Non-Communicable Diseases

非传染性疾病(NCD)对撒哈拉以南非洲(SSA)构成威胁，但几乎没有研究来应对这一挑战。我们已经证明NCD在SSA中的表现不同。例如，精神疾病常见于慢性感染(如艾滋病毒)。同样，2型糖尿病发生在非洲的瘦人身上，而不像在西方，2型糖尿病与肥胖联系在一起。因此，来自其他地方的解决方案在SSA不一定有效。独特的非传染性疾病表现很可能受到当地因素的影响，如遗传易感性和其他暴露，包括感染和营养不良。我们的目标是进行严格的研究，以揭示根本的潜在机制，并找到在非洲预防和治疗这些疾病的最佳方法。我们将仔细描述糖尿病的特征，看看它是由于缺乏胰岛素(例如，因为之前的营养不良或感染导致胰腺变小)还是因为产生的胰岛素不起作用而引起的。我们将测试用于治疗肥胖者糖尿病的药物是否对非洲苗条的人有效。在我们研究艾滋病毒与抑郁症，特别是年轻人抑郁症的基础上，我们将设计和测试由非专业卫生工作者提供的心理干预(S)，以管理艾滋病毒携带者年轻人的抑郁症。由于感染和非传染性疾病的结合可能导致巨大的残疾，我们将研究如何改善残疾人的生活质量，包括通过更好地获得医疗保健。

Non-communicable diseases (NCDs) pose a threat to sub-Saharan Africa (SSA), but there is little research to address this challenge. We have shown that NCD manifest differently in SSA. For example, mental illness is often seen with chronic infections (eg HIV). Similarly, type 2 diabetes occurs in lean individuals Africa, unlike in the West where it associates with obesity. Solutions from elsewhere may therefore not be necessarily effective in SSA. The unique NCD presentations are likely shaped by local factors, such as genetic susceptibility and other exposures, including infections and malnutrition. We aim to do rigorous research to uncover the fundamental underlying mechanisms, and to find best ways to prevent and treat these disorders in Africa. We will carefully characterise diabetes to see if it is caused either by lack of insulin (eg because the pancreas is small from previous malnutrition or infection) or because the insulin produced is not working well. We will test if drugs used to treat diabetes in the obese work in thin Africans. Building on our studies that have strongly linked HIV and depression, particularly in young people, we will design and test psychological intervention(s), delivered by lay health workers, to manage depression in young people living with HIV. As combination of infection and NCDs can cause huge disability, we will study how to improve the quality of life of people with disabilities, including through better access to healthcare.