Blood-borne infection screening in an Afghan antenatal population

描述(由申请人提供)：该奖项将为凯瑟琳·托德博士提供受保护的时间和专业知识，以发展在有限资源环境下生殖保健期间降低血液传播病毒感染(BBV)和性传播感染(STI)风险的国际研究。托德是一名产科/妇科医生，他完成了计划生育奖学金，并担任过国际顾问，大部分时间都在阿富汗度过。她目前是加州大学圣地亚哥分校国际健康与跨文化医学部的助理教授。她的职业和培训目标是：1.获得高级流行病学研究设计方面的知识，特别是观察性和干预性研究；2.获得调查发展和心理测量学方法技能；3.提高对国际环境下生殖健康和传染病研究交叉的了解；4.学习适合资源匮乏环境的BBV/STI诊断方法；5.熟练掌握先进的定量数据分析能力；6.开展一项研究，调查阿富汗产前人群中人类免疫缺陷病毒(HIV)、梅毒和乙肝(乙肝)的患病率、相关性和筛查障碍；以及7.学习国际卫生规划理论，以设计和试点实施产前筛查的干预措施。培训计划包括传染病流行病学、国际孕产妇健康和心理测量量表方法方面的专家的课程作业和指导。一个关键组成部分是需求评估研究和实施产前检测的试点干预。拟议研究的目的是：1)确定阿富汗喀布尔产前人群中艾滋病毒、梅毒和乙肝病毒的流行率和相关性；2)评估患者对产科服务中艾滋病毒、梅毒和乙肝病毒筛查价值的知识和看法；3)评估医务人员的知识和行为及其对艾滋病毒、梅毒和乙肝病毒预防咨询、筛查和医源性感染预防实践的影响；以及4)确定阿富汗喀布尔产科患者和提供者入院时进行产前筛查的可行性和接受性。虽然关于BBV在阿富汗的流行情况知之甚少，但多种因素增加了流行病的风险，特别是产前人口；实施检测可能会绕过这一点。这项研究产生的试点数据将被用来测试在更大的阿富汗人口中的干预。

DESCRIPTION (provided by applicant): This award will provide Dr. Catherine Todd with protected time and expertise to develop international research in risk reduction of blood-borne viral infections (BBV) and sexually-transmitted infections (STI) during reproductive care in limited-resource settings. Dr. Todd is an obstetrician/gynecologist who completed a family planning fellowship and worked as an international consultant, with the majority of time spent in Afghanistan. She is currently Assistant Professor in the Division of International Health & Cross-Cultural Medicine at the University of California, San Diego. Her career and training goals are to: 1. Gain knowledge in advanced epidemiologic study design, particularly observational and intervention research; 2. Acquire survey development and psychometric methodology skills; 3. Improve understanding of the intersection of reproductive health and infectious disease research in international settings; 4. Learn BBV/STI diagnostic methods suited to resource-poor environments; 5. Acquire advanced quantitative data analysis proficiency; 6. Conduct a study investigating prevalence and correlates of and barriers to screening for human immunodeficiency virus (HIV), syphilis, and hepatitis B (HBV) in an Afghan antenatal population; and 7. Learn international health programming theory to design and pilot an intervention implementing antenatal screening. The training plan includes coursework and mentoring by experts in infectious disease epidemiology, international maternal health, and psychometric scale methods. A key component is a needs assessment study and a pilot intervention to implement antenatal testing. The aims of the proposed research are to: 1) Determine prevalence and correlates of HIV, syphilis, and HBV in an antenatal population in Kabul, Afghanistan, 2) Assess patient knowledge and perceptions on screening value for HIV, syphilis, and HBV in obstetric care, 3) Assess knowledge and practice of medical personnel and their influence on HIV, syphilis, and HBV prevention counseling, screening, and iatrogenic infection prevention practice, and 4) Determine feasibility and acceptance of antenatal screening at hospital admission for obstetric patients and providers in Kabul, Afghanistan. Though little is known about BBV prevalence in Afghanistan, multiple factors increase the risk of an epidemic, particularly the antenatal population; implementing testing may circumvent this. Pilot data generated from this study will be used to test the intervention in a larger Afghan population.