Central Africa IeDEA

描述(由申请人提供)： 抗逆转录病毒疗法(ART)为数百万非洲人提供新的健康的承诺现在正在实现。随着艾滋病毒护理和治疗方案在非洲各地的实施，仔细监测其有效性至关重要，以便护理和治疗资源能够最大限度地发挥效益。需要阐明对ART的免疫学和临床反应、护理中的保留和行为成分(例如，治疗依从性)，并定义生存预测因素。艾滋病毒和抗逆转录病毒疗法对非洲癌症的影响基本上没有描述，与疟疾等主要环境共病的相互作用也鲜为人知。我们提出了一个新的中部非洲leDEA(CA-leDEA)，旨在优化和提高科学生产力和快速、高影响的出版物；我们将1.)通过a.编辑和管理大量患者的二次源患者级别数据。)从现有电子数据中提取，或b.)新的地面系统，用于在低资源的临床环境中有效地获取临床数据；2.制定创造性和灵活的科学程序，促进大量数据分析，以回答流行病学、业务性和其他与艾滋病毒有关的研究问题，最终形成影响较大的出版物；以及在五到十年的时间里，在每个中非国家发展独立研究、数据管理、分析和出版的能力，确保可持续发展数据评估。我们的团队在研究生产力和运营成功以及支持研究的创新IT开发领域拥有悠久的历史，并拥有互补的技能和经验，以优化CA-leDEA的活动。我们的四个合作伙伴是艾滋病毒护理服务的实施者(即政府)，第五个合作伙伴WE-ACTx卢旺达为调查艾滋病恶性肿瘤带来了患者数量、研究经验和特殊资源。我们将开发一个行政和数据管理基础设施，支持流行病学和实施科学的实施，以回答在较低资源环境下艾滋病毒护理和治疗的关键问题，并在美国、喀麦隆和卢旺达建立综合研究团队。

DESCRIPTION (provided by applicant): The promise of antiretroviral therapy (ART) to provide renewed health is now being realized for millions of Africans. As HIV care and treatment programs are implemented throughout Africa, careful monitoring of their effectiveness is of crucial importance, so that care and treatment resources can be deployed to optimal benefit. Immunologic and clinical responses to ART, retention in care, and behavioral components (e.g., treatment adherence) need to be elucidated and predictors of survival defined. The impact of HIV and ART on cancers in Africa is essentially undescribed, and interactions with major ambient co-morbidities such as malaria are poorly understood. We propose a new Central Africa leDEA (CA-leDEA), designed to optimize and augment scientific productivity and rapid, high-impact publications; we will 1.) Compile and manage secondary source patient-level data on a large volume of patients through a.) extraction from existing electronic data, or b.) new on-the-ground systems for efficient capture of clinical data in low-resource clinical settings; 2.) Develop a creative and flexible scientific process that fosters high throughput of many analyses of data to answer epidemiologic, operational and other HIV-related research questions, culminating in high- impact publications; and 3.) Develop capacity for independent research, data management, analysis and publication in each of the Central African countries over five to ten years, ensuring the sustainability of CA-leDEA. Our team brings a long history in the region of research productivity and operational success, as well as innovative IT development to support research, with complementary skills and experience to optimize the activities of CA-leDEA. Four of our partners are the implementers of HIV care services (i.e., the governments) and the fifth partner, WE-ACTx Rwanda, brings patient volume, research experience and special resources to investigate AIDS malignancies. We will develop an administrative and data management infrastructure that supports the implementation of epidemiologic and implementation science to answer key questions in HIV care and treatment in lower-resource settings, with integrated research teams in the US, Cameroon and Rwanda.