Central Africa International Epidemiology databases to Evaluate AIDS

项目摘要 随着艾滋病毒护理和治疗方案在整个撒哈拉以南非洲（SSA）的实施， 需要在研究和政策方面取得重大进展，以便护理和治疗资源能够 最佳效益：减少新的艾滋病毒传播、艾滋病毒相关发病率和 死亡率和非传染性疾病（NCD）引起的疾病。抗逆转录病毒疗法的覆盖率 在我们地区，“一视同仁”时代的艾滋病毒/艾滋病感染率差异很大，从卢旺达的87%到刚果民主共和国的25%， 刚果是撒哈拉以南非洲所有消除毒品和毒瘾综合教育国家中覆盖率最低的国家。我们的研究议程是 旨在产生可操作的知识，以帮助缩小这些差距。我们的区域队列 数据库包括81，183名成年人和11，789名儿童的纵向数据，这些儿童曾经登记过艾滋病毒 在布隆迪、喀麦隆、刚果民主共和国、刚果共和国的22个地点提供护理 和卢旺达。我们建议用链接的队列补充这个数据库，以解决一系列 与本区域相关的调查，包括：1）利用实施科学 为旨在改进艾滋病毒预防、护理和治疗的战略提供信息的方法 （2）开展深入的艾滋病毒相关的临床调查， 结果和感染性（如结核病）和非感染性（如非传染性疾病）合并症（目标2）; 3） 在更大的IEDEA范围内领导和支持创新的多区域科学议程 网络（目标3）;以及4.）为早期研究人员提供科学和职业指导 以及来自中非和美国的研究人员（目标4）。中非IeDEA有一个 多元化的科学团队，在实施科学、流行病学、 和临床研究。我们在科学上具有很高的生产力，发表了超过45篇论文， 一系列主题，并继续培养非洲领导力和建立当地的研究 容量我们申请的主题包括强调“一视同仁”的政策实施， 心理健康和物质使用（酒精），防止母婴传播和儿童和青少年艾滋病毒， 结核病、通过PrEP预防艾滋病毒以及艾滋病毒感染者中的非传染性疾病（例如， 肾病）。

Project Summary As HIV care and treatment programs are implemented throughout sub-Saharan Africa (SSA), critical advances in research and policy are needed so that care and treatment resources can be deployed to optimal benefit: decreasing new HIV transmissions, HIV-related morbidity and mortality, and illness from non-communicable disease (NCD). Coverage of antiretroviral therapy in the 'Treat All' era varies widely in our region, from 87% in Rwanda to 25% in Republic of Congo, the lowest coverage among all IeDEA countries in SSA. Our research agenda is designed to generate actionable knowledge to help close these gaps. Our regional cohort database includes longitudinal data for 81,183 adults and 11,789 children ever enrolling in HIV care at 22 sites in Burundi, Cameroon, the Democratic Republic of Congo, Republic of Congo and Rwanda. We propose to supplement this database with linked cohorts to address a range of investigations relevant to our region including: 1) leveraging implementation science approaches to inform strategies aimed at improving HIV prevention, care and treatment outcomes in the region (Aim 1); 2) conducting in-depth clinical investigations of HIV-related outcomes and infectious (e.g. TB) and non-infectious (e.g. NCDs) comorbidities (Aim 2); 3) leading and supporting an innovative multiregional scientific agenda within the larger IeDEA network (Aim 3); and 4.) providing scientific and career mentoring to early stage investigators and researchers from Central Africa and from the US (Aim 4). Central Africa IeDEA has a diverse scientific team with broad and deep expertise in implementation science, epidemiology and clinical research. We have been highly productive scientifically with >45 publications across a range of topics, and have continued to foster African leadership and build local research capacity. Themes in our application include an emphasis on ‘treat all’ policy implementation, mental health and substance use (alcohol), PMTCT and pediatric and adolescent HIV, tuberculosis, HIV prevention through PrEP, and NCDs in aging people living with HIV (e.g. kidney disease).