Central Africa IeDEA

中部非洲 IeDEA

• 批准号: 8190086
• 负责人: Kathryn M. Anastos
• 金额: $ 84.89万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-15 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8190086
• 关键词: Acquired Immunodeficiency Syndrome; Affect; Africa; Africa South of the Sahara; African; African American; Age; Aging; Behavioral; CD4 Lymphocyte Count; CD4 Positive T Lymphocytes; Cameroon; Cardiovascular Diseases; Caring; Cause of Death; Central Africa; Characteristics; Chronic; Clinic; Clinical; Clinical Data; Clinical Sciences; Collaborations; Commit; Comorbidity; Conflict (Psychology); Country; Data; Data Analyses; Data Set; Disease; Disease Progression; Effectiveness; Enrollment; Ensure; Epidemiology; Europe; Exposure to; Fostering; Genetic; Government; Guidelines; HIV; HIV Infections; Health; Immunologics; Incidence; Individual; Intermediate Variables; Investigation; Kidney; Knowledge; Leadership; Malaria; Malignant Neoplasms; Metabolic; Methods; Modeling; Monitor; Morbidity - disease rate; Nutritional status; Office of Administrative Management; Outcome; Patients; Pattern; Persons; Policies; Policy Maker; Pregnancy; Prenatal care; Prevention; Process; Productivity; Public Health; Publications; Recording of previous events; Regimen; Reproductive Health; Research; Research Infrastructure; Research Support; Resources; Role; Rural; Rwanda; Services; Source; Specimen; Staging; Stigmata; System; Technology; Therapeutic; Time; Toxic effect; Tuberculosis; Ursidae Family; Vertical Disease Transmission; Viral Load result; Weight Gain; Woman; Work; antiretroviral therapy; burden of illness; care systems; clinical epidemiology; clinical phenotype; data management; design; electronic data; experience; flexibility; follow-up; implementation science; improved; innovation; interest; mortality; neoplasm registry; programs; reproductive; response; sex; skills; social stigma; success; technology development; translational study; treatment adherence; treatment program

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. PUBLIC HEALTH RELEVANCE: Sub-Saharan Africa bears the greatest burden of HIV disease globally. Research to define clinical and epidemiologic predictors of treatment success is needed to guide clinicians caring for persons with HIV. In addition, implementation science can guide policy makers and program implementers on service delivery mechanisms to provide most efficient use of treatment resources and the optimal gain to the public's health.

描述（由申请人提供）： 抗逆转录病毒疗法 (ART) 为数百万非洲人带来新健康的承诺现已成为现实。随着艾滋病毒护理和治疗计划在整个非洲实施，仔细监测其有效性至关重要，以便能够部署护理和治疗资源以获得最佳效益。需要阐明对 ART 的免疫学和临床反应、护理保留和行为因素（例如治疗依从性），并确定生存的预测因素。艾滋病毒和抗逆转录病毒治疗对非洲癌症的影响基本上没有被描述，而且与疟疾等主要环境并发症的相互作用也知之甚少。我们提出了一个新的中非LeDEA（CA-leDEA），旨在优化和增强科学生产力以及快速、高影响力的出版物；我们将 1.) 通过 a.) 从现有电子数据中提取，或 b.) 用于在资源匮乏的临床环境中有效捕获临床数据的新的现场系统，编译和管理大量患者的二级来源患者级数据； 2.) 开发创造性和灵活的科学流程，促进大量数据分析的高通量，以回答流行病学、操作和其他艾滋病毒相关研究问题，最终发表高影响力的出版物； 3.) 在五到十年内发展每个中部非洲国家的独立研究、数据管理、分析和出版能力，确保 CA-leDEA 的可持续性。我们的团队在研究生产力和运营成功领域拥有悠久的历史，以及支持研究的创新 IT 开发，并具有互补的技能和经验来优化 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。我们将与美国、喀麦隆和卢旺达的综合研究团队一起开发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，以回答资源匮乏地区艾滋病毒护理和治疗的关键问题。 公共卫生相关性： 撒哈拉以南非洲地区是全球艾滋病毒疾病负担最重的地区。需要进行研究来确定治疗成功的临床和流行病学预测因子，以指导临床医生护理艾滋病毒感染者。此外，实施科学可以指导政策制定者和项目实施者制定服务提供机制，以最有效地利用治疗资源并为公众健康带来最佳收益。