaican faculty mentor is building a critical mass for virological research at University of West Indies. Working with former Fogarty Trainee Dr. Peter Figueroa, director of the Global Fund supported HIV treatment access program in Jamaica, a molecular analysis of drug pattern resistance and transmission of drug resistant virus is planned.
Nigerian faculty mentor and senior scientist/biochemist at the National Institutes for Pharmaceutical Research and Development (NIPRD) in Nigeria, Dr. Ibrahim Iliya is collaborating with UM-IHV faculty to support south-to south research training capacity building for natural products research.
Since HIV patients typically first seek a traditional healer for medical problems, understanding the anti-HIV effects of natural plants is of high priority to the Nigerian research community.
Current research training targets eight plants originally shown to have some anti-HIV activity by past Fogarty fellow Dr. Muhammad Gwarzo, now on the faculty of Bayero University in Kano. Extracts of these plants are being further analyzed in employing biochemical and biological approaches.
As a Nigerian Faculty mentor, Dr. Iliya mentors Musa Abdullahi, who is currently performing his thesis research as a PhD candidate at the Ahmadu Bello University, Zaria, as part of the UM-IHV AITRP south to south research training program.
Musa’s PhD thesis research involves the characterization of flavonoids identified in fractions of the plants with anti-HIV properties previously studied by Dr. Gwarzo.
Sandwich training for Dr. Abdullahi is planned in Baltimore at the School of Pharmacy to help build more advanced capacity in the Nigerian laboratory.
Alfred Chucks Nwofor; FIMLT, MSc, a current UM-IHV AITRP Fellow under the mentorship of Dr. Alash’le Abimiku (co-PI) d is in the process of completing a PhD dissertation on ‘’ Characterization of Mycobacteria Isolates from Sputum of HIV+ and HIV- persons in Ilorin: A Comparative Approach’’. The sampling for his study was carried out at the University of Ilorin Teaching Hospital (TB Lab), Ilorin, Kwara State of Nigeria, one of IHVN supported PEPFAR sites. With his Fogarty supported training in Hain Line Probe Assay, Alfred has applied the technique to his isolates to discriminate the MTB complex, determine sensitivity/ resistance of isolates to Rifampicin and Isoniazid as well as speciate the members of the MTB complex and the Non – tuberculous mycobacteria species. Currently, analysis of data is ongoing and we expect results will be ready for PhD defense in February, 2010. As a laboratory scientist at the National TB and Leprosy Training Center (NTBLTC) in Zaria he is engaged in supporting the national TB drug resistance survey being conducted by the National TB Control Agency with WHO. Alfred has been supporting the NTBLTC laboratory activities on diagnosis of HIV infected persons and monitoring of those on antiretroviral drugs; and identifying HIV infected persons that are co-infected with TB. He is also a member of Nigeria National Laboratory TB working group and a registered member of the America Society for Microbiology. Alfred has benefitted from a number of Fogarty and PEPFAR funded trainings, and he is now a member of the pool of internal trainers at NTBLTC, Zaria, facilitating collaborative trainings on good Sputum smear microscopy for Medical Laboratory Scientists and other laboratory personnel, supervising the preparation of sputum smear Panel slides at the Centre for proficiency testing. He also initiated TB culture (conventional L/J medium method) and has been involved in the establishment of the Gene Line Probe Assay (Hain assay) in Zaria; use of fluorescent microscopy and LED microscopes in the detection of stained bacilli in sputum smears.
The training in Research Ethics and Research misconduct for members of the IHV-Nigeria Research Ethics Committee took place from November 2-6, 2009 at Bolton White Hotel, in Abuja, Nigeria. Faculty from the West African Bioethics Center, an NIH Fogarty sponsored training center based in Ibadan, Nigeria, conducted the training.
The objectives of the training were to improve the knowledge and understanding of ethical principles and their application in the ethical review process among participants. The training focused on the National Code for Health Research Ethics, 45 CFR 46, and other international ethics. Mock protocol reviews were included as part of the training to acquaint members who would be participating in protocol reviews for the first time with the intricacies in the process. Selected papers from the WHO Casebook reviews were used for the exercise.
Overall, the participants were very satisfied with the training and acknowledged that although they had undertaken the CITI training, the onsite training had further improved their understanding and demonstrated how better to apply the knowledge they have gained from the materials from the CITI training modules and those presented at the training in the practical work of the ethics committee. The training is now being utilized by the IHV-Nigeria Ethics Committee which has responsibility for over 10 research protocols.
The Institute of Human Virology, Nigeria (IHV-N) in collaboration with the UM-IHV-AITRP sponsored a ten-day training course (12th-23rd October, 2009) on Statistical Methods of Epidemiology conducted at the IHV-Nigeria training center. This course focused on strengthening the research initiative in Nigeria by introducing statistical and epidemiological concepts involved in conducting quantitative research. Thirty physicians, nurses and program officers from several university and research partner institutions countrywide, attended the course. The two-week training consisted of 23 didactic modules, 8 exercises, and a hands-on analysis laboratory using STATA for statistical analysis and DST software for power and sample size calculation.
The course included modules on Introduction to Epidemiology, emphasizing methodology, and applications in research and public health. Areas covered include: Measures of Disease Outcomes, Study Designs (such as Cohort Studies, Case-Control Studies, Randomized Clinical Trials, Crosssection Studies. The Statistical Methods section of the training covered Measures of Associations, Biases, Confounding and Interaction, Statistical Inferences, Bivariate Analyses, and Multivariate Analyses. For each module, there were group sessions, practical exercises, and graded assignments. The Nigerian teaching assistants, who were former Fogarty Scholars and trainees, were also utilized. Examples of published case series and population-based studies from Africa, the US, and Europe were discussed and analyzed. At the conclusion of the course, students were able to distinguish between different types of study designs and their strengths and weaknesses and select appropriate study designs to address specific research questions. Participant feedback emphasized the “empowerment” that trainees experienced in being able to take STATA back to their research institution to support capacity building at partner research institutions. This course was designed and facilitated by University of Maryland Faculty/ Staff (John Sorkin, Manhattan Charurat and Modupe Oyegunle)
In response to the national research priority of the Federal Ministry of Health, the UM-IHV AITRP grant is providing training to resuscitate the National Cancer Registration System for Nigeria. In partnership with the International Agency for Research on Cancer (IARC), Society of Oncology and Cancer Research of Nigeria (SOCRON) and the Federal Ministry of Heath, a 3- day training on the use of Cancer Registration employing CanReg4 Software for Cancer Registrars was conducted Dec 14th to 16th 2009. The training benefited from the real-time video training venue at IHV-Nigeria to allow faculty from Lyon France to provide live training sessions and ongoing dialogue to complement training by onsite faculty including Dr. Clement Adebamowo. IHV-Nigeria staffer – Dr. Elima Jedy-Agba, MD, MPH – worked closely with Dr. Maria Paual Curado and Mr. Morten Ervik of IARC over a 6 week period, facilitated by the broad band capacity at IHV-Nigeria, to adapt the Can- Reg4 platform for use by cancer registries in Nigeria. The adapted version incorporates new variables that were not in the original version and also modifies some of the old variables. For example, in the group, ‘patient’, variables such as Marital Status, Educational attainment and Religion have been included. For the ‘Tumor’ variable, the modified version includes; ‘type of diagnosis, ‘tumor differentiation’, and ‘type of treatment given’. The group, ‘follow up’ now includes; ‘the name of the primary doctor’, ‘the cause of death’ if the patient is deceased and the, ‘name of the registrar’. A new dictionary has been created that takes into account the new variables created, tribes in Nigeria and names of Hospitals in Nigeria.