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地区(SSA)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 以最佳效益进行部署：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)疾病。关于抗逆转录病毒治疗的报道 在我们区域，从卢旺达的87%到共和国的25%，我们区域的情况差异很大。 刚果，在南部非洲所有IeDEA国家中覆盖率最低。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。我们的地区队列 数据库包括81,183名成年人和11,789名儿童的纵向数据 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 还有卢旺达。我们建议用相关联的队列来补充这个数据库，以解决一个范围 与本区域有关的调查包括：1)利用实施科学 为旨在改善艾滋病毒预防、护理和治疗的战略提供信息的方法 该区域的成果(目标1)；2)深入开展与艾滋病毒有关的临床调查 结果和传染性(如结核病)和非传染性(如非传染性疾病)并存(目标2)； 在更大的IeDEA内领导和支持创新的多区域科学议程 网络(目标3)；和4.为早期调查人员提供科学和职业指导 来自中非和美国的研究人员(AIM 4)。中部非洲IeDEA有一个 多样化的科学团队，在实施科学、流行病学方面拥有广泛而深厚的专业知识 和临床研究。我们在科学方面取得了很高的生产力，出版了45种出版物 一系列主题，并继续培养非洲的领导力和建立当地研究 容量。我们的应用程序中的主题包括强调“对待所有人”的政策实施， 精神健康和药物使用(酒精)、防止母婴传播以及儿童和青少年艾滋病毒， 结核病，通过PrEP预防艾滋病毒，以及老年艾滋病毒携带者的非传染性疾病(例如 肾脏疾病)。

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).